Ramadan fasting and infectious diseases: a systematic review

Abstract

Ramadan represents the fourth of the five pillars of the Islamic creed. Although patients are exempted from observing this duty, they may be eager to share this moment of the year with their peers. However, there are no guidelines that can help physicians to address the concerns of patients with infectious diseases fasting during Ramadan. For this purpose, we performed a systematic review. of 51 articles. Our main findings are that: 1) patients suffering from diabetes at risk of developing infectious complications should not fast; 2) Ramadan fasting has little impact on diarrheal patients; 3) HIV represents a challenge, and ad hoc drug combinations should be recommended to patients, and the patients should be advised not to take fatty meals that could interfere with the treatment; 4) Ramadan has no effect on the effectiveness of anti-helminthic therapy; and 5) patients with active ulcers should not fast, as they have a higher probability of developing complications.

Muslim patients in Ramadan: A review for primary care physicians

“…[141516] The main purpose of fasting the holy month is to attain righteousness. [17] Some other benefits include strengthening the believers' relationship with their Creator (His name is Allah), having self-reflection and appreciation of Allah's blessings, remembering and helping the people in need, and learning self-control.…”

“…[1521222324] However, many exempt Muslim patients with chronic medical conditions (e.g., diabetes) may still choose to fast. They may discontinue their medications or alter treatment regimens to fast with/out consulting their primary care physicians (PCPs).…”

“…[43] Although most Muslim scholars and physicians recommend against fasting for patients with uncontrolled diabetes,[215] a large population-based study that included participants from 13 countries estimated that about 79% of Muslims with Type 2 diabetes would fast during Ramadan. [44] This suggests that management of fasting diabetic patients is an essential, but challenging, topic that PCPs need to know.…”

“…[15] On the other hand, patients with nonactive peptic ulcers can fast with using proton pump inhibitors, between iftar and suhoor, when needed. [15] Patients with stable inflammatory bowel disease or chronic hepatitis may also be able to fast without negative consequences on their health. [51]…”

Ramadan fasting during Covid-19 pandemic

“…[34] Moreover, in patients with diabetes, it is demonstrated that Ramadan Fasting can lead to an increased risk of infection. [35] Notwithstanding all aforementioned evidence in favor or against the practice of Ramadan Fasting in terms of infection risk, there is no conclusive evidence to acknowledge or refute increased susceptibility of fasting individuals to contracting Covid-19 infection. Similarly, no evidence has emerged indicating that drinking water during daytime can prevent corona virus infection in healthy individuals.…”