Si eres de los que cuando tienes acidez te tomas un vaso de leche o tomas zumo de limón en ayunas, no lo estás haciendo bien. Estos y otros muchos bulos muy comunes entre los españoles, han sido desmentidos por la Sociedad Española de Médicos de Atención Primaria (SEMERGEN) y el Instituto SaludSinBulos. Nuestro nutricionista Eric Iges nos ayuda a desmentirlos y arroja luz sobre Reflujo gastroesofágico.
El reflujo gastroesofágico
Se produce cuando el esfínter inferior del esófago, comúnmente conocido como cardias, zona anatómica encargada de cerrar el paso del esófago hacia el estómago, no cumple su función.
Y permite así, que el contenido gástrico pueda ascender hacia el esófago y la boca, lo que produce molestias como: irritación, inflamación y dolor, asociándose a complicaciones como esofagitis (una lesión de la mucosa derivada de la regurgitación gastroesofágica repetida) o úlceras.
En condiciones normales, el cardias solo se abre con los movimientos peristálticos del esófago desencadenados al tragar los alimentos. Los movimientos peristálticos son aquellos que produce el esófago para empujar el bolo alimenticio desde el inicio del esófago hasta su final, es decir, hasta el inicio del estómago. Se explican como las contracciones y relajaciones simétricas que se realizan a lo largo del tubo digestivo.
Causas de cardias
Las causas que pueden provocar que el cardias no realice bien su función son diversas: una hernia de hiato, la obesidad, el embarazo, ciertos fármacos, la inmadurez del cardias en los niños y ciertas cirugías de esófago y estómago.
Entre el arsenal terapéutico con el que podemos abordar el reflujo gastroesofágico, el Consejo General de Colegios Oficiales de Farmacéuticos cita los medicamentos que suprimen la acidez gástrica y los medicamentos que mejoran el vaciamiento gástrico y aumentan la presión del esfínter esofágico inferior.
Esófago de Barret
El llamado “síndrome o esófago de Barret” es una condición que adquiere el esófago y que se debe a un reflujo gastroesofágico prolongado en el tiempo, que expone la mucosa del esófago al ácido y la bilis. El esófago de Barret puede ser un factor de riesgo de cáncer del esófago, aunque los enfermos bajo control y tratamiento adecuado pueden minimizar este riesgo.
Reflujo y acidez: 10 mitos a desterrar
Recientemente, el Instituto SaludSinBulos ha llevado a cabo una encuesta online a la población con el objetivo de descubrir los mitos y las falsas creencias sobre protección esofágica, cáncer de esófago y reflujo gastroesofágico, y concienciar sobre el daño esofágico en reflujo y sus consecuencias.
La encuesta tiene el aval de la (SEMERGEN) y ha sido realizada a 1.200 personas y ha servido de base para la redacción del Informe Mitos sobre protección esofágica. De esta encuesta se extraen datos interesantes, como que una de cada cinco personas recurre a remedios caseros, como el bicarbonato o la leche, para solucionar síntomas relacionados con el reflujo esofágico como es la acidez.
Llama la atención que, si los síntomas relacionados con el reflujo, como la regurgitación, el dolor torácico, la disfonía o la tos irritativa, persisten, el 14% no hace nada para remediarlos, mientras siete de cada diez personas no saben o no creen que la tos y la disfonía sean síntomas relacionados con el reflujo gastroesofágico, sino con la alimentación, los problemas emocionales y las enfermedades del estómago o el esófago.
Estos son los 10 bulos relacionados con protección esofágica y sus desmentidos que han aglutinado los expertos en su informe:
1. La leche ayuda a aliviar la acidez. FALSO. La leche parece provocar un alivio momentáneo de la acidez de estómago, pero también estimula la producción de ácido. Por ello, la sensación de acidez regresa tras un período corto de tiempo. La leche contiene caseína, que estimula la producción de la hormona gastrina, responsable de la producción de ácido gástrico.
2. El consumo puntual de inhibidores de la bomba de protones puede provocar daños neurológicos. FALSO. El bulo se basa en el potencial de los inhibidores de protones para causar déficit de vitamina B12. Este déficit se relaciona con anemia, trastornos mentales y demencia. Sin embargo, el consumo de IBP, si es solo con indicación médica, no tiene un efecto importante sobre la absorción de la vitamina B12. Bajo un control médico adecuado no existe riesgo, no obstante, hay que tener en cuenta que hasta el 69% de las prescripciones de IBP en España son inadecuadas, según la Sociedad Española de Patología Digestiva.
3. El azúcar empeora el cáncer de esófago. FALSO. No hay evidencias que indiquen que consumir azúcar provoca un empeoramiento del cáncer de esófago ni que, si se deja de consumir azúcar, el cáncer remite. Lo que sí se sabe es que una alimentación con un alto contenido en azúcar puede derivar en obesidad, asociada a un riesgo elevado de padecer cáncer.
