No Relation of Sigmoid Volvulus to Fiber Content of African Diet

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To the Editor: There is a common assumption that since Africans often have volvulus and since they eat high-fiber diets, the latter are therefore the cause of the former. Sigmoid volvulus is indeed exceedingly common in some African tribes. However, it must be emphasized that the distribution of this disorder is extremely variable throughout Africa and that it is very uncommon in women. Hall-Craggs1 reported a prevalence of 25 cases a year at Mulago Hospital in Kampala, Uganda. Sixteen years before, Burkitt2 had given an almost identical figure. In striking contrast, only one of 436 consecutive cases of identical obstruction . . .

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