CULTURAL BOWEL PATTERNS AND SEX DIFFERENCE IN SIGMOID VOLVULUS MORBIDITY IN AN ETHIOPIAN HOSPITAL

A qualitative anthropological study in Gondar region, northwestern Eth iopia, revealed a very striking difference in cultural patterns of def ecation in the two sexes which coincided with a high male/female ratio (16.5:1) of sigmoid volvulus morbidity in the regional hospital. Adul t males show very irregular bowel behaviour, with bowel motions varyin g from Zero to four per day. Irregular bowel behaviour in males, combi ned with the population's consumption of high fibre diets producing fl atus and bulky stools, appears to overload the sigmoid colon, which el ongates and dilates gradually, and subsequently undergoes volvulus occ asionally, In women, on the other hand, the custom of limiting defecat ion to dawn and dusk is strictly adhered to and this regularity of bow el movements seems to protect them from overloading of the sigmoid col on and its consequences, despite their consumption of similar diets, I n conclusion, it is believed that the high male/female ratio in sigmoi d volvulus morbidity in Gondar region appears to be connected to gende r specific patterns of defecation.