While there’s no direct evidence that apple cider vinegar has benefits related to Crohn’s disease, there are some known properties of apple cider vinegar that might be beneficial in some cases. But before you decide to add this ingredient to your diet, you should consider its potential risks and downsides — and make sure, above all, that it won’t make your condition worse. Here’s a look at what apple cider vinegar is, what benefits it might have that could be relevant to Crohn’s, and what you should know before you decide to take it.
What’s in Apple Cider Vinegar, and What It Does
Apple cider vinegar is created in a process of fermentation, in which yeast turns sugars in apples into alcohol, and then bacteria turns this alcohol into acetic acid — the key ingredient that makes it vinegar. It’s about the same color as apple juice, and it contains vitamins and plant-based antioxidants (called polyphenols) at about the same levels as apple juice. Unfiltered apple cider vinegar has a cloudy substance that settles in it, called the “mother.” This sludge contains yeast, bacteria, and acids from the fermentation process. While there’s a lot of hype about the supposedly beneficial effects of the mother, the long history of therapeutic uses for apple cider vinegar is “most likely just due to the acetic acid,” says Olivia Vaughn, RDN, a dietitian in the division of gastroenterology, hepatology, and nutrition at the Ohio State University Wexner Medical Center, in Columbus. Acetic acid — which is found in all types of vinegar — “has some health-promoting properties,” says Vaughn. “It’s an antimicrobial agent. It’s antifungal.” And outside the realm of IBD, there’s compelling evidence that it may help certain people with diabetes lower their blood sugar levels. The antimicrobial properties of acetic acid are the theoretical basis for how it might help certain people with Crohn’s. “It may alter our microbiomes, all those organisms within the GI tract that do very much affect our health,” Vaughn explains. “The microbiome directly impacts the health of our GI tract.” But exactly how our microbiomes — consisting of bacteria, fungi, and other small organisms — affect our digestive and overall health is an area of science that’s quite new. There are only a few clues about how apple cider vinegar affects our microbiomes, and what this may mean for IBD. RELATED: 7 Potential Side Effects of Apple Cider Vinegar
Apple Cider Vinegar and Crohn’s: What the Science Says
There have been no scientific studies to date looking at the effects of consuming apple cider vinegar on Crohn’s disease. In fact, the one piece of evidence that vinegar may have any impact on IBD is a single study involving mice. Published in January 2016 in the Journal of Agricultural and Food Chemistry, the study was designed to investigate whether vinegar could help prevent ulcerative colitis in mice — which the researchers induced by giving the mice a chemical. Some of the mice were given vinegar for 28 days as part of their drinking water, before any other chemicals were given. The researchers found that these mice had higher levels of certain potentially beneficial bacteria in their feces, and lower levels of E. coli, a potentially harmful type of bacteria. Once the researchers gave the mice a chemical to cause UC, they found that the vinegar-fed mice had significantly lower disease activity and lost less body weight than the other mice. A further analysis showed specific biological mechanisms through which vinegar reduced inflammation in this group of mice. While this study is certainly intriguing, it doesn’t show that taking vinegar has any benefit in humans who already have UC or Crohn’s. But Vaughn notes that the alteration of the mice’s microbiome is important, because “[the microbiome] may play a role in the development of inflammatory bowel disease” in humans.
Should You Take Apple Cider Vinegar if You Have Crohn’s?
There’s certainly no overall recommendation that people with Crohn’s should take apple cider vinegar. In fact, Vaughn says, she rarely gets questions about it from her IBD patients. Since vinegar is sold as a food in the United States, it’s not something many doctors or even dietitians will mention when discussing drugs and supplements with patients. But that doesn’t mean you can consume it without risk, or that you should start adding it to your diet without first discussing it with a health professional. The lack of studies on vinegar and IBD means that its safety profile as a food ingredient just isn’t known. “We have an evidence-based practice,” says Vaughn. “I don’t want to just say, ‘It’s safe because it’s food, so go use it as much as you’d like,’ if I don’t truly know.” When it comes to potential effects on your digestive tract, vinegar “could absolutely be an irritant,” says Vaughn, contributing to digestive upset and possibly exacerbating Crohn’s symptoms. But this is likely to vary from person to person. And it’s worth remembering, Vaughn says, that “you do have your stomach to help neutralize it a little bit. It’s not like you’re pouring it directly on an area of inflammation.” Still, it’s best to follow some precautions if you’re interested in taking apple cider vinegar, including: Discuss it with your doctor first. Apple cider vinegar may interact with certain drugs or supplements. It’s especially important to have this discussion if you take insulin for diabetes, or a diuretic drug. If you have chronic kidney disease, your kidneys may have trouble removing the extra acetic acid from your body. Dilute it. You should never take apple cider vinegar without first diluting it in water, since the concentrated acid can damage your tooth enamel and irritate your throat. You may also want to drink plain water immediately after taking it, to rinse it out of your mouth and throat. Look out for both positive and negative effects. While it’s a good idea to be patient when evaluating the potential benefit from any drug or dietary change, you should also look out for any worsening of your Crohn’s symptoms if you start taking apple cider vinegar. And if you aren’t seeing any noticeable improvement in your Crohn’s symptoms after a while, you’ll need to reevaluate whether taking apple cider vinegar makes sense for you. Ultimately, the only way to know if apple cider vinegar will have any beneficial effect is to try it. “I’m not one to totally discredit the health-promoting properties it may have for some people,” says Vaughn. “I just don’t think we know enough.” RELATED: Apple Cider Vinegar and Diabetes: A Cure or an Aid?
