CC BY-NC-ND 4.0 · Avicenna J Med 2017; 07(03): 81-87
DOI: 10.4103/ajm.AJM_76_17
REVIEW ARTICLE

Muslim patients in Ramadan: A review for primary care physicians

Heba Abolaban
Massachusetts Department of Public Health, Care Coordination Program, Boston, MA, USA
,
Ahmad Al Moujahed
Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
› Author Affiliations
Financial support and sponsorship Nil.

Abstract

Fasting Ramadan, in which Muslims abstain from specific habits and behaviors from dawn to sunset, is one of the five Pillars of Islam. While there are several exemptions from fasting, many Muslim patients with acute or chronic medical conditions still choose to fast, which may adversely affect their health if not addressed properly. Some patients may not be well educated about the effects of some medical treatments and procedures on the validity of their fast, which can unnecessarily lead to suboptimal management of their conditions or treatment nonadherence. Since spirituality, religiosity, and personal beliefs affect patients' health behaviors and adherence to treatments, health-care providers need to learn how fasting Ramadan can affect the health of their Muslim patients, especially those with chronic medical conditions, and how to help them achieve safe fasting. This article aims to provide an overview of the main topics that primary care physicians may need to know in order to improve their cultural competence when caring for their fasting Muslim patients.



Publication History

Article published online:
09 August 2021

© 2017. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Chamsi-Pasha M, Chamsi-Pasha H. The cardiac patient in Ramadan. Avicenna J Med 2016;6:33-8. [This article provides a comprehensive review about caring for patients with cardiovascular diseases in Ramadan].
  • 2 Hassanein M, Al-Arouj M, Hamdy O, Bebakar WM, Jabbar A, Al-Madani A, et al. Diabetes and Ramadan: Practical guidelines. Diabetes Res Clin Pract 2017;126:303-16. [This article is an excellent and comprehensive reference about caring for patients with diabetes in Ramadan].
  • 3 Pew Research Center. Muslims and Islam: Key Findings in the U.S. and Around the World. Available from: http://www.pewresearch.org/fact-tank/2017/02/27/muslims-and-islam-key-findings-in-the-u-s-and-around-the-world/. [Last retrieved on 2017 Apr 18].
  • 4 Abdullah YA, translator. The Qur'an. Ch. 2, Ver. 187. New York: Tahrike Tarsile Qur'an Inc.; 2003.
  • 5 Khalife T, Pettit JM, Weiss BD. Caring for Muslim patients who fast during Ramadan. Am Fam Physician 2015;91:641-2.
  • 6 Bahammam AS, Almushailhi K, Pandi-Perumal SR, Sharif MM. Intermittent fasting during Ramadan: Does it affect sleep? J Sleep Res 2014;23:35-43.
  • 7 Turin TC, Ahmed S, Shommu NS, Afzal AR, Al Mamun M, Qasqas M, et al. Ramadan fasting is not usually associated with the risk of cardiovascular events: A systematic review and meta-analysis. J Family Community Med 2016;23:73-81.
  • 8 Qasrawi SO, Pandi-Perumal SR, BaHammam AS. The effect of intermittent fasting during Ramadan on sleep, sleepiness, cognitive function, and circadian rhythm. Sleep Breath 2017 [Epub ahead of print].
  • 9 Alvarez JS, Goldraich LA, Nunes AH, Zandavalli MC, Zandavalli RB, Belli KC, et al. Association between spirituality and adherence to management in outpatients with heart failure. Arq Bras Cardiol 2016;106:491-501.
  • 10 Kretchy I, Owusu-Daaku F, Danquah S. Spiritual and religious beliefs: Do they matter in the medication adherence behaviour of hypertensive patients? Biopsychosoc Med 2013;7:15.
  • 11 Parsons SK, Cruise PL, Davenport WM, Jones V. Religious beliefs, practices and treatment adherence among individuals with HIV in the Southern United States. AIDS Patient Care STDS 2006;20:97-111.
  • 12 Cruz JP, Colet PC, Alquwez N, Inocian EP, Al-Otaibi RS, Islam SM. Influence of religiosity and spiritual coping on health-related quality of life in Saudi haemodialysis patients. Hemodial Int 2017;21:125-32.
  • 13 Ahmedani MY, Hashmi BZ, Ulhaque MS. Ramadan and diabetes – Knowledge, attitude and practices of general practitioners; a cross-sectional study. Pak J Med Sci 2016;32:846-50.
  • 14 Mughal F. Ramadan: What it means for general practice. Br J Gen Pract 2014;64:356.
  • 15 Bragazzi NL, Briki W, Khabbache H, Rammouz I, Mnadla S, Demaj T, et al. Ramadan fasting and infectious diseases: A systematic review. J Infect Dev Ctries 2015;9:1186-94. [This article provides a review of literature in regards to caring for fasting patients with different infectious diseases, including HIV, eye infections and others].
  • 16 Rouhani MH, Azadbakht L. Is Ramadan fasting related to health outcomes? A review on the related evidence. J Res Med Sci 2014;19:987-92.
  • 17 Abdullah YA, translator. The Qur'an. Ch. 2, Ver. 183. New York: Tahrike Tarsile Qur'an Inc.; 2003.
  • 18 Kul S, Savas E, Öztürk ZA, Karadag G. Does Ramadan fasting alter body weight and blood lipids and fasting blood glucose in a healthy population? A meta-analysis. J Relig Health 2014;53:929-42.
  • 19 Meo SA, Hassan A. Physiological changes during fasting in Ramadan. J Pak Med Assoc 2015;65 5 Suppl 1:S6-14.
  • 20 Aveyard P, Begh R, Sheikh A, Amos A. Promoting smoking cessation through smoking reduction during Ramadan. Addiction 2011;106:1379-80.
  • 21 Al-Munajjid SM. Ruling on Fasting for Pregnant Women and Breastfeeding Mothers. Available from: http://www.islam-qa.com/. [Last accessed on 2017 Apr 17].
  • 22 Abdullah YA, translator. The Qur'an. Ch. 2, Ver. 185. New York: Tahrike Tarsile Qur'an Inc.; 2003.
  • 23 Al-Munajjid SM. Reasons for Which One May Excused from Fasting in Ramadan. Available from: http://www.islam-qa.com/. [Last accessed on 2017 Apr 17].
  • 24 Al-Munajjid SM. Minimum Distance of Travel at Which it is Permissible Not to Fast and to Shorten Prayers. Available from: http://www.islam-qa.com/. [Last accessed on 2017 Apr 17].
  • 25 Kumar N, Jivan S. Ramadan and eyedrops: The Muslim perspective. Ophthalmology 2007;114:2356-60.
  • 26 Al-Munajjid SM. Things that Invalidate the Fast. Available from: http://www.islam-qa.com/. [Last accessed on 2017 Apr 17].
  • 27 Al-Munajjid SM. If a Person Cannot Help Vomiting then Some of the Vomit Goes Back into His Stomach Unintentionally, that Does Not Invalidate His Fast. Available from: http://www.islam-qa.com/. [Last accessed on 2017 Apr 17].
  • 28 Al-Munajjid SM. He Needs to Have an Injection into a Vein – Will that Affect His Fast? Available from: http://www.islam-qa.com/. [Last accessed on 2017 Apr 17].
  • 29 Al-Munajjid SM. Effect of Medicines and Medical Treatments on Fasting. Available from: http://www.islam-qa.com/. [Last accessed on 2017 Apr 17].
  • 30 Queensland Health and Islamic Council of Queensland. Health Care Physicians' Handbook on Muslim Patients. 2nd ed. Brisbane: Division of the Chief Health Officer, Queensland Health; 2010.
  • 31 Al-Munajjid SM. Using Suppositories Does Not Invalidate the Fast. Available from: http://www.islam-qa.com/. [Last accessed on 2017 Apr 17].
  • 32 Al-Munajjid SM. Does Having an Enema Break the Fast? Available from: http://www.islam-qa.com/. [Last accessed on 2017 Apr 17].
  • 33 Al-Munajjid SM. Ruling on Nicotine Patches. Available from: http://www.islam-qa.com/. [Last accessed on 2017 Apr 17].
  • 34 Al-Munajjid SM. Types of Asthma Medication and the Ruling on Taking Them during the Day in Ramadan. Available from: http://www.islam-qa.com/. [Last accessed on 2017 Apr 17].
  • 35 Al-Munajjid SM. Insulin Injections Taken by a Diabetic Do Not Invalidate the Fast. Available from: http://www.islam-qa.com/. [Last accessed on 2017 Apr 17].
