It seems impossible to go a year without hearing reports of a new vinegar "cure." For health and beauty enthusiasts, the ingredient has been touted as a remedy for digestive issues, hair thinning and skin breakouts. But when it comes to vinegar and acid reflux, does it live up to its hype?
Video of the Day
It’s All About pH
Heartburn, commonly caused by acid reflux, occurs when stomach acid flows back into the esophagus, the tube connecting the mouth to the stomach. The Mayo Clinic says this backwash can irritate the esophagus and cause symptoms like burning pain in the chest.
According to University of California San Francisco Health (UCSF), pH is a measure of acidity, and the lower a number, the more acidic the substance. The pH of stomach acid is generally around 2, UCSF says. Vinegar solutions are generally around a 2 or 3.
Because vinegar is so acidic, it is unlikely that it can neutralize stomach acid and relieve heartburn symptoms, Joan Weichun Chen, MD, a gastroenterologist, acid reflux specialist and assistant professor at the University of Michigan in Ann Arbor, says. "There's no data to support this idea," Dr. Chen says.
How could it be, then, that some people report feeling better after a swig (or more) of vinegar? Dr. Chen says that if someone insists that vinegar is relieving his or her heartburn, she can think of two possibilities. First, not all heartburn is related to acid reflux, so perhaps the symptoms are related to another condition. Second, she believes saturating pain receptors with another acidic substance like vinegar may temporarily distract the body from the true stomach acid source.
Instead of trying vinegar, Dr. Chen suggests lifestyle changes. Strategies like losing weight if needed and avoiding your trigger foods and beverages have been shown to improve acid reflux symptoms.
Research published in March 2017 in Current Opinion in Gastroenterology points out the link between obesity and gastroesophageal reflux disease (GERD). It emphasizes the role of diet as a first-line therapy not just for losing weight, but also for evaluating whether certain foods lead to symptoms.
According to University of Florida Health (UF Health), citrus, caffeinated drinks, alcohol and peppermint are common triggers. Dr. Chen adds that high-fat foods have been linked to increased acid and may, in turn, lead to increased reflux. Avoiding late-night meals and elevating the head of your bed can also help you avoid symptoms, UF Health says.
Three Classes of Medications
If lifestyle changes don't lead to a real reprieve from heartburn, Dr. Chen says medication may be in order.
Antacids. This is the lowest strength of medication for reflux. Antacids reduce the effect of acid in the stomach by neutralizing it. UF Health notes there are many types of antacids, and many are available without a prescription. This medication commonly contains magnesium, calcium, sodium bicarbonate or aluminum to offset the stomach's acidity. Be sure to read the directions so that you don't take more than the appropriate amount. Common antacids include Tums, Gaviscon and Maalox.
Histamine H2 antagonists (H2 blockers). These are the next level of medication for acid reflux. According to the Mayo Clinic, these drugs work by decreasing the amount of acid produced in the stomach. They're available both over the counter and with a doctor's prescription for a stronger version. H2 blockers work fast, and they're stronger than antacids, making them a good option for quick relief. Pepcid (famotidine) is a common brand.
Proton pump inhibitors (PPIs). This is the strongest class of medication for acid reflux. Like H2 antagonists, PPIs work by reducing the amount of stomach acid made by glands lining the stomach, but do so at a different level.
According to Mount Sinai, these stronger medications not only help with acid reflux, but they can also help treat ulcers. PPIs are available with a prescription and often available over the counter as well, but talk to your doctor rather than starting on your own because the length of time you need to take them varies with your condition.
Also, they need to be taken 30 minutes before your first meal of the day. Common brands include Prilosec (omeprazole), Nexium (esomeprazole) and Prevacid (lansoprazole).
Is This an Emergency?
- Mayo Clinic: “Gastroesophageal Reflux Disease (GERD)”
- University of California San Francisco Health: “Medical Tests: Stomach Acid Test”
- Joan Weichun Chen, MD, gastroenterologist, assistant professor, University of Michigan, Ann Arbor
- University of Florida Health: “Taking Antacids”
- University of Florida Health: “Gastroesophageal Reflux - Discharge”
- Mayo Clinic: “Histamine H2 Antagonist (Oral Route, Injection Route, Intravenous Route)”
- Mount Sinai: “Proton Pump Inhibitors”
- Current Opinion in Gastroenterology: “Diet and Gastroesophageal Reflux Disease Role in Pathogenesis and Management”