Can Apple Cider Vinegar Really Treat Acid Reflux?

As many as 20% of Americans suffer from acid reflux, which occurs when stomach acid or bile flows into their esophagus (food pipe), irritating the lining and causing symptoms like heartburn.

There are many things that can help soothe the symptoms of acid reflux, including over-the-counter (OTC) medications and some home remedies. Some sufferers swear by certain at-home remedies—but not all of them work.

In this article, I’ll talk about apple cider vinegar and acid reflux. I’ll explain more about what acid reflux is and why it happens, whether apple cider vinegar can help, and outline some other home remedies.

I’ll also talk about when you should speak to your doctor about your acid reflux.

What is Acid Reflux?

When the valve at the end of the esophagus doesn’t close properly, stomach acid can flow back up the esophagus and into the throat and mouth.

This condition is called acid reflux.

Symptoms of acid reflux 

The main symptom of both acid reflux and gastroesophageal reflux disease (GERD) is heartburn, which is an uncomfortable burning feeling in your chest that can move up into your throat and down into your upper abdomen.

Other symptoms of acid reflux include:

• Regurgitation, or the feeling of fluid or food coming up into the chest
• Chest pain or burning, especially felt when lying down or bending over
• Unpleasant taste in the mouth (including bitter, sour, or acidic tastes)
• Sore throat 
• Hoarseness
• Pain or discomfort that appears after a large or spicy meal

Additional symptoms that are often a sign of chronic acid reflux, or GERD, are:

• Difficulty swallowing
• Pain that can move into your throat, but doesn’t usually radiate to your shoulders, neck and arms

Causes of acid reflux

Lifestyle and diet habits can trigger acid reflux in some people.

You are more at risk for developing acid reflux if you:

• Eat large portions of food in a sitting
• Eat spicy, fatty, or greasy foods
• Eat a lot of acidic food, such as tomatoes or citrus fruits
• Eat close to bedtime
• Drink large amounts of caffeinated, alcoholic, or carbonated drinks
• Experience stress
• Smoke
• Wear tight-fitting clothes

Acid reflux can also be caused by medical or natural conditions, including:

• Too much acid in the stomach
• Delayed stomach emptying
• Poor clearance of food or acid from the esophagus
• Relaxation of the lower esophageal sphincter
• Anxiety or depression
• Pregnancy
• Hiatal hernia

Though everyone can get acid reflux from time to time, GERD is a chronic condition that can lead to more serious problems if not treated.

What is Apple Cider Vinegar?

Apple cider vinegar is apple juice that has been fermented twice.

During the first fermentation process, the juice is mixed with yeast, sugar, or another carbohydrate, and then left for a time to allow natural bacteria and yeast to transform the carbohydrates into alcohol. During the second fermentation process, the alcohol is converted into acetic acid. 

Apple cider vinegar has been used as a tonic for centuries, and has recently gained popularity as a natural remedy for acid reflux, weight loss, and more.

Because of its high acetic acid content, many people use apple cider vinegar to aid digestion and help break down food. However, the studies researching the health benefits of vinegar contain either small samples, or were conducted only on rats.

Unfortunately, there is little to no evidence that it is a safe and effective treatment for acid reflux. 

Can Apple Cider Vinegar Help With Acid Reflux?

What the research says 

Apple cider vinegar contains natural probiotics and antioxidants, two properties that could be beneficial for your health. But there are very few scientific studies to support the claims that apple cider vinegar can treat or relieve acid reflux.

The risks of taking apple cider vinegar are low, however. If your provider says it’s OK to try, apple cider vinegar is a simple remedy you can try at home.

How to use apple cider vinegar

Though there’s limited evidence that using apple cider vinegar can improve acid reflux, there are several ways you can incorporate it into your diet, including:

• Diluting a teaspoon of apple cider vinegar into a glass of warm water before drinking
• Adding a teaspoon (per serving) of apple cider vinegar to salad dressing
• Adding a teaspoon (per serving) of apple cider vinegar to soups or stews
• Using apple cider vinegars in jarring and pickling

Side effects of drinking apple cider vinegar

Apple cider vinegar has a high acidity content that can cause problems when ingested in excessive amounts.

