Does fasting during Ramadan have an impact on duodenal ulcer perforation ?

Abstract EN

Objective: Gastrointestinal disorders can be precipitated or exacerbated by prolonged fasting.

Gastric acid and pepsin levels, which increase during Ramadan fasting, present a potential risk of peptic ulcer complication.

Studies looking at the impact of Ramadan fasting on duodenal ulcer perforation were controversial.

The aim of this work was to evaluate the impact of fasting in Ramadan on duodenal ulcer perforation through studying perforated duodenal ulcer cases among three consecutive lunar months including Ramadan for eight years.

Methods: This descriptive retrospective study was conducted by evaluating file records of patients undergoing emergency surgery for managing perforated duodenal ulcer (PDU) during the months Shaban, Ramadan and Shawal annually for a period of eight years, from 2011 to 2018 in Al-Hillah Teaching General Hospital.

The characteristics of patients including, age, sex, fasting, smoking, use of steroids and non-steroidal anti-inflammatory drugs (NSAIDs), site of duodenal perforation were recorded.

Patients aged below 15 years and patients with gastric ulcer perforations were excluded.

Results: Eighty two patients were included in the study, 69 (84%) were males, and 13 (16%) were females.

The mean age was 34.66 years.

The peak of PDU was within the age group 21-30.

The cases were distributed among the lunar months Shaban, Ramadan and Shawal as 23 (28.04%), 39 (47.56%) and 20 (24.39%), respectively.

The fasting cases in all Ramadan months of the study years were 30 (77%) out of 39, while all PDU patients in Shaban and Shawal months (43 patients) were nonfasting.

Conclusions: There was a great increase in the incidence of PDU in Ramadan in comparison to both Shaban and Shawal.

Males were affected more than five times in comparison to females.

Anti-ulcer medications prescription during fasting to patients diagnosed with peptic ulcer, and to dyspeptic patients with positive H.

pylori infection is advisable.