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Preparing to fast with a chronic illness

by Luqmaan Rawat
With Ramadaan approaching, preparation have began for the fasting month Photo Hospitalsmagazine

South Africa – Fasting from dawn until dusk can be challenging for those who have a chronic illness or take certain tablets. While everyone would love to fast during Ramadaan, those with chronic illnesses should take special care during this blessed month.

For a person who cannot manage to fast due to sickness, they are exempt from fasting. Dr Fatima Peer, general practitioner, explained one should be aware of their symptoms and know what their body can handle.

“Be honest with yourself. Once you have decided that you are indeed able to fast, think about whether you’ll need an occasional day off or you’ll manage the month, and what symptoms would guide you for this. Decide these things before Ramadaan so that you make a fair decision while you are mentally in a good space. And finally it’s the little things like timing medications, preparing appropriate foods and drinks. Remember to factor in the current weather with your illness too. Take ownership of your dietary requirements and make it part of your routine with the intention that it is for the pleasure of Allah (SWT).”

In the Indian community there are many who have diabetes and/or hypertension (high blood pressure). For them, it is all about managing the food they eat and not avoiding their medication, said Peer.

“They must not skip their medication or tamper with their doses. Those with diabetes should consume low GI foods, which they should be doing on a regular day. Avoid sugary items and especially foods with a lot of salt for those who have hypertension.”

Those who have hypertension should also monitor their blood pressure regularly. Try to get your blood pressure under control before you try fasting. It is also advisable to stay away from high-fat food during this month.


Fasting for those who have heart problems

Fasting during the month of Ramadaan for those who have heart problems is generally quite safe. However, they still have to keep an eye on their diet. Those who take Diuretics, sometimes water pills, should try their best to take the two tablets as far apart as they can before Ramadaan starts, explained Dr Fathima Osman, general practitioner.

“Ramadan fasting is safe for most patients with chronic heart failure and reduced ejection fraction. My advice to patients is to adhere to fluid and salt restrictions, and do not omit any doses of drugs. For drugs with two daily doses, take them with as wide a gap as possible during non-fasting hours.”

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Fasting for those who have ulcers

When it comes to fasting for those who have an ulcer, it is important to know what kind of ulcer they have. Peptic ulcers are open sores on the mucus lining of the stomach or upper intestine. If you have a peptic ulcer, your ability to fast can be compromised, explained Osman.

“The question of whether or not fasting should be recommended to peptic ulcer disease patients is difficult because the physiological changes during Ramadan are not precisely known. Perforation of an ulcer is one of the most serious complications of peptic ulcer disease and has a great potential risk of morbidity and even lethality. Prolonged fasting has been shown to affect many things including metabolic profiles, weight, kidney function, blood pressure, and diabetes mellitus control. Thus, it can easily be expected that the duration has an effect on the rates of perforation. In conclusion, a significant difference was found in the frequency of PUP during Ramadan, especially when the period of fasting was longer than 12 hours. On the other hand, it seems safe for other individuals.”

It is extremely important to not skip any meals. Eating slow carbohydrates will keep you energised throughout the day. If one isn’t hungry, a glass of milk, a few almonds and dates are advised. 

Ramadaan is a time to get closer to Allah (SWT). To gain His (SWT) mercy and forgiveness. Even if one cannot abstain from food and drink, they must still fast with their eyes, hands, feet, tongue and ears. If one prepares properly, they can still reap the full benefits of Ramadaan even if they have a chronic illness. Preparation and understanding your body is key to having a successful Ramadaan.

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