When Fasting Hurts

As millions of Muslims all over the world observe fasting this Ramadan, some of us may need to pay extra care to our stomach. While a degree of discomfort may be experienced now and then, people with pre-existing gastritis or peptic ulcer disease (PUD) have to be careful, or else fasting can be a painful experience for them.

The acid in our tummy

Normally, the acid in our stomach has an important role: it creates the appropriate environment for digestion to take place. This is because enzymes such as proteases (which digest the protein in our food) work best in an acidic environment. The acidic environment of the stomach also kills many harmful germs present in the food and drink consumed.

For people with gastritis or PUD, fasting causes the level of acid in their stomach to rise. Increased levels of acid in an empty stomach would end up aggravating their condition – with painful consequences.

To understand why this is so, let us take a look at the nature of these stomach conditions. Gastritis occurs when the stomach lining experiences inflammation, erosion or irritation; in PUD, the 

stomach lining contains ulcers. Both gastritis and PUD are sometimes associated with dyspepsia (indigestion), a symptom in which the person experiences abdominal pain, heartburn, bloating and nausea.

Signs to watch out for

• Heartburn
• Persistent nausea
• Vomiting, especially if blood is present
• Black tarry stool
• Severe pain in the abdomen area
• Unusual changes in weight and appetite

There are medications called antacids that can provide relief for stomach problems associated with high levels of acid. Typical antacids may contain active ingredients such as aluminium hydroxide, magnesium hydroxide and simethicone, and they can be used to address the symptoms experienced during the fasting month. More severe symptoms may require a physician’s attention. Consult your doctor for more information.

Fasting tips for the tender stomach

To reduce complications while fasting, try the following:

• Discuss with your doctor your fasting plans, and stock up on the necessary medications. If you have concerns about taking the proper amount of medication during this period, ask your doctor for advice.
• Stop fasting and seek medical attention when you experience severe or prolonged symptoms of complications.
• Have a healthy pre-dawn breakfast during sahur. Many people opt to return to sleep after sahur, a practice which can cause acid reflux.   
• Watch your portion sizes when you break your fast, as overeating may trigger dyspepsia and acid reflux. Instead of eating a large meal in one go, you should eat smaller portions more frequently. Begin with dates and something light, then rest and perform your Maghrib prayers, before having your main meal prior to Tarawih.
• Smoking can aggravate your condition, so use this opportunity to quit the habit.
• Stop eating 3-4 hours before bedtime (this means cutting down on post-Tarawih snacks!). This gives your digestive system enough time to rest.
• Eat less spicy and acidic meals during this period. Also, cut down on coffee and sugary drinks. Drink at least 8 glasses of water daily.

Break your fast gently

Note:

1. Limit your intake of processed foods containing preservatives and other chemicals, as they may irritate your stomach.
2. A glass of fresh milk during sahur can help soothe your gastritis and peptic ulcer disease.
3. Watch out for signs of complications during noon, as this is the time when your stomach acid level is at the highest!

References:

Smith, JL. (2003). The role of gastric acid in preventing foodborne disease and how bacteria overcome acid conditions. J Food Prot. Jul;66(7):1292-303.

WebMD. Available at www.webmd.com

If you like this article, do subscribe here.