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O que é a doença diverticular? Diverticulose? Diverticulite?
Doença diverticular é o nome geral de uma doença que cria pequenos sacos ou bolsas na parede do cólon (intestino grosso), chamadas divertículos. Embora esses sacos possam se formar em todo o cólon, em países ocidentais como o Brasil eles são mais comumente encontrados no cólon sigmóide, a porção do intestino grosso mais próxima do reto.
O termo diverticulose refere-se a simplesmente ter divertículos dentro do cólon, mas sem complicações ou problemas desses sacos. A diverticulose geralmente não causa sintomas e, como tal, costumam ser diagnosticadas por achado incidental. A diverticulose é muito comum e a proporção da população com diverticulose aumenta com a idade. Aproximadamente 30-40% das pessoas com 60 anos têm diverticulose e com 80 anos essa taxa pode chegar a 50-80%.
A diverticulite é um processo inflamatório do cólon que se acredita ser causado pela perfuração de um dos divertículos. Estima-se que 10-20% das pessoas com diverticulose desenvolverão diverticulite. Os sintomas mais comuns da diverticulite simples são dor abdominal ou pélvica, sensibilidade abdominal e febres. A diverticulite complicada ocorre quando há formação de abscesso e/ou perfuração do cólon com peritonite.
Na diverticulite simples, o tratamento é baseado em sintomáticos e antibióticos orais ou venosos. Na diverticulite complicada, o tratamento depende da gravidade das complicações, que vai desde antibiótico venoso e/ou punção do abscesso à cirurgia de urgência, na peritonite grave.
Episódios de diverticulite ainda podem gerar complicações tardias, como estenose (estreitamento do cólon que não deixa as fezes passarem facilmente) e fístula (trajeto/comunicação com outro órgão ou pele). Quando uma fístula se forma, ela mais comumente conecta o cólon à bexiga. Também pode conectar o cólon à pele, útero, vagina ou outra parte do intestino. O tratamento dessas complicações, em geral, é feito por cirurgia eletiva/programada, dando preferência às cirurgias minimamente invasivas.
Uma complicação da diverticulose é o sangramento dos sacos diverticulares, que podem ou não ocorrer durante um ataque de diverticulite. O tratamento em resumo é cuidado e suporte intra-hospitalar, associados a colonoscopia ou arteriografia, quando necessário intervenção.
Causa e fatores de risco
A causa exata da diverticulose não é conhecida. A teoria mais aceita para a formação de diverticulose está relacionada à alta pressão dentro do cólon, que faz com que áreas fracas da parede do cólon se projetem e formem os sacos. Uma dieta pobre em fibras e rica em carne vermelha também pode desempenhar um papel importante.
Existem muitos fatores de risco (algo que aumenta a chance de contrair uma doença) para a doença diverticular, incluindo:
– Dieta pobre em fibras (frutas e vegetais) e com alto teor de carne vermelha. No passado, os pacientes com diverticulose eram instruídos a evitar sementes e pipoca, pois se acreditava que isso poderia aumentar o risco de diverticulite, mas estudos mostram que essa recomendação não era verdadeira;
– Idade. Quanto maior for, maior também será a chance de ter diverticulose;
– Tabagismo;
– Álcool. O consumo excessivo de álcool pode aumentar o risco de diverticulite em 2 a 3 vezes em comparação com a população em geral.
Tratamento Cirúrgico
Muitos fatores influenciam a escolha de uma determinada operação e técnica operatória. Isso inclui a saúde geral do paciente, seu estado clínico atual e a preferência ou experiência do cirurgião com essas técnicas. O objetivo geral é controlar a infecção e devolver ao paciente uma boa saúde, minimizando os riscos de complicações graves.
As opções de tratamento cirúrgico incluem:
– Remoção da parte envolvida do cólon (intestino grosso), com ou sem criação de uma colostomia (bolsinha);
– Aspiração do abscesso (pus) e lavagem da cavidade abdominal, ou;
– Criar uma ostomia (uma abertura feita cirurgicamente entre um órgão interno e a superfície do corpo) para desviar o fluxo fecal sem a remoção do cólon.
A ressecção da porção afetada do cólon, geralmente o cólon sigmóide, é o procedimento mais comum quando se decide pelo tratamento cirúrgico da diverticulite aguda complicada.
Em resumo, a doença diverticular é uma condição comum, especialmente entre os idosos. Pode se apresentar com uma ampla gama de sintomas e gravidade, variando de doença assintomática a infecções abdominais com risco de vida. Existem várias estratégias de tratamento com a maioria das terapias consistindo em medidas conservadoras, como uma mudança na dieta ou antibióticos. A cirurgia pode desempenhar um papel curativo, especialmente em casos mais avançados.
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text_shadow_blur=”0″ text_shadow_color=”” margin_top_medium=”” margin_right_medium=”” margin_bottom_medium=”” margin_left_medium=”” margin_top_small=”” margin_right_small=”” margin_bottom_small=”” margin_left_small=”” margin_top=”” margin_right=”” margin_bottom=”2px” margin_left=”” margin_top_mobile=”” margin_bottom_mobile=”” text_color=”#202020″ animated_text_color=”” highlight_color=”” style_type=”default” sep_color=”” link_color=”” link_hover_color=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=””]Dra. Sonaira Bernardes[/fusion_title][fusion_title title_type=”text” rotation_effect=”bounceIn” display_time=”1200″ highlight_effect=”circle” loop_animation=”off” highlight_width=”9″ highlight_top_margin=”0″ before_text=”” rotation_text=”” highlight_text=”” after_text=”” title_link=”off” link_url=”” link_target=”_self” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” sticky_display=”normal,sticky” class=”” id=”” content_align_medium=”” content_align_small=”” content_align=”left” size=”6″ font_size=”” animated_font_size=”” fusion_font_family_title_font=”Poppins” fusion_font_variant_title_font=”700″ line_height=”” letter_spacing=”” text_shadow=”no” text_shadow_vertical=”” text_shadow_horizontal=”” text_shadow_blur=”0″ text_shadow_color=”” margin_top_medium=”” margin_right_medium=”” margin_bottom_medium=”” margin_left_medium=”” margin_top_small=”” margin_right_small=”” margin_bottom_small=”” margin_left_small=”” margin_top=”” margin_right=”” margin_bottom=”” margin_left=”” margin_top_mobile=”” margin_bottom_mobile=”” text_color=”#202020″ animated_text_color=”” highlight_color=”” style_type=”default” sep_color=”” link_color=”” link_hover_color=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=””]Proctologista em Brasília, CRM-DF: 21376, RQE: 15426 e 17106[/fusion_title][fusion_text columns=”” column_min_width=”” column_spacing=”” rule_style=”default” rule_size=”” rule_color=”” content_alignment_medium=”” content_alignment_small=”” content_alignment=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” sticky_display=”normal,sticky” class=”” id=”” margin_top=”” margin_right=”” margin_bottom=”10px” margin_left=”” font_size=”” fusion_font_family_text_font=”” fusion_font_variant_text_font=”” line_height=”” letter_spacing=”” text_color=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=””]Proctologia | Colonoscopia[/fusion_text][fusion_text columns=”” column_min_width=”” column_spacing=”” rule_style=”default” rule_size=”” rule_color=”” content_alignment_medium=”” content_alignment_small=”” content_alignment=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” sticky_display=”normal,sticky” class=”” id=”” margin_top=”0px” margin_right=”” margin_bottom=”10px” margin_left=”” font_size=”15px” fusion_font_family_text_font=”Poppins” fusion_font_variant_text_font=”400italic” line_height=”” letter_spacing=”” text_color=”#7e858e” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=””]“Só será possível salvar o mundo quando conhecer-te a ti mesma. Por isso, prevenção é sobretudo um ato de amor que começa de dentro para fora e se estende ao outro.”[/fusion_text][fusion_button link=”https://grupoelasbrasilia.com.br/sonairabernardes/” text_transform=”” title=”” target=”_self” link_attributes=”” alignment_medium=”” alignment_small=”” alignment=”” modal=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” sticky_display=”normal,sticky” class=”” id=”” color=”default” button_gradient_top_color=”” button_gradient_bottom_color=”” button_gradient_top_color_hover=”” button_gradient_bottom_color_hover=”” accent_color=”” accent_hover_color=”” type=”” bevel_color=”” border_width=”” border_radius=”” border_color=”” border_hover_color=”” size=”small” stretch=”default” margin_top=”” margin_right=”” margin_bottom=”” margin_left=”” icon=”fusion-prefix-fa-message-medical” icon_position=”left” icon_divider=”no” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=””]CONHEÇA A MÉDICA[/fusion_button][/fusion_builder_column_inner][/fusion_builder_row_inner][/fusion_builder_column][fusion_builder_column type=”1_6″ layout=”1_6″ align_self=”auto” content_layout=”column” align_content=”flex-start” valign_content=”flex-start” content_wrap=”wrap” spacing=”” center_content=”no” link=”” target=”_self” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” sticky_display=”normal,sticky” class=”” id=”” order_medium=”0″ order_small=”0″ hover_type=”none” border_color=”” border_style=”solid” box_shadow=”no” box_shadow_blur=”0″ box_shadow_spread=”0″ box_shadow_color=”” box_shadow_style=”” background_type=”single” gradient_start_position=”0″ gradient_end_position=”100″ gradient_type=”linear” radial_direction=”center center” linear_angle=”180″ background_color=”” background_image=”” background_image_id=”” background_position=”left top” background_repeat=”no-repeat” background_blend_mode=”none” filter_type=”regular” filter_hue=”0″ 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padding_top=”6%” admin_label=”Call to Action Agendamento” admin_toggled=”yes” background_image=”https://ml1ca8kph5lh.i.optimole.com/f8pwKbQ-zroGwOxF/w:auto/h:auto/q:auto/https://grupoelasbrasilia.com.br/wp-content/uploads/2021/05/cta-agende-sua-consulta.jpg” padding_bottom=”5%” padding_left=”0px” padding_right=”0px” background_color=”rgba(0,0,0,0.6)”][fusion_builder_row][fusion_builder_column type=”1_1″ layout=”1_2″ align_self=”center” content_layout=”column” align_content=”flex-start” content_wrap=”wrap” spacing=”” center_content=”no” link=”” target=”_self” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” sticky_display=”normal,sticky” class=”” id=”” order_medium=”0″ order_small=”0″ hover_type=”none” border_color=”” border_style=”solid” box_shadow=”no” box_shadow_blur=”0″ box_shadow_spread=”0″ box_shadow_color=”” box_shadow_style=”” background_type=”single” gradient_start_position=”0″ gradient_end_position=”100″ gradient_type=”linear” radial_direction=”center center” linear_angle=”180″ background_color=”” background_image=”” background_image_id=”” background_position=”left top” background_repeat=”no-repeat” background_blend_mode=”none” animation_type=”fade” animation_direction=”right” animation_speed=”1.0″ animation_offset=”” filter_type=”regular” filter_hue=”0″ filter_saturation=”100″ filter_brightness=”100″ filter_contrast=”100″ filter_invert=”0″ filter_sepia=”0″ filter_opacity=”100″ filter_blur=”0″ filter_hue_hover=”0″ filter_saturation_hover=”100″ filter_brightness_hover=”100″ filter_contrast_hover=”100″ filter_invert_hover=”0″ filter_sepia_hover=”0″ filter_opacity_hover=”100″ filter_blur_hover=”0″ padding_right=”” last=”true” border_position=”all” padding_right_small=”0px” first=”true”][fusion_title title_type=”text” rotation_effect=”bounceIn” display_time=”1200″ highlight_effect=”circle” loop_animation=”off” highlight_width=”9″ highlight_top_margin=”0″ before_text=”” rotation_text=”” highlight_text=”” after_text=”” content_align_medium=”” content_align_small=”center” content_align=”center” size=”2″ font_size=”” animated_font_size=”” line_height=”” letter_spacing=”” dimensions_medium=”” dimensions_small=”” text_color=”#dbc5a6″ animated_text_color=”” highlight_color=”” style_type=”default” sep_color=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” sticky_display=”normal,sticky” class=”” id=”” fusion_font_variant_title_font=”700″ fusion_font_family_title_font=”Open Sans” margin_bottom=”30px”]Agende sua consulta[/fusion_title][fusion_button link=”https://grupoelasbrasilia.com.br/contato/” text_transform=”” title=”” target=”_self” link_attributes=”” alignment_medium=”” alignment_small=”” alignment=”center” modal=”” color=”default” button_gradient_top_color=”” button_gradient_bottom_color=”” button_gradient_top_color_hover=”” button_gradient_bottom_color_hover=”” accent_color=”” 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