A Preliminary Study on the Benefits of Bicarbonate Natural Mineral Water from Source ‘Aqua 3’ on Dyspeptic Symptoms and Digestion

Background: The intake of mineral water for therapeutic purposes (crenotherapy) in digestive system disorders is a long-established practice, but there are still few controlled clinical studies confirming the effects of natural mineral water rich in bicarbonate. Objective: To verify whether the daily intake of Aqua 3 bicarbonate natural mineral water is able to improve digestion in a population of patients with functional dyspepsia and gastroesophageal reflux disease symptoms. Methods: Patients with a diagnosis of functional dyspepsia, formulated in accordance with the Rome IV criteria, were subjected to three 2-week intake periods: a tap water period (wash-out), a bicarbonate natural mineral water period, and an oligomineral water period. The mineral water bottles were anonymized by removing the identifying labels. The primary efficacy endpoint was the change in the Patient Assessment of Upper Gastrointestinal Disorders–Symptom Severity Index (PAGI-SYM) total score. The secondary endpoints were: improvements in the PAGI-SYM subscale scores, the use of antacids, and the self-assessment of efficacy of digestion. Power analysis indicated that a minimum of 48 pairs were required and, to ensure adequate sample size, 50 subjects were enrolled. Results: The PAGI-SYM total score and the six subscale scores significantly decreased after bicarbonate mineral water intake and significantly increased after oligomineral water supplementation. During the bicarbonate mineral water period, antacid use decreased significantly, with nine patients discontinuing antacid medication (p = 0.004). During the subsequent oligomineral water period, antacid use increased, with seven patients requiring new antacid administration, although this increase did not reach statistical significance (p = 0.070). The comparison between changes observed during the bicarbonate and oligomineral water periods was significant (p = 0.005). In addition, the scores of the patients’ subjective assessments of the effectiveness of their digestion were significantly better after the intake of bicarbonate water than after intake of oligomineral water. Conclusions: In line with the evidence reported in the literature, the preliminary findings suggest that the intake of Aqua 3 bicarbonate mineral water may alleviate dyspeptic and reflux-related symptoms and improve digestive effectiveness in patients with functional dyspepsia. Given the exploratory design, small sample size, and fixed treatment sequence, these results should be interpreted as hypothesis-generating and require confirmation in adequately powered randomized controlled trials. The intake of Aqua 3 bicarbonate mineral water proved to be a simple, safe, and natural intervention capable of improving digestive symptoms in patients with functional dyspepsia and reflux-related disorders while promoting the digestive process.