La flora intestinal

Carmen de Lucas Vallejo.

Alrededor de un kilo, kilo y medio, del peso corporal en un individuo adulto se debe a los microorganismos que alberga en el tracto gastrointestinal, los cuales constituyen un complejo ecosistema de más de 400 especies distintas, que conviven en armonía, sintetizando vitaminas, sustancias beneficiosas, contribuyendo a la absorción de nutrientes, favoreciendo el metabolismo colónico de la fibra, mejorando la digestibilidad y neutralizando sustancias potencialmente patógenas.

Las principales funciones de la flora intestinal son limitar el crecimiento de microorganismos patógenos en el intestino e interactuar con substratos no absorbidos de la dieta. El tracto gastrointestinal contiene una flora normal abundante y diversa. Aunque la acidez del estómago impide cualquier colonización significativa en un individuo sano, no todos los gérmenes que entran al organismo por vía oral se destruyen al pasar por el estómago, muchas especies pueden sobrevivir y establecerse en el tracto intestinal inferior.

intestinoEl intestino grueso es la parte más importante, ya que en él se llevan a cabo todos los procesos de reabsorción. Los residuos alimenticios permanecen en él de 16 a 68 horas y es la región que comprende la mayor carga microbiana del cuerpo. La flora intestinal coloniza la parte baja del intestino delgado y el intestino grueso, donde hay ausencia de oxígeno, porque es incapaz de reproducirse en presencia de éste. Normalmente, la vida microfloral es relativamente escasa en el intestino delgado, en particular hay Estreptococos, Lactobacilos y levaduras, pero se vuelve crecientemente abundante en el íleon inferior y el colon, encontrándose ya Enterobacteriaceae y Bacteroides.

El colon humano participa en varias enfermedades y es el lugar preferido para la colonización de muchos patógenos, además, hay otras enfermedades intestinales crónicas, como las enfermedades inflamatorias del intestino, el cáncer de colon y la colitis pseudomembranosa, en las que en su etiología interviene la flora bacteriana. El grupo de bacterias más numeroso es el de los anaeróbicos, que representan un 90%, incluyendo Bacteroides y Bífidobacterias, en primer orden, seguidos de Eubacterias y Peptoestreptococos. En un rango del 1% – 5% se encuentran los anaeróbicos facultativos, como Lactobacilos, Enterococos y Coliformes.

La principal función de la microflora intestinal es digestiva, es decir, la degradación de ciertos componentes presentes en los alimentos. Una flora armonizada y balanceada contribuye a una mejor absorción de los nutrientes, es decir, minerales, oligoelementos, vitaminas y aminoácidos Durante muchos años, se consideró que los microorganismos de la flora intestinal degradaban los productos de la digestión sin ningún beneficio para el ser humano, sin embargo, no es así, la flora bacteriana genera compuestos útiles para la nutrición del individuo, produce ciertas vitaminas (vitaminas del grupo B y vitamina K), algunos aminoácidos esenciales, como lisina, y ácidos grasos de cadena corta que resultan esenciales para el crecimiento de los enterocitos.

Además, la flora intestinal suministra la primera línea de defensa contra los agentes patógenos, impidiendo su implantación y desarrollo en el tracto gastrointestinal; esta función es conocida con el nombre de efecto barrera. El epitelio intestinal constituiría la segunda línea de defensa y una verdadera barrera por la acción combinada de la mucosa y de las células epiteliales y la tercera línea de defensa sería el sistema inmunitario. Un epitelio intestinal intacto con una flora óptima, caracterizada por un equilibrio sensible entre bacterias beneficiosas y bacterias potencialmente dañinas, representa, pues, una barrera frente a la invasión de microorganismos patógenos, antígenos y compuestos nocivos desde el intestino.

Hoy consideramos a la flora intestinal como un factor clave y el balance de su composición influye en el bienestar y la salud. Su desequilibrio puede prevenirse con una buena alimentación y con la administración de cultivos microbianos vivos. Desde hace muchos años se viene intentando la administración de preparados bacterianos, que restablezcan este equilibrio, en la actualidad hay un considerable interés por el estudio de la flora benéfica, estableciéndose diferentes estrategias para modificar la flora intestinal humana que van desde la inclusión en los alimentos de bacterias consideradas probióticas y de carbohidratos no digeribles considerados prebióticos. Dichas estrategias pudieran ofrecer los siguientes beneficios nutricionales: una mejora en la supervivencia de bacterias vivas en productos alimenticios, un aumento en el número de bacterias ingeridas que alcanzan el colon, la estimulación en el colon de un crecimiento e implantación de bacterias tanto exógenas como endógenas y una activación del metabolismo de éstas, ya que es importante enfatizar que solo las bacterias metabólicamente activas pueden promover un estado de salud.

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