It’s time to enter the shaky ground of folk medicine by discussing apple cider vinegar as a treatment for GERD. Hopefully, you will bear with me and consider the logic. If you recall, the larger context is “functional medicine” and whether a cure works with or against the body’s natural processes, deals with root causes of disease and considers the whole person rather than just an organ system. Several year ago, I became fed up with having so many patients dependent on PPI’s while seeing multiple credible reports about their adverse effects. I began looking for alternatives and remembered several older patients testifying to the benefits of apple cider vinegar. Research revealed no great studies but numerous personal testimonies rang true. There were also reasonable theories as to why it works. Convinced of it’s relative safety, my next step was to buy some vinegar and try it myself just to determine taste and side effects. I then tried it on a few patients with an explanation of my task and an admission of having only testimonial data. One of the first patients I treated had a remarkable result. Dealing with long term delayed gastric emptying, he was miserable after meals with a bloated stomach for hours and acid reflux. Apple Cider Vinegar gave him such effective relief that he scheduled an additional appointment just to thank me. (First and only time that has happened! :)) Subsequently, many patients have had less dramatic but positive responses, many being able to discontinue medication.Current success rate in relieving symptoms stands at over 80%.
So now you may be asking: how does apple cider vinegar treat acid reflux? I do not know but find both lower acid and higher acid theories compelling. Vinegar is acetic acid. As it is less acidic than HCl (stomach acid), when diluted with water and consumed before meals it may actually buffer the stomach’s acid content resulting in adequate gut function and less acid to the esophagus. If the reflux patient suffers from hypochlorhydria (low acid) which causes the upper valve to remain open and the lower valve to remain closed, the additional acid will restore function. I suspect this happened in my patient with restored stomach emptying. Plausible but unproven theories and happy patients: is that enough? Not quite. Will attempt to complete this discussion on Friday.