CHAMGAP
APPROVEDReviewed and approved by the Chamgap Editorial Team (2026-08-04). The draft was written by AI, the existence of all 1 cited sources was verified at the original page, and the verdict passed blind grading and adversarial audit. Methodology v0.6.
Verdict No. 2124 · Search date 2026-08-04 · Methodology v0.6

Two liters of mineral water plus fiber,
does it really help with Increased stool frequency and reduced laxative use in adults with chronic functional constipation?

30-Second Summary
C
Evidence Grade C · 42 · Safety caution
An older high-fiber trial was positive when fluid increased, but outcome magnitude was incompletely reported.
Abrupt increases in fluid and fiber can cause bloating or discomfort. People with heart failure, kidney disease, hyponatremia risk, or prescribed fluid restriction should individualize intake with a clinician.
What the
research shows
The grade is C. A two-month trial randomized 117 adults with chronic functional constipation. Both arms consumed 25 g/day of fiber, while total fluid averaged 2.1 L/day with prescribed mineral water versus 1.1 L/day with ad libitum intake. Stool frequency and laxative use improved more with water, but publicly accessible reporting lacks arm-level outcome values, dispersion, and test statistics needed to calculate the effect magnitude. One old small short trial gives C with 42 points.
What the
ads claim
The fluid difference and statistical bowel improvement were real. Turning a trial that supplied 25 g/day of fiber to everyone into a promise that water alone cures any constipation removes the co-intervention and unknown magnitude.
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Useful facts when choosing a product

  • Actual total fluid averaged 2.1 versus 1.1 L/day, a separation of about 1.0 L/day.
  • All participants consumed about 25 g/day of fiber, so this was not a water-only trial.
  • Group 24-hour urine volume and urine osmolality were not found in the publicly accessible report.
  • Verdict 1088 is D with 30 points for postexercise rehydration; this verdict concerns stool frequency and laxative use during a high-fiber diet.
Gap Measurement · Verdict 2124 · C 42
What advertising claims
What independent, higher-quality research supports
△ GAP
01

What the research actually shows

Anti randomized 117 adults aged 18 to 50 years with chronic functional constipation: 58 to ad libitum fluids and 59 to 2 L/day of mineral water. Both groups followed the same approximately 25-g/day fiber diet for two months. Actual total fluid separated to 1.1 versus 2.1 L/day, while fiber intake remained similar. Stool frequency and laxative use improved more with added water, but the article lacks the standard error, confidence interval, and covariance for the adjusted between-group contrast, so the clinical size of the effect cannot be judged. Group 24-hour urine volume, osmolality, and a registered primary endpoint were not confirmed. The article contains no funding-support statement; the independence value reflects unconfirmed funding, not an absence of industry funding, not a finding of mixed funding.

02

Why this is classified as C (42)

Actual intake separated and both bowel outcomes were statistically positive, but magnitude was not recoverable and one small short unblinded trial gives C with 42 points.

Counterpoint. Unknown magnitude does not mean no effect, but P<.001 alone cannot establish a patient-noticeable large effect.

Rejudgment record. Cross-check applied — One-liter daily fluid separation with positive bowel outcomes, limited by unrecoverable arm-level magnitude and a small short unblinded design

Scoring profile behind this grade
EndpointPPatient-reported treatment goal - the symptom is the goal
ReplicationR1Single confirmatory trial
IndependenceI1Mixed funding sources
Effect sizeEXThe clinical size of the effect could not be judged

The scoring table and the verdict agree (C).

Sub-claim grades by effect

This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.

Effect (sub-claim)GradeBasis
Increased stool frequency and reduced laxative use during a high-fiber dietCBoth outcomes were statistically positive, but the public data do not permit calculation of the between-group magnitude.

Cross-check — Codex and Claude

This verdict was drafted by Codex through literature review and source-existence checks, cross-checked through blind grading and adversarial audit, and settled by reapplying the methodology boundary rules. Cases with split grades were resolved through rejudgment.
03

Evidence Table

StudyDesignSampleFundingEndpointResultWeight
Study 1Two-month parallel randomized clinical trial59No funding-support statement in the article; I1 is the default for unconfirmed fundingStool frequency and laxative useTotal fluid 1.1 versus 2.1 L/day; both outcomes improved more with added water (P<.001), without arm-level absolute values or CIsPivotal older single trial
§

Receipt — 1 References

All 1 cited sources were verified for existence at the original page (as of 2026-08-04).

Anti M, Pignataro G, Armuzzi A, et al. Water supplementation enhances the effect of high-fiber diet on stool frequency and laxative consumption in adult patients with functional constipation. Hepatogastroenterology. 1998;45(21):727-732. PMID: 9684123.
checked
Draft and rewrite: Codex (AI) · Verification: Codex blind grading and adversarial audit · Final adjudication: Claude
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-04 · Corrections: none

Cite this verdict

Two liters of mineral water plus fiber x improvement of functional constipation Evidence Grade C card
[Chamgap] Two liters of mineral water plus fiber x improvement of functional constipation — Evidence Grade C·42. 1 cited sources checked. Source: https://chamgap.com/en/verdicts/gut/mineral-water-high-fiber-functional-constipation/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

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