Ultrasound Assessment of the Effectiveness of Bicarbonate Mineral Water “Aqua 3” on Gallbladder Motility

Background: Bicarbonate mineral waters have been reported to modulate biliary dynamics. Prior symptom based data with Aqua 3 suggested digestive benefits, but objective confirmation is still lacking. Aims: To evaluate, the effect of Aqua 3 on gallbladder motility in fasting healthy adults, compared with an oligomineral water. Methods: In this randomized, crossover study, twenty healthy volunteers underwent two ultrasound sessions after an overnight fast and the ingestion of 500 mL of either Aqua 3 (bicarbonate mineral water) or oligomineral water. Gallbladder volume was measured at baseline and after 10, 20, 30, and 60 minutes. Primary endpoint was the maximum ejection fraction. Results: Bicarbonate mineral water induced a rapid increase in ejection fraction: peaking at 10 minutes, persisting at 20 minutes and attenuating by 30 minutes. At 60 minutes, gallbladder refilling exceeded baseline. Oligomineral water produced only modest early emptying at 10 minutes, no significant change at 20 minutes, and progressive refilling thereafter. Throughout the observation period, ejection fraction was significantly higher after bicarbonate than oligomineral water. Maximum ejection fraction was significantly greater with bicarbonate than oligomineral water, occurring most frequently at 10 minutes for both waters. Conclusions: A single 500 mL dose of bicarbonate mineral water elicits a rapid and pronounced cholagogue response, with ejection fraction increases evident within 10 minutes that significantly exceed those observed after oligomineral water, providing a mechanistic rationale for the previously reported digestive benefits of bicarbonate mineral water. These findings may be clinically relevant for optimizing early postprandial digestion and mitigating biliary stasis in hypomotile gallbladders.