People often try to use Apple cider Vinegar for various digestive issues including reflux symptoms, weight loss and other general wellbeing such as better blood sugar control and to maintain skin health etc. Here is a logical discussion of the scientific facts behind the practice.
Vinegar is obtained by fermentation of dilute alcohols such as beer, wine and cider. It contains acetic acid and tastes sour. It is one of the most commonly used acidic condiments across many civilizations since ancient times. Apple cider vinegar is obtained by adding bacteria and yeast to crushed apple juice. In the first step, the yeast converts sugars to alcohol. In the second step, bacteria convert alcohol into acetic acid.
Many people take a small amount of apple cider vinegar for their reflux symptoms (Heartburn) with an assumption that it will reduce the amount of acid production by the stomach. There is no strong clinical research supporting the use of Apple cider Vinegar for Gastro oesophageal reflux (GERD). However, there is some published data to say it has plenty of antioxidants and helps in better sugar control, reduce fats, improve blood pressure and enhance immunity. But being an acid itself, it is not logical to assume that it will help in reducing acid-related reflux symptoms. Small clinical trials done on diabetic patients have clearly shown it to reduce gastric emptying time as well (time taken by ingested food to get emptied from the stomach), thereby leading to an imbalance of blood glucose levels. Delayed gastric emptying means more time for acid sitting in the stomach and thereby leading to more reflux into the oesophagus.
Being acetic acid, apple cider vinegar can lead to caustic injury to the esophageal mucous lining if the concentration exceeds 20%. As the consumer market in this segment is poorly regulated, taking vinegar for the control of reflux symptoms can be counterproductive and prove to be dangerous.
Apple cider vinegar has no scientific basis to help reflux symptoms and is also not supported in any clinical research. On the other hand, it can be harmful if consumed in excess. Lifestyle modifications and minimum doses of antacids or PPIs (with doctor’s prescription) is a better way to keep a check on acid-related reflux symptoms or heartburn.
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About Author –
Consultant Medical Gastroenterologist , Yashoda Hospitals – Hyderabad
MRCP(UK), FRCP (Lon) CCT Gastro (UK) Fellowship in Advanced Endoscopy and IBD (Aus)
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