  • 36 Al-Munajjid SM. Definition of the Blood Which Invalidates the Fast. Available from: http://www.islam-qa.com/. [Last accessed on 2017 Apr 17].
  • 37 Al-Munajjid SM. Having a Blood Sample Taken for Testing Does Not Invalidate the Fast. Available from: http://www.islam-qa.com/. [Last accessed on 2017 Apr 17].
  • 38 Almalki MH, Alshahrani F. Options for controlling type 2 diabetes during Ramadan. Front Endocrinol (Lausanne) 2016;7:32.
  • 39 Sheikh A, Wallia S. Ramadan fasting and diabetes. BMJ 2007;335:613-4.
  • 40 Sadeghirad B, Motaghipisheh S, Kolahdooz F, Zahedi MJ, Haghdoost AA. Islamic fasting and weight loss: A systematic review and meta-analysis. Public Health Nutr 2014;17:396-406.
  • 41 Saedeghi H, Omar-Fauzee MS, Jahromi MK, Abdullah MN, Rosli MH. The effects of Ramadan fasting on the body fat percent among adults. Ann Biol Res. 2012;3:3958-61.
  • 42 Fahrial Syam A, Suryani Sobur C, Abdullah M, Makmun D. Ramadan fasting decreases body fat but not protein mass. Int J Endocrinol Metab 2016;14:e29687.
  • 43 Almansour HA, Chaar B, Saini B. Fasting, diabetes, and optimizing health outcomes for Ramadan observers: A literature review. Diabetes Ther 2017;8:227-49.
  • 44 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;27:2306-11.
  • 45 Beshyah SA, Fathalla W, Saleh A, Al Kaddour A, Noshi M, Al Hateethi H, et al. Ramadan fasting and the medical patient: An overview for clinicians. Ibnosina J Med Biomed Sci 2010;2:240-57.
  • 46 Hypertension during Ramadan and Hajj. Guidelines for Management of Hypertension in Primary care Settings and Outpatient Clinics in the Kingdom of Bahrain. Bahrain: Ministry of Health, Health Promotion Council; 2008. p. 35-6.
  • 47 Saudi Hypertension Management Group. Saudi Hypertension Management Guidelines, 2007: Executive Summary/Saudi Arabia. Riyadh: Saudi Hypertension Management Group; 2007. p. 26-7.
  • 48 Skaik Y, Chamsi-Pasha H. The effects of fasting in Muslim patients taking warfarin: Comment. J Thromb Haemost 2014;12:807-8.
  • 49 Saour JN, Sieck J, Khan M, Mammo L. Does Ramadan fasting complicate anticoagulation therapy? Ann Saudi Med 1989;9:538-40.
  • 50 Slim I, Ach K, Chaieb L. Lipid management in Ramadan. J Pak Med Assoc 2015;65 5 Suppl 1:S57-61.
  • 51 Abbas Z. Gastrointestinal health in Ramadan with special reference to diabetes. J Pak Med Assoc 2015;65 5 Suppl 1:S68-71.
  • 52 Bragazzi NL. Ramadan fasting and chronic kidney disease: A systematic review. J Res Med Sci 2014;19:665-76.
  • 53 Emami-Naini A, Roomizadeh P, Baradaran A, Abedini A, Abtahi M. Ramadan fasting and patients with renal diseases: A mini review of the literature. J Res Med Sci 2013;18:711-6.
  • 54 Abdolreza N, Omalbanin A, Mahdieh TS, Mohammad Ali MR, Reza MS, Maryam S, et al. Comparison of the number of patients admitted with renal colic during various stages of peri-Ramadan month. Saudi J Kidney Dis Transpl 2011;22:1199-202.
  • 55 al-Hadramy MS. Seasonal variations of urinary stone colic in Arabia. J Pak Med Assoc 1997;47:281-4.
  • 56 Basiri A, Moghaddam SM, Khoddam R, Nejad ST, Hakimi A. Monthly variations of urinary stone colic in Iran and its relationship to the fasting month of Ramadan. J Pak Med Assoc 2004;54:6-8.
  • 57 Miladipour AH, Shakhssalim N, Parvin M, Azadvari M. Effect of Ramadan fasting on urinary risk factors for calculus formation. Iran J Kidney Dis 2012;6:33-8.
  • 58 Qurashi S, Tamimi A, Jaradat M, Al Sayyari A. Effect of fasting for Ramadan on kidney graft function during the hottest month of the year (August) in Riyadh, Saudi Arabia. Exp Clin Transplant 2012;10:551-3.
  • 59 Boobes Y, Bernieh B, Al Hakim MR. Fasting Ramadan in kidney transplant patients is safe. Saudi J Kidney Dis Transpl 2009;20:198-200.
  • 60 Ghalib M, Qureshi J, Tamim H, Ghamdi G, Flaiw A, Hejaili F, et al. Does repeated Ramadan fasting adversely affect kidney function in renal transplant patients? Transplantation 2008;85:141-4.