These side effects include:

• Eroded tooth enamel
• Lower potassium levels
• Interactions with certain medicines, including insulin and diuretics
• Nausea 
• Vomiting

Other Home Remedies and OTC Options for Acid Reflux

Home remedies and over-the-counter (OTC) options can sometimes soothe heartburn and acid reflux.

It may take some trial and error to find a remedy that works for your symptoms. Talk to your doctor or primary care provider before trying any at-home remedy, and also ask whether over the counter or prescription medications may be good options for you

Here are some home remedies and OTC options that may help to soothe your acid reflux:

• Baking soda mixed with water: Baking soda can neutralize stomach acid and temporarily relieve some symptoms of indigestion and acid reflux. In fact, some safe and effective OTC antacids, like Alka-Seltzer, contain baking soda (also known as sodium bicarbonate). To use this remedy at home, just add ½ teaspoon to at least four ounces of water and drink the solution. Be careful not to use too much, though. One study found that adults should have no more than seven half-teaspoons of baking soda in one day, and no more than three half-teaspoons if over the age of 60.

• Herbal teas: While there has been little scientific study of the effects of herbal teas specifically on acid reflux, some herbs have properties that could help with acid reflux symptoms. Ginger, for example, has been shown to help the stomach empty faster—and slow gastric emptying has been tied to acid reflux. In an animal study, licorice extract was shown to have similar anti-inflammatory properties to famotidine, a popular heartburn medication. Neither of these teas has been studied specifically for acid reflux, though. Talk to your doctor or primary care provider before adding new herbs or herbal supplements to your daily routine.

• Eating a healthy diet: Diet and lifestyle changes that can help prevent acid reflux, including eating a diet high in healthy, unsaturated fats as opposed to saturated fats. You should also try to limit or avoid food that can worsen acid reflux, including caffeine, spicy, and fatty foods.

• Antacids: OTC antacids are usually the first-line recommendation for acid reflux and heartburn because of their availability and low risk of side effects. They work by neutralizing acids in your stomach and can provide fast, short-term relief. You can find them in a variety of forms—including chewables, dissolving tablets, and liquids. Some examples of antacids include calcium carbonate (Tums), simethicone (Mylanta), and sodium bicarbonate (Alka-Seltzer).

• Histamine-2 (H2) Blockers: H2 blockers are available by prescription and OTC. They can reduce the amount of acid your stomach produces to help alleviate heartburn. H2 blockers don’t work as quickly to reduce heartburn as antacids, but the effect can last longer. Examples include famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine (Zantac 75). 

• Proton Pump Inhibitors (PPIs): PPIs also work to reduce stomach acid. They can be especially effective when antacids or H2 blockers haven’t worked. Recently, some PPIs have become available OTC, including esomeprazole (Nexium) and omeprazole (Prilosec). Other PPIs, like rabeprazole (AcipHex), are only available with a prescription. Research shows that long-term use of PPIs can lead to kidney problems, including kidney failure. Experts recommend using PPIs only when necessary and for a limited period of time, and PPIs are not intended to be a chronic medication.

When to See a Doctor

Many cases of mild acid reflux can be managed at home or with OTC medication.

If you experience any of the below symptoms, reach out to your healthcare provider for personalized medical advice:

• Severe headache
• Unintentional weight loss or loss of appetite
• Bloody vomit or vomit that resembles coffee grounds
• Frequent vomiting
• Frequent urge to urinate
• Black, tarry stool
• Severe, constant stomach pain 
• Difficulty swallowing that gets progressively worse
• Fatigue or weakness
• Shortness of breath, sweating, or chest pain that radiates to the neck, jaw, or arm
• Chest pain with stress or exertion
• Yellowing of the skin or eyes
• Heartburn or acid reflux symptoms that last longer than two weeks

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