- How to handle specific fasting-related medical emergencies.
While fasting for over 12 hours during the Holy month of Ramadan is one of the finest examples of intermittent fasting with remarkable health benefits, induced by abstinence and detoxing, for believers, if done without the right precautions, it can trigger a health emergency that might land you in the intensive care unit of a hospital.
Dr. Adel Al Sisi
Group Chief Medical Officer & Consultant
Prime Healthcare Group, Ambassador of World
Federation of Intensive & Critical Care
Describing the health emergencies, Dr Adil Al Sisi, Group Chief Medical Officer & Consultant, Prime Healthcare Group, told HEALTH, “It is a well-known fact that most hospital Emergency Departments experience a surge of cases during the early days of Ramadan. That is because people do not take the precaution to hydrate themselves well initially and ingest the right kind of nutrition during Suhoor to keep them on high energy and have the right electrolyte balance.
“Emergencies range from basic ones such as dehydration and disorientation due to electrolyte imbalance and gastrointestinal problems can occur, often triggered by long fasting hours followed by sudden overloading of the body with rich food items. During the day, people may also suffer from migraines, which can be triggered by caffeine withdrawal. Patients suffering from kidney disease or diabetes could also experience health complications such as potassium overload, hyperglycaemia, or hypoglycaemia (high or low blood sugar).
“It is important to educate patients, especially those with co-morbidities such as heart diseases, Type II diabetes, chronic kidney disease (CKD), hypertension and the like, so that they are pre-warned and know when to reach the hospital and seek medical intervention in case of such a situation,” added Dr Alsisi.
Common Emergencies & Issues
Dehydration: Especially in hot climates, leading to headaches, fatigue, and renal colic (kidney stones).
Gastrointestinal Problems: Acid reflux, indigestion, and gastritis from overeating heavy, fried foods after sunset.
Headaches/Migraines: Often due to caffeine withdrawal in the first few days.
Diabetes Complications: Hypoglycemia or hyperglycemia from altered eating and medication schedules.
Cