1Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2Golestan University of Medical Sciences, Department of Nutrition, Gorgan, Iran
Introduction: Ramadan is the ninth month of Muslim's calendar during which Muslims fast. Ramadan lasts 29-30 days based on the visual sightings of the crescent moon. Fasting during Ramadan has significant health effects. The present study aimed at reviewing the literature of the impact of Ramadan fasting on upper gastrointestinal disorders. Methods: MEDLINE and Google Scholar were searched by using ((“Ramadan” R fasting”) AND( "Upper Gastrointestinal Tract" OR "Gastrointestinal Diseases" OR "Dyspepsia" OR "Gastroesophageal Reflux" OR "Peptic Ulcer" OR "Gastrointestinal Hemorrhage")) as keywords in the title and abstract. Relevant, non- duplicate full articles written in English were reviewed. Results: Gastric acid and pepsin secretion increase during Ramadan fasting, probably associated with dyspeptic symptoms. Regarding peptic ulcer frequency, results are inconsistent. However, peptic ulcer complications such as gastrointestinal bleeding and peptic ulcer perforation increase during Ramadan fasting. Conclusion: Fasting during Ramadan seems to be beneficial for healthy individuals, but in people with gastrointestinal disorders, it might be harmful as it increases the risk of complications. Therefore, taking medical advice before Ramadan fasting is highly recommended to people suffering from gastrointestinal symptoms.
Miller T. Mapping the global Muslim population: a report on the size and distribution of the world’s Muslim population. Washington, DC: Pew Research Center; 2009.
Leiper J, Molla AM. Effects on health of fluid restriction during fasting in Ramadan. Eur J Clin Nutr. 2003; 57(Suppl 2):S30-8.
Göçmen E, Koç M, Tez M, Yoldaş Ö, Bilgin A, Keşkek M. Effect of Ramadan on surgical emergencies. Ann Emerg Med. 2004; 44(3):283-5.
Azizi F. Islamic fasting and health. Ann Nutr Metab. 2010; 56(4):273-82.
Barkia A, Mohamed K, Smaoui M, Zouari N, Hammami M, Nasri M. Change of diet, plasma lipids, lipoproteins, and fatty acids during Ramadan: a controversial association of the considered Ramadan model with atherosclerosis risk. J Health Popul Nutr. 2011; 29(5):486-93.
Gharbi M, Akrout M, Zouari B. Food intake during and outside Ramadan. East Mediterr Health J. 2003; 9(1-2):131-40.
Roky R, Chapotot F, Hakkou F, Benchekroun MT, Buguet A. Sleep during Ramadan intermittent fasting. J Sleep Res. 2001; 10(4):319-27.
Trepanowski JF, Canale RE, Marshall KE, Kabir MM, Bloomer RJ. Impact of caloric and dietary restriction regimens on markers of health and longevity in humans and animals: a summary of available findings. Nutr J. 2011; 10(1):107.
Larijani B, Zahedi F, Sanjari M, Amini MR, Jalili RB, Adibi H, et al. The effect of Ramadan fasting on fasting serum glucose in healthy adults. Med J Malaysia. 2003; 58(5):678-80.
Salti I, Bénard E, Detournay B, Bianchi-Biscay M, Le Brigand C, Voinet C, et al. A population-based study of diabetes and its characteristics during the fasting month of Ramadan in 13 countries results of the epidemiology of diabetes and Ramadan 1422/2001 (EPIDIAR) study. Diabetes Care. 2004; 27(10):2306-11.
Ural E, Kozdag G, Kilic T, Ural D, Şahin T, Celebi O, et al. The effect of Ramadan fasting on ambulatory blood pressure in hypertensive patients using combination drug therapy. J Hum Hypertens. 2008; 22(3):208-10.
Balaban RS, Nemoto S, Finkel T. Mitochondria, oxidants, and aging. Cell. 2005; 120(4):483-95.
Talley NJ, Phung N, Kalantar JS. ABC of the upper gastrointestingal tract: Indigestion: When is it functional? BMJ. 2001; 323(7324):1294-7.
Amini E, Keshteli AH, Jazi MS, Jahangiri P, Adibi P. Dyspepsia in Iran: SEPAHAN Systematic Review No. 3. Int J Prev Med. 2012; 3(Suppl 1):S18-25.
Keshteli AH, Sadeghpour S, Feizi A, Boyce P, Adibi P. Evaluation of self-perceived changes in gastroin-testinal symptoms during Ramadan fasting. J Relig Health. 2015; 24:1-8.
Torab FC, Amer M, Abu-Zidan FM, Branicki FJ. Perforated peptic ulcer: different ethnic, climatic and fasting risk factors for morbidity in Al-ain medical district, United Arab Emirates. Asian J Surg. 2009; 32(2):95-101.
Iraki L, Abkari A, Vallot T, Amrani N, Khlifa RH, Jellouli K, et al. Effect of Ramadan fasting on intragastric pH recorded during 24 hours in healthy subjects. Gastroenterol Clin Biol. 1997; 21(11):813-9.
Hakkou F, Tazi A, Iraqui L, Celice-Pingaud C, Vatier J. The observance of Ramadan and its repercussion on gastric secretion. Gastroenterol Clin Biol. 1993; 18(3):190-4.
Bener A, Derbala MF, Al-Kaabi S, Taryam LO, Al-Ameri MM, Al-Muraikhi NM, et al. Frequency of peptic ulcer disease during and after Ramadan in a United Arab Emirates hospital. East Mediterr Health J. 2006; 12(1-2):105-11.
Al-Kaabi S, Bener A, Butt MT, Taweel M, Samson S, Al-Mosalamani Y, et al. Effect of Ramadan fasting on peptic ulcer disease. Indian J Gastroenterol 2004; 23(1):35.
Gokakin AK, Kurt A, Akgol G, Karakus BC, Atabey M, Koyuncu A, et al. Effects of Ramadan fasting on peptic ulcer disease as diagnosed by upper gastrointestinal endoscopy. Arab J Gastroenterol. 2012; 13(4):180-3.
Hosseini-Asl K, Rafieian-Kopaei M. Can patients with active duodenal ulcer fast Ramadan? Am J Gastroenterol. 2002; 97(9):2471-2.
Dönderici O, Temizhan A, Küçükbaş T, Eskioglu E. Effect of Ramadan on peptic ulcer complications. Scand J Gastroenterol. 1994; 29(7):603-6.
Ozkan S, Durukan P, Akdur O, Vardar A, Torun E, Ikizceli I. Does Ramadan fasting increase acute upper gastrointestinal haemorrhage? J Int Med Rese. 2009; 37(6):1988-93.
Amine el M, Kaoutar S, Ihssane M, Adil I, Dafr-Allah B. Effect of Ramadan fasting on acute upper gastrointestinal bleeding. J Res Med Sci. 2013; 18(3):230-3.
Emami MH, Rahimi H. Effects of Ramadan fasting on acute upper gastrointestinal bleeding due to peptic ulcer. J Res Med Sci. 2006; 11(3):170-5.