4. Los remedios naturales curan el cáncer de esófago. FALSO. Existen muchos mitos sobre tratamientos y remedios naturales que curan el cáncer. No tienen ninguna evidencia científica.
5. El ajo es bueno para prevenir el cáncer de esófago. FALSO. Un ensayo aleatorizado de múltiples intervenciones en Shandong, China, probó la eficacia de 800 mg de extracto de ajo más 4mg de aceite de ajo destilado al vapor, para inhibir la progresión de las lesiones gástricas precancerosas.
Sin embargo, después de 7,3 años de seguimiento, el tratamiento con ajo no disminuyó la prevalencia de lesiones gástricas precancerosas, ni afectó la incidencia de cáncer.
6. El zumo de limón en ayunas mejora el reflujo esofágico y previene el cáncer. FALSO. El limón estimula la producción de los ácidos del sistema digestivo. De hecho, puede llegar a agravar el ardor de estómago. En cuanto al cáncer, el zumo de limón diluido en agua no tiene ningún poder anticancerígeno extraordinario.
7. Los suplementos de vitaminas reducen el riesgo de padecer cáncer de esófago. FALSO. La evidencia científica disponible sugiere que el consumo de frutas y verduras podría reducir la probabilidad de padecer cáncer, pero no hay ninguna prueba que avale el efecto de los suplementos de vitaminas.
8. Calentar en recipientes plásticos produce cáncer de esófago. FALSO. El bulo se basa en que al calentar plástico pueden liberarse sustancias potencialmente tóxicas. Sin embargo, en la actualidad existe una normativa muy estricta sobre los materiales empleados en la industria alimentaria que evita la exposición a sustancias nocivas.
9. Los edulcorantes artificiales provocan cáncer de esófago. FALSO. Los estudios epidemiológicos en humanos no han encontrado ninguna evidencia de la relación entre edulcorantes artificiales y cáncer.
10. Si tienes ardores, tu bebé nacerá con mucho pelo. FALSO. La acidez de estómago en las embarazadas no tiene ninguna relación con el cabello del feto. La acidez de estómago es muy común en el embarazo ante la acción de la progesterona y el aumento de tamaño del útero.
12 pautas a seguir
Los objetivos a cumplir con el tratamiento nutricional deben ir encaminados a evitar el reflujo, así como a disminuir las molestias existentes y prevenir complicaciones. Para conseguir estos objetivos, es necesario tener en cuenta una serie de recomendaciones:
1. Mantener una composición corporal óptima, ya que el acúmulo de grasa abdominal se relaciona con un aumento del riesgo de sufrir reflujo.
2. Realizar una alimentación S.A.V.E. (Saludable, Adecuada, Variada y Equilibrada).
3. Evitar las comidas abundantes. Es recomendable repartir las ingestas en muchas tomas a lo largo del día y con poca cantidad en cada una de ellas.
4. Es importante comer despacio, masticar bien, siendo siempre consciente de lo que se está comiendo y encontrarse en un ambiente tranquilo.
5. Es recomendable realizar las comidas sentado y, hasta media hora después, permanecer sentado o incorporado al menos unos 30-45º C. Por lo tanto, será de interés no realizar las cenas especialmente tarde, para no comprometer el descanso, ya que es conveniente realizar esta pauta. Centrándonos en estas últimas horas del día, limitar el consumo de alimentos dos horas antes de acostarse y elevar la cabecera de la cama pueden ser consejos útiles.
6. Por otra parte, tomar líquidos y agua en pequeñas cantidades fuera de las comidas, puede prevenir la aparición de reflujo
7. Es de especial interés utilizar técnicas de cocinado saludables (hervidos, en su jugo, plancha, vapor, horno) y evitar los fritos, rebozados, empanados y guisos con salsas grasientas.
8. Si nos centramos un poco más en detalle en alimentos y bebidas en concreto, es recomendable limitar o evitar el consumo de alimentos y bebidas que disminuyen la presión del esfínter: alimentos de elevado contenido en grasa (aceites, mantequilla, nata, margarinas, salsas, fritos, carnes grasas, quesos fermentados y muy curados); ajo, cebolla, chocolate y, muy importante, las bebidas alcohólicas.
9. Por otra parte, será conveniente evitar aquellos con un efecto irritante directo sobre la mucosa esofágica inflamada: frutas y zumos cítricos, así como productos derivados del tomate, determinadas especias como la pimienta, clavo, paprika, mostaza o canela y alimentos muy condimentados, el café, y, por último, será conveniente evitar comidas o bebidas con temperaturas extremas (muy calientes o muy fríos).
10. Aunque saludables, ciertos alimentos con un elevado contenido en fibra, como las legumbres, algunas verduras, frutas con piel y los alimentos integrales puede ser recomendable moderar su consumo en función de la tolerancia. Por otra parte, las bebidas gaseosas pueden incrementar también el reflujo.
11. El acto de fumar disminuye la presión del esfínter y por ello aumenta el riesgo de reflujo.
955 comentarios
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