Ph And Total Dissolved Solids In Drinking Water: Associations With Gastrointestinal Health In Rural South India

Introduction: Poor water quality, particularly abnormal pH and high Total Dissolved Solids (TDS), contributes significantly to gastrointestinal (GI) disorders in rural India, where 90% of households rely on untreated groundwater, and 21% of communicable diseases are water-related. This study examines these associations in Palnadu District, Andhra Pradesh, a region with documented groundwater contamination. Methods: A cross-sectional study was conducted from November 1-30, 2024, among 504 adults from 150 rural households across three villages in Edlapadu Mandal, Palnadu District, selected via multi-stage random sampling. Water samples were tested for pH and TDS using calibrated digital meters. GI symptoms were assessed through structured interviews. Chi-square tests and ANOVA were used for statistical analysis (p < 0.05). Results: Of 504 water samples, 89.7% had normal pH (6.5-8.5, mean 7.64 ± 0.49), and 10.3% had abnormal pH (8.5, mean 7.89 ± 1.36, range 5.8-9.3). GI symptoms were significantly higher with abnormal pH (84.6% vs. 69.9%, p = 0.026) and unsafe TDS levels (>900 ppm, 94.1% vs. 66.1%, p < 0.0001). Well water had the highest TDS (mean 729.65 ± 296.5 ppm). Reverse Osmosis (RO) water use for drinking significantly reduced GI symptoms (33.3% vs. 86.2%, p < 0.00001). Conclusions: Abnormal pH and high TDS significantly increase GI symptom risk in rural Palnadu District, with well water posing the greatest risk. RO systems offer substantial protection, but comprehensive water quality interventions, including affordable treatment solutions, are essential for public health.