Apple Cider Vinegar & Acid Reflux

Published on Tuesday, April 19, 2022 by Brooke Orr

I’m sure somebody out there has heard about this…

Gastroesophageal Reflux (GER) occurs when content from the stomach comes back up into the esophagus (NIDDK). Most Americans experience GER at some point in time, but about 20% of the population experience it with such frequency and severity that they are diagnosed with Gastroesophageal Reflux Disease (GERD).

In addition to lifestyle changes in the treatment of GER or GERD, pharmaceuticals are often a first line of defense but many people seek out alternative treatments. While there is an abundance of anecdotal stories available, medical research is lacking on many popular alternative treatments- including the use of apple cider vinegar (ACV).

People claim ACV is helpful for a myriad of things such as weight loss, blood sugar control and even treating GERD- but what is it and how does it work?

What is Apple Cider Vinegar?

Bragg, a popular manufacturer of ACV, says: “Organic Apple Cider Vinegar is produced in a two-step process: The organic apples are crushed and pressed into apple juice. Apples are not peeled nor de-seeded.Then the organic apple juice is fermented with the naturally occurring bacteria and sugars found in apples, converting the apple juice into ethanol (alcohol). The product undergoes a second fermentation where ethanol is converted to acetic acid and results in the formation of the "Mother", consisting of Acetobacter aceti bacteria, cellulose and enzymes, and finally water is added to dilute the organic apple cider vinegar to 5% acidity” (Bragg, 2022).

How Does it Relieve GERD Symptoms?

If you ask Dr. Google how to treat GERD a myriad of anecdotal stories of success using ACV will appear; however, you will find little to no scientific research to support the claims (Nutrients, 2022).

It seems counter intuitive that one would use an acid to treat an acid problem but Marcelo Campos MD, contributor at Harvard Health publishing company says, “There is a theory stating that what controls the lower esophageal sphincter (LES) is the stomach’s acidity. If for some reason the stomach is not producing enough acid, the muscles around the LES would relax, resulting in more reflux”(Campos, M., 2020).

Based on this theory adding acid via ASV would theoretically keep the LES from relaxing and allowing acid reflux. He goes on to say, “However, the mechanism that controls this valve is much more complex than the level of gastric acidity. It involves a complex network of involuntary muscles and several different hormones and neurotransmitters”(Campos, M., 2020).

Could ACV Be Used to Treat GERD?

The answer is complex: more research needs to be done confirming the safety, efficacy and dosage.

While many claim it is helpful it is hard to determine if the perceived success is a placebo effect, correlation instead of causation, or if it works then by what mechanism.

It is also important to understand the root cause of GERD so that treatment can be individualized- i.e. is it pressure, an underlying medical condition, lack of acid, etc. causing the symptoms?

ACV is a potential “natural” remedy but is not without risk— it can cause irritation and interact with some medications. So, just to be safe- before using ACV to treat your symptoms speak with your medical team to evaluate any potential negative side effects you may experience.