Pilot Trial on the Efficacy and Safety of a Natural Mineral Water Rich in Hydrogen Carbonate on Functional Dyspepsia and Heartburn

Abstract

Background: Dyspepsia and heartburn are among the most frequent complaints of the upper gastrointestinal tract impacting quality of life. The present study aimed to investigate the impact of drinking a natural mineral water (medicinal product category "Heilwasser" in Germany) high in hydrogen carbonate (Staatl. Fachingen STILL) on functional dyspeptic complaints and heartburn. Methods: 56 men and women with self-reported heartburn were enrolled to this one-arm pilot study. They had to drink 1.5 L of a hydrogen carbonate rich mineral water each day over a course of six weeks. Participants reported the number and duration of heartburn episodes in a daily dairy. The Reflux Disease Questionnaire (RDQ), Quality of Life in Reflux and Dyspepsia questionnaire (QOLRAD) and the Gastrointestinal Quality of Life Index (GILQI) were used to assess the therapeutic course of the treatment and the Short Form Health Survey (SF-12) to assess general quality of life. Mean ± standard deviation were calculated and pre-and post-treatment changes were compared using the Wilcoxon test. Results: The consumption of a hydrogen carbonate rich mineral water decreased the number of heartburn episodes per week significantly by 4.8 ± 8.2 at the end of the study (p < 0.001). The duration of episodes was also significantly reduced by 25.7 minutes after six weeks of intervention (p < 0.001). Accordingly, the subjectively perceived severity of heartburn, regurgitation and dyspeptic complaints as well as the GERD dimension as assessed by Reflux Disease Questionnaire improved significantly. There was a significant improvement in the disease-specific quality of life as measured by the Gastrointestinal Quality of Life Index (p < 0.001) and by the Quality Of Life in Reflux and Dyspepsia (p < 0.001) questionnaires and the general health-related quality of life as assessed by SF-12 (p < 0.007). Conclusions: The present pilot study provides evidence that supplementation with natural mineral water rich in hydrogen * Corresponding author. U. Pohl et al. 89carbonate may improve heartburn and dyspeptic symptoms, which finally resulted in an improvement of the subjectively perceived quality of life. Drinking mineral water rich in hydrogen carbonate may be an alternative remedy for the treatment of dyspeptic symptoms and heartburn.

How Effective Is Drinking Natural Mineral Water against Heartburn from Functional Dyspepsia, Gastroesophageal Reflux Disease, or Other Causes? A Systematic Review of Clinical Intervention Studies

“…The two studies with good methodological quality ratings (for pre-post experiments) were funded by producers of mineral waters. Using hydrogen carbonate-rich mineral waters, both studies showed considerable reductions in the frequency and duration of heartburn episodes after 6 weeks [ 45 , 47 ].…”

“…Out of the six single arm intervention studies, only two were rated as having good quality, for studies with pre-post comparisons [ 45 , 47 ]. Both studies examined 1.5 L (per day) of hydrogen carbonate-rich mineral water for 6 weeks.…”

“…This suggests that HCO 3 − has a direct buffer effect on the protons of the gastric acid [ 21 , 22 ]. Thus, hydrogen carbonate-rich mineral water may deliver a similar buffer capacity to that achieved by pharmacological treatments including over-the-counter antacids based on calcium carbonate/magnesium carbonate [ 47 ]. However, the findings from our evaluation of studies determining patient-reported and relevant clinical outcomes (i.e., reduction of symptoms and duration of episodes) can support but not explain mechanisms of the potential effect of drinking mineral water.…”

“…Fourth, the patient samples were not comparable across the reviewed studies e.g., the mean age ranged from 36 [ 47 ] to 65 years [ 50 ]. Only a few included studies assessed comorbidities; demographic variables such as occupational and socioeconomic status were not reported in any of the studies.…”

Effects of Alkaline‐Reduced Drinking Water on Irritable Bowel Syndrome with Diarrhea: A Randomized Double‐Blind, Placebo‐Controlled Pilot Study

“…Furthermore, mineral water with various electrolyte compositions has been utilized in the treatment of functional gastrointestinal diseases; mineral water supplements have been reported to improve functional dyspepsia associated with IBS by controlling gastric acid output and intestinal transit time [ 17 ]. In addition, carbonated water not only attenuates the hunger but also improves dyspeptic symptoms and heartburn [ 18 , 19 ]. Drinking sulfur-rich mineral water for more than three weeks was found to be effective in treating constipation by increasing frequency of bowel movements [ 20 ].…”