Factors associated with redundant sigmoid colon in Mulago hospital, Uganda

Abstract

INTRODUCTION: In order to combat the continuing morbidity and mortality due to redundant sigmoid colon and its complications in Mulago hospital, a prospective case-control study was conducted from 1st may, 2006 to 31st December, 2006. OBJECTIVES: To establish the demographic, dietary and socio-economic factors associated with redundant sigmoid colon in order to improve patient management. METHODS: Demographic, dietary and socio-economic factors were compared between 68 patients diagnosed with redundant sigmoid colon (cases) confirmed radiologically and at laparotomy, and 136 controls selected from patients admitted on Mulago hospital surgical wards during the same period. RESULTS: 64.7% of cases were of age between 30 and 70 years with male to female ratio of 5.1 statistically significant association was achieved between redundant sigmoid colon and consumption of: rice (or=2.9, p=0.00), millet porridge (OR= 1.5, P= 0.00), wheat products (OR = 2.9, P=0.00), Irish potatoes (OR= 2.4, P=0.000), Yams (OR 2.8, P= 0.00), Peas (or 2.6, p=0.00), Soya beans (OR=2.1, P=0.00), Blue band (OR= 2.0, P=0.00), Poultry (0R = 1.6, p=0.01) and Oranges (OR= 2.1, P=0.00). There was a strong association between irregular bowel habits and redundant sigmoid colon (OR= 4.9, P= 0.00). Statistically significant association was not achieved between redundant sigmoid colon and consumption of Matooke (OR= 0.9, P=0.25, 95% c1= 0.25). 57.4% of cases were peasant farmers, 52.9% had peasant farming as the main source of family income and the majority (47.1%) had average family income of below 50,000/= Ug. Shs. Per month. CONCLUSIONS: Redundant sigmoid colon is common among the young and middle age groups and is dominant among the male sex. These results suggest that there is an association between redundant sigmoid colon and consumption of : Rice, millet porridge, wheat products, irish potatoes, yams, peas, soya bean, blue band, poultry, oragnes and mangoes. Results also suggest that there is no association between redundant sigmoid colon and consumption of matooke, and that people with irregular bowel habits are about five times more likely to have redundant sigmoid colon than those who have regular bowel habits. Majority of patients with redundant sigmoid colon are of low socio-economic status. RECOMMENDATIONS: An RCT is needed to further assess the association between redundant sigmoid colon and consumption of rice, millet porridge, wheat products, irish potatoes, yams, peas, soya beans, blue band and oranges. The public should be encouraged to seek medical advice as soon as they develop irregular bowel habits. Patients with redundant sigmoid colon should be given priority especially in paying health facilities since they may not afford treatment costs.