Apple Cider Vinegar vs. Acid Reflux

March 21, 2006 6:58 PM

Does Apple Cider Vinegar really cure Acid Reflux Disease or GERDs?

My father is suffering from a terrible case of GERDs and has tried everything but Apple Cider Vinegar. I have only heard positive reviews of this remedy but have never had a need to try it myself.

He thinks I am pulling his leg about the ACV but I assured him I am not and will find useful information for him via the web....
But almost every site I have been to is trying to sell the product and none really offer a solid explanation of ACV's medicinal values.

If anyone has had experience with this cure or has any good information that I can share with my pops, that would be greatly appreciated.

Thanks!

posted by Gankmore to health & fitness (28 comments total)

After reading something in the paper about this treatment about a month ago, my mom began using ACV in addition to her regular medication and she says it's helped.

Given her results, I wouldn't consider it a miracle cure but it's definitely not wasted effort.
posted by ryanhealy at 7:01 PM on March 21, 2006

This just reported today -- Heartburn linked to cancer of esophagus.
posted by ericb at 7:04 PM on March 21, 2006

ericb: Nothing new, this has been known for years.
posted by gramcracker at 7:19 PM on March 21, 2006

I've heard that it works. Apparently, more and more medical professionals now believe that acid reflux is caused by not enough stomach acid, instead of the common belief that there's too much.
posted by fvox13 at 7:31 PM on March 21, 2006

My parents swear by it, fwiw.
posted by ashbury at 8:04 PM on March 21, 2006

Another folk remedy to try, and it is related: an apple at bedtime. A friend heard this from his pharmacist and it has been working for him. YMMV
posted by caddis at 8:27 PM on March 21, 2006

An apple every 8 hours keeps three doctors away.
posted by zadcat at 9:06 PM on March 21, 2006

Has your father tried Nexium ("the purple pill")? Despite the hype, it really helped repair the damage caused by GERD over time in my case.
posted by jca at 9:12 PM on March 21, 2006

This may be purely anecdotal, but the few (three, ever) times I have had "heartburn," the only thing that helped me was a tablespoon of organic unfiltered apple cider vinegar. And the relief from that was damn close to immediate.
posted by dersins at 9:29 PM on March 21, 2006

YES it does, and as a singer I have visited ear, nose and throat doctors many times over the years and they all concurred that a small shot of ACV once a day could help with vocal problems that acid reflux can cause.
posted by SwingingJohnson1968 at 9:31 PM on March 21, 2006

(I can't add anything, but thank you for asking this. My wife suffers from acid reflux, and I'd never heard of this. I'll suggest she try it.)
posted by stavrosthewonderchicken at 9:36 PM on March 21, 2006

First of all, tell your father to go see a doctor, m'kay? It's entirely possible that if he's tried "everything," including the appropriate medical management of GERD, and it hasn't worked then he might have another condition which may mimic reflux disease. These include potentially life-threatening maladies such as: angina, pericarditis, esophageal spasms or strictures, and cancers of the mediastinum, among others.

Second of all, if you think it's prudent to try remedies based on hearsay, then go ahead and try the cider vinegar, but ultimately what you have here is no different than all the rest of the testimonials on the internet. Here is the available research you can find on PubMed regarding apple cidar vinegar. As you can see, the pickings are quite slim, and as far as I know, there's no science whatsoever to backup any claims made about GERD and cider vinegar. Of course, that doesn't rule out the possibility that it might be beneficial. But beyond a series of strangers who swear by it, there is no "solid" support of ACV's medicinal value at this time.
posted by drpynchon at 10:01 PM on March 21, 2006

I have fairly mean GERD myself. I'll try this and report back.
posted by ikkyu2 at 11:43 PM on March 21, 2006

Thank you for your responses.

My father has been to the doctor and they have concluded that it is definitely GERDs.

It is too bad there is no science behind the ACV claim, but personal testimony might be good enough for now.

Again, I appreciate all responses and links.
posted by Gankmore at 4:06 AM on March 22, 2006

What is the recommended dosage? Is one supposed to just swallow this stuff straight? Yikes!
posted by Hobgoblin at 6:35 AM on March 22, 2006

I have the GERD, the hiatal hernia, etc. I've got it bad, well, not as bad as the cancer article above, but bad enough to be painful. Not terribly fun. This "cure" sounds pretty dubious. Adding acid to your already acid refluxing stomach sounds like pouring gasoline on a fire in hopes that it will snuff it out.

Put bricks under the bed posts on the head of his bed, really. Also the medicine is great. After a week or so, no more pain, all is at peace.
posted by Pollomacho at 7:02 AM on March 22, 2006

I suppose it would be, by now, standard practice for any GI workup to include a screening and treatment plan for H. pylori bacteria infection. This article discusses recent anecdotal evidence that successful treatment of this infection however, sometimes make GERD symptoms worse instead of better, and recommends higher dosages of acid controlling medications thereafter.

I had very bad heartburn and frequent regurgitation at night for years, to the point I woke up choking and coughing several nights a month. But when I was hospitalized for hip replacement surgery, I got a whopping load of antibiotics, including a lot of vancomycin, and haven't had any stomach problems whatsoever since (+12 years). It wasn't quite worth going through the surgery for this unintended side effect, but it has been nice to be free of the pain and regurgitation.
posted by paulsc at 8:22 AM on March 22, 2006

The people who suggest not trying it due to the lack of science surprise me. Apple cider vinegar may or may not work, but why not try it, even with a lack of strong scientific study? If it works keep using it; if it fails stop using it. The side effects of using this remedy are likely minimal. Most of the prescription and over the counter drugs which treat GERD have quite a bit more daunting side effect profiles. For instance, Nexium, which includes:

Postmarketing Reports – There have been spontaneous reports of adverse events with postmarketing use of esomeprazole. These reports have included rare cases of anaphylactic reaction, severe dermatologic reactions, including toxic epidermal necrolysis (TEN, some fatal), Stevens-Johnson syndrome, and erythema multiforme, and pancreatitis.

Ouch! (of course, one can not say for sure whether these events occurred due to taking esomeprazole or not)
posted by caddis at 9:38 AM on March 22, 2006

Lots of ACV info and anecdotes...
posted by dpcoffin at 10:41 AM on March 22, 2006

caddis, there is NO reason, whatsoever to expect any fewer adverse reactions to ACV. Just as the scientific evidence towards its efficacy is lacking, so is a well-documented accounting of abreactions to it. Remember that in the case of aftermarket case reports of prescription drugs, these reports are exceedingly rare and often reported after TENS OF MILLIONS of doses of the drug have been ingested.

In fact the only article on PubMed that relates directly to this matter refers to reports of esophageal injuries due to ACV, and the investigators find wide fluctuations in the pH of over-the-counter formulations. As always science isn't perfect, however prescription drugs are still far better studied for both beneficial and adverse effects than supplements, and the industry sets far higher standards as far as quality control and uniformity in production than the supplements industry.

It's probably human nature to want to experiment in this setting, and I don't begrudge that. But at this point, I don't even know if this product truly is harmless or not. What I do know with a good amount of evidence is that the wall of the esophagus is far more fragile than that of the stomach, and repeated exposures to low pH (as in acid/vinegar) causes chronic inflammation, cellular dysplasia, and ultimately a high risk of cancer. And in the case of cancer of the esophagus, we're talking about a cancer among cancers, with quite dismal outcomes. Based on that, recommending ACV without a single well-designed study to support its use is far beyond the boundaries of what I consider to be an evidence-based practice of medicine.
posted by drpynchon at 11:07 AM on March 22, 2006

there is NO reason, whatsoever to expect any fewer adverse reactions to ACV.

Except that people have been ingesting vinegar for centuries with as far as I know no ill effects aside from perhaps a sour stomach here or there. Do you really believe that proton pump inhibitors are more benign than vinegar?

Proton pump inhibitors are not something we have been putting into our bodies over the centuries so a close study of possible side effects is warranted. The one percent side effect looks pretty minor on the label but when you consider how many people use these products it adds up to a lot of suffering people.


Ingesting a bit of vinegar to treat GERD is not like taking vitamin C to fend off colds where you can't tell whether it is working and you may be taking far more than a normal amount. One can get a pretty good idea based upon pain as to whether vinegar is working or not.

Rather than take a pill, or ACV, the best defense against GERD is probably to lose weight, drink less alcohol and elevate the head of your bed, etc. All too often we seek a quick solution in a pill to make up for deficiencies in our lifestyle. These pills (proton pump inhibitors) are a fantastic invention and an important medicine. However, I think it is important to keep the total picture in perspective. Personally, I doubt that apple cider vinegar works, but it seems worth a shot and despite your hypothesis about esophageal damage I doubt there is much risk. Follow the vinegar with a glass of water to rinse the esophagus if you are concerned.
posted by caddis at 11:39 AM on March 22, 2006

Except that people have been ingesting vinegar for centuries with as far as I know no ill effects aside from perhaps a sour stomach here or there. Do you really believe that proton pump inhibitors are more benign than vinegar?

I repeat, I don't know. There is to date, regardless of how many people have or have not been ingesting vinegar frequently and chronically, no accurate and detailed account of its ill effects, in particular with respect to the formulation which have actually only been around for a few years, marketed as remedies for everything from GERD to high blood pressure, dermatitis, arthritis, chronic fatigue, gout, etc (are you kidding me?). I can list if you like, plenty of things people were ingesting for millenia that turned out to be awful for them. Consider the link between pickled foods, nitrates, and stomach cancer for starters.

The one percent side effect looks pretty minor on the label but when you consider how many people use these products it adds up to a lot of suffering people.

One always must way the risks and benefits of taking any prescription medication, and there is always an implicit gamble involved in this. You realize that severe reactions like anaphylaxis and TEN are probably about as common as say severe peanut allergies in the general population. Based on what is probably societal concensus, the fact that people have unpredictable but rare allergies isn't a major limiting factor in giving kids peanuts or giving people with GERD nexium. As a personal choice, one is always free to defer ALL medications or foods based on this implicit risk, which is almost universal. That said, I don't advocate chronic use of PPIs either in most settings due to the limited long-term data out there.

One can get a pretty good idea based upon pain as to whether vinegar is working or not.

You would think so, but based on what we know about the placebo effect, that isn't necessarily a reliable indicator. Moreover, adverse effects may be unrelated to the presenting complaint and may be insidious. Consider for example what dentists might think about frequent ingestion of vinegar and tooth enamel erosion.

Rather than take a pill, or ACV, the best defense against GERD is probably to lose weight, drink less alcohol and elevate the head of your bed, etc. All too often we seek a quick solution in a pill to make up for deficiencies in our lifestyle.

Couldn't agree more.

Personally, I doubt that apple cider vinegar works, but it seems worth a shot and despite your hypothesis about esophageal damage I doubt there is much risk.

Again, I have no interest in your conjectures or opinions, and I don't let my own hypotheses guide recommendations without a higher standard of evidence. That's why we have things like randomization, blinding, placebo control, etc. The scientific method again isn't perfect, but it yields far more reliable information than folk remedy and anecdote. The bottom line is the only reason you know the first thing about PPIs is because they are under a far higher degree of scrutiny. And I agree, justifiably so.

There are two different matters here: one is whether on a personal level, anecdotal information and what you know about vinegar already are enough to persuade one to experiment with it, and I submit that most people would be perfectly comfortable with trying it a few times. But another matter is the issue of what we actually "know" about ACV as is another important part of the asker's post. And the answer to that is not much lot.
posted by drpynchon at 12:25 PM on March 22, 2006

Well, from what I've learned about anything GI, is that there's almost nothing that is definitely "Known" about any of it.

Unlike Asprin and Tylenol, there's no drug that's guaranteed to have a result on your GI system... My dad can eat a roll of Tums and not get the same relief that he gets from one Rolaids.

The problem comes from the fact that there are a LOT of chemicals in your GI system, and you are constantly putting more chemicals into it every time you eat. People who drink milk often will build up chemicals to help deal with Lactose, while those who eat spicy food build up chemicals to neutralize the spices. The chemical make-up of your gastric juices depends on your race, ethnicity, the diet of your ancestors, your diet growing up, your current diet and your stress levels. There are so many wild variations that it is utterly impossible to say that there is one thing that works.

On the contrary, there are hundreds of things that work. For some, it's drinking warm milk before bed. Some, it's a glass of water, some it's an apple, and some ACV... and what works might even change from day-to-day.

If your father is really as bad as it sounds, I highly recommend keeping a food journal, keeping record of what he ate, and how his GERD reacted. If he can't find any food combinations that help, then he should step out of his comfort zone to try that out. Go a week without meat, without bread, without milk... mix it up, and hopefully he'll find his answers.
posted by hatsix at 4:16 PM on March 22, 2006

drpynchon, it's fine to rely on class A evidence, but oftentimes there is no class A evidence for the information a person would like to obtain. That doesn't make all attempts to gain that knowledge prima facie worthless; it does mean that the knowledge that's acquired isn't going to be as strong as it would be if there were class A evidence backing it up.

I've had terrible GERD for years, I'm not fat, and my habits aren't unusual. One of the things I've learned about my own GERD is that it's mostly brought on by work-related stresses; it goes away when I go on vacation, even if I overindulge in all kinds of things. Another thing I've learned is that elevation of the bed doesn't help it. Typical triggers like alcohol, tomatoes, chocolate etc don't amount to a hill of beans; what triggers mine is eating a lot of fatty foods.

The very worst, though, is when it gets bad enough that I need to pop a prilosec OTC. I know that if I take one of those tablets, I'll have a day of relief followed by at least three days of rebound GERD. For this reason, I've come to question the wisdom of using that medicine personally for my own self.

I don't need class A evidence to support this observation, because I am not generalizing to make recommendations to large groups of people. However, if other people would like to apply my methods of observation to their own situation, nothing is stopping them.
posted by ikkyu2 at 8:47 PM on March 22, 2006

I also wanted to echo that losing weight can help with GERD. (If that applies to your situtation.)
posted by jca at 5:12 PM on March 23, 2006

Anyone give the ACV a try? ikkyu2?
posted by desuetude at 12:26 PM on October 9, 2006

No, but I've got some reflux right now. Let's see what happens.
posted by ikkyu2 at 2:45 AM on October 17, 2006

The vinegar hurt quite a bit going down, almost as much as a shot of whisky would have. (Every time I take a drink of hard liquor, I'm treated to a measurement of how bad my reflux has been over the past couple of weeks.)

After that, I belched and I could feel my stomach moving around a bit. It's been 10 minutes and no reflux, which is sort of surprising.

Dunno if it's a placebo effect or what. I'll conduct further trials.
posted by ikkyu2 at 2:56 AM on October 17, 2006