Ramadan fasting and digestive disorders: SEPAHAN systematic review No. 7

BACKGROUND: During Ramadan, the 9 month in the Hijri lunar calendar, healthy adult Muslims are obliged to fast from sunrise to sunset. The fast of Ramadan has significant health effects and is the most commonly researched religious fasting. In this study, we will investigate available findings on the effects of Ramadan fasting on gastrointestinal (GI) signs, symptoms, and diseases. METHODS: We searched PubMed, Google Scholar, Iran Medex, and Scientific Information Database (SID) for related articles in English or Farsi. Editorial articles and case reports were excluded. RESULTS: Of 2312 articles found, 23 articles fulfilled our inclusion criteria and were included. Ramadan fasting seems to increase peptic ulcer complications (peptic ulcer perforation and bleeding) and have a deteriorating effect on patients with chronic peptic ulcer diseases on drug therapy, but not on duodenal ulcer patients under treatment. Healthy individuals might experience minor GI symptoms but no serious complications have been reported. Studies regarding the incidence of acute appendicitis and peptic ulcer diseases are not in agreement, but acute mesenteric ischemia, hyperemesis gravidarum and primary small bowel volvulus seem to be increased during Ramadan. No increase in idiopathic intussusception is observed during Ramadan and fasting does not appear to impose serious risks on patients with an inflammatory bowel. CONCLUSIONS: Fasting is generally safe for healthy individuals, but might be hazardous to patients with various GI diseases and may increase the risk of complications in this group.