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ESTOMAGO Y ARROZ
1.
430 Rice has been
related to the formation of peptic ulcers (1, 2). For many people who do not eventually develop an ulcer, it is also a common experience that having rice, especially glutinous rice, may cause stomach discomfort or heartburn. Studies carried out to understand the underlying mechanism have been mainly focused on the bran of rice (1). It has been found that bran oil becomes ulcerogenic upon storage (1,2). The present work attempts to approach this question in a different way, offering an alternative explanation for the mechanism and, on the basis of it, a suggestion as to how to minimize the unwanted effect of rice. The gastrointestinal tract is protected by its mucosa epithelium and mucus layer, with the latter functioning as a mechanical and chemical buffer as well as a lubrica- tive (3). Mucin molecules, the major constituent of mucus, are protein densely coated with oligosaccharides, which afford the stickiness and viscosity. Starch, which makes up most mass of rice, is polysaccharide. Upon hydration through cooking, rice becomes sticky. When rice is ingested into the stomach, it readily forms food masses that are sticky. As the food masses move along the stomach that undergoes peristalsis, the sticky rice takes the sticky gastric mucus with it through adhesion. Snowball effect results in removal of increasing amounts of mucus from the stomach wall. Moreover, as the food masses are mixed in this process, rice previously in the middle of food masses is turned out and can bind more mucus, while the mucus bound rice is moved into the masses. Depending on the degree of stickiness and the amount of rice, the end result can be an effective peeling off of gastric mucus, making the stomach vulnerable to the damaging power of gastric acid and pepsin, which are all at their peak phase of secretion. Duodenum may be affected in a similar way. Any kind of food will take a cer- tain amount of mucus with it, and the stomach secretes new mucus to meet its normal needs. Problems arise when the removal of mucus becomes excessive and sur- passes the speed of new mucus secretion. Accordingly, glutinous rice would cause heartburn more readily than nonglutinous rice does, which is consistent with the experience of the general public, especially Asians. On the basis of the above discussion, it becomes clear that unrefined cereals, when compared with refined rice and wheat, are associated with lower ulcer rates (2) because bran reduces the stickiness. It is, however, not necessary for rice eaters to give up their favorite rice and shift to unrefined nonglutinous rice. A simple and effi- cient solution is to drink enough water or other liquids while having rice meal. Sufficient amounts of water can convert rice masses into rice slurry in the stomach, which is no longer able to remove large quantities of mucus. Rice hurts the stomach by its stickiness X. Wang Cornell University Medical College, New York, USA Summary Rice masses remove mucus from the stomach and duodenum as the sticky starch binds the sticky mucus, weakening the defense against acid and pepsin which may in turn cause heartburn and ulcer. Such unwanted effect can be avoided by taking enough water with rice meal as water converts rice masses into slurry. © 2000 Harcourt Publishers Ltd Received 22 June 1998 Accepted 22 March 1999 Correspondence to: Dr Xiao Wang, 450 East 63rd Street, Room 7G, New York, NY 10021, USA. Phone: +1 212 223 0997; Fax: +1 212 421 1122 Medical Hypotheses (2000) 54(3), 430–431 © 2000 Harcourt Publishers Ltd DOI: 10.1054/mehy.1999.0868, available online at http://www.idealibrary.com on
2.
Unwanted effects of
rice 431 © 2000 Harcourt Publishers Ltd Medical Hypotheses (2000) 54(3), 430–431 REFERENCES 1. Jayaraj A. P., Tovey F. I., Clark C. G., Rees K. R.., White J. S., Lewin M.R. The ulcerogenic and protective action of rice and rice fractions in experimental peptic ulceration. Clin Sci 1987; 72: 463–466. 2. Tovey F. I. Duodenal ulcer in China. J Gastroenterol Hepatol 1992; 7: 427–431. 3. Wang X. Aspirin-like drugs cause gastrointestinal injuries by metallic cation chelation. Med Hypotheses 1998; 50: 227–238.
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