Impacto de las medidas generales en el tratamiento del reflujo gastroesofágico: una revisión basada en la evidencia

  • Roger Castillo
  • William Otero
  • Alba Trespalacios

Resumen

Contexto: la enfermedad por reflujo gastroesofágico (ERGE) es una patología muy prevalente en adultos que altera la calidad de vida. Se han investigado múltiples tratamientos, algunos de ellos son cambios en el estilo de vida, dado que se han descrito algunos factores de riesgo asociados. El cambio en el estilo de vida es recomendado, sin embargo la evidencia que la soporta es controvertida y escasa.

Objetivo: estimar el impacto que tienen los cambios en el estilo de vida en los pacientes con ERGE.

Metodología: se realizó un búsqueda sistemática de la literatura en 3 bases de datos (PubMed, ScienceDirect y Embase) y se utilizaron las palabras claves “gastroesophagueal reflux”, “heartburn”, “bed head elevation”, “Carbonated Beverages”, “mint”, “cacao”, “citrus”, “alcohol drinking”, “caffeine”, “coffee”, “late-evening meal”, “spicy food”, “fatty foods”, “obesity”, “weight loss”, “exercise” y “Smoking Cessation”. Se incluyeron ensayos clínicos controlados y estudios de cohortes prospectivos que hayan estudiado una intervención en el estilo de vida sobre y evaluado su efecto sobre la ERGE.

Resultados: se encontraron 2731 artículos, de los cuales 15 fueron incluidos para ser analizados. Suspender algunos alimentos o bebidas como la menta, el chocolate, cítricos, bebidas carbonatadas, co- midas grasas y picantes para mejorar la clínica de la ERGE carece de evidencia. Tomar café descafeinado podría disminuir la cantidad de reflujo. Dejar de fumar se asoció con mejoría de la sintomatología. El horario de la comida en la noche puede alterar algunos parámetros de la pH-metría pero no modificó los síntomas. Algunos ejercicios, principalmente respiratorios podrían mejorar la sintomatología. La elevación de la cabe- cera de la cama y disminuir de peso en pacientes en sobrepeso/obesos tienen evidencia a favor de la mejoría de los síntomas, sin embargo cuentan con evidencia en contra y limitaciones metodológicas.

Conclusión: los cambios en el estilo de vida para mejorar la ERGE no cuentan con evidencia adecuada, existen principalmente ensayos clínicos no controlados o estudios observacionales. Se necesitan más ensa- yos clínicos y de mejor calidad para definir el impacto de estas medidas en la ERGE. 

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Biografía del autor/a

Roger Castillo
  1. Residente de último año de Medicina Interna. Universidad Nacional de Colombia. Bogotá, Colombia 

William Otero
  1. Profesor de Medicina, Unidad de Gastroenterología. Universidad Nacional de Colombia. Gastroenterólogo, Clínica Fundadores. Bogotá, Colombia 

Alba Trespalacios
  1. Directora especialización microbiología médica. Directora Colección de Microorganismos, Departamento de Microbiología, Pontificia Universidad Javeriana. Bogotá, Colombia 

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Publicado
2016-10-28
Cómo citar
Castillo, R., Otero, W., & Trespalacios, A. (2016). Impacto de las medidas generales en el tratamiento del reflujo gastroesofágico: una revisión basada en la evidencia. Revista Colombiana De Gastroenterología, 30(4), 431-446. https://doi.org/10.22516/25007440.7
Sección
Revisión de tema
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