It's been almost 2 years now, and no GERD symptoms, no PPI or other prescriptions. My Doc prescribed a PPI after diagnosing me with GERD. After 2 months, I experienced joint pain that started keeping me up at night, only to have a friend of mine suggest that it's a side effect of the PPI...so, after talking with my doctor, I discontinued the PPI and sure enough the joint pain went away. Desperate to find a solution, I decided to try the vinegar...this is what I've found: After several weeks, I started using 2 tablespoons of apple cider vinegar diluted with 7 oz of water, drank it with a straw (recommended to avoid having the vinegar affect tooth enamel), 15 minutes prior to dinners. The theory is of course is that the acid of the vinegar tells your brain to 'hold off' on sending the message for your stomach to start producing excessive amounts of acid after larger meals, with the vinegar being a more mild acid solution than your natural stomach acid. To be fair, I did stop with any coffee in the afternoons...but, I still drink several cups in the morning. And, I've switched to balsamic vinegar...it just is easier for me to drink being a grape extract as opposed to the apple. On rare occasions, probably once every 3 or 4 months, if I've 'over-done' a meal I will occasionally use pepto, the pink over the counter. The only negative is this: it took me several weeks to begin to notice a real difference...the vinegar doesn't work as fast as the PPI drugs. Also, once started, I need to be sure not to miss...if I forget to take the vinegar, by 6:30pm I can tell that there's something not happy with my stomach... even if I am at a restaurant, i'll seek out some 'malt vinegar' which most restaurants typically have. I'm otherwise very healthy, 49 years of age, male with no other dietary restrictions, other than the no coffee after noon, and I do stay away from pineapple and other citrus fruits after noon as well. thank you for this forum to be able to communicate. I did ask my doc about the vinegar prior to using, and the reply was that there 'wasn't enough studies' to merit an opinion. I thought I would contribute to this forum after I tried it for a year because it was a forum I consulted and still do with other health related issues.