Can you think of anything more paradoxical? Here you have a burning sensation caused by hydrochloric acid coming up through the lower esophageal sphincter (heartburn), and the suggested remedy is to swallow yet more acid. How can that possibly be? Especially as one of the potential causes of heartburn is excess acid from acidic foods.

For example, a glass of tomato juice may herald the onset of heartburn, this in itself could be the cause. You may be able to counter it with an antacid or an alkali such as bicarbonate of soda.

But there are cases where antacids simply do not work and many heartburn sufferers swear by vinegar, especially apple cider vinegar, as a remedy for heartburn. Yet vinegar itself is acidic, so how can it possibly work?

Too Little Acid

To understand the condition fully, we need to take a look at how this part of the digestive system works.

The lower esophageal sphincter (LES) forms the entrance to the stomach. Above it is the esophagus which has only one job in life, to transport food from the mouth to the stomach. Once past the sphincter, hydrochloric acid begins breaking down the food into particles we can digest.

The muscles of the LES simply open and close the entry to the stomach which is, of course, the acidic region. When food is swallowed, the LES opens. When no food is present in the esophagus, the LES stays closed.

When closed, the LES creates a pressure difference between the esophagus and the stomach with the higher pressure being in the esophagus.

If the sphincter muscles relax too much, the pressure equalizes and acid can enter the esophagus giving rise to the sensation we know as heartburn. A change in position such as bending forward, for instance, can cause a reflux of acid with the resulting familiar pain and burning sensation in the gullet. This pain alone makes the idea of ingesting yet more acid in the form of vinegar a ridiculous notion.

And yet it, in some conditions, it does work and work very well. So how?

It comes down to the mechanics of the sphincter. One of the things that triggers the LES to close is acid itself. When acid is detected, the muscles pull tight to stay closed. However if your stomach does not create enough acid, or if you have eaten food that is very alkaline, the muscles controlling the sphincter may relax, allowing a reflux of stomach juices into the esophagus.

The result is heartburn. The remedy, therefore, is to increase the presence of acid and the answer may be to drink a couple of tablespoons of vinegar in a glass of water. This is usually enough and, in particular, raw (unprocessed) apple cider vinegar is thought to be very beneficial in this respect.

In some cases drinking plain water can also help keep stomach acid where it belongs, as can a gentle stomach 'liner' such as goat milk.

Try some plain water first, then milk and finally the acid intake outlined above. But take care. Heartburn can be a symptom of a much more serious condition and may not just be acid reflux. If it is persistent it is very important that you seek medical advice and the sooner the better.