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CC BY-NC-ND 4.0 · Ibnosina Journal of Medicine and Biomedical Sciences 2023; 15(04): 188
DOI: 10.1055/s-0043-1772819
Letter to the Editor

Comments on ‘The Role of Ramadan Fasting on Intestinal Volvulus and Knotting’

Sabri Selcuk Atamanalp 
1   Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
,
Esra Disci
1   Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
,
Rifat Peksoz
1   Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
› Author Affiliations Funding and Sponsorship This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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We read the article written by Hafidh at al[1] on the effects of Ramadan fasting on human health. Among the discussed subjects, our comments relate to the effects of fasting on sigmoid volvulus (SV) and ileosigmoid knotting (ISK) based on our 57-year (from June 1966 to July 2023) experience including 1,071 SV patients, the most comprehensive monocenter SV data over the world, and 80 ISK cases, one of the most extensive worldwide ISK series.[2]

SV, rotation of the sigmoid colon around itself causing a colonic obstruction, is a rare disease. Similarly, ISK, twisting of the ileum or sigmoid colon around each other, resulting in a double-loop intestinal obstruction, is a very rare clinical entity. Most likely due to the rarity of these conditions, the relationship between fasting and SV or ISK is not clearly defined.[3] Of 416 SV patients evaluated in our series, 31 (7.5%) are caused by fasting, while 8 of 80 ISK patients (10.0%) are caused by fasting. In these cases, fasting looks likely to lead to the development of both SV and ISK when compared with nonvolvulus intestinal obstructions (7.5 vs. 2.0% and 10.0 vs. 1.3%, respectively, p < 0.05, chi-squared test). In theoretical opinion, ingestion of high-bulk food and fluid after prolonged fasting may cause rapid transportation of intestinal content into small and large bowels and may force them into rotation or knotting.[4] [5] Although this theory needs additional evidence including prospective data analyses of large SV and ISK series, the rarity of both diseases makes it difficult at least for now or in the near future.

Authors' Contribution

All the authors contributed equally to the study.


Compliance with Ethical Principles

Ethical approval not required.




Publication History

Article published online:
29 August 2023

© 2023. The Libyan Biotechnology Research Center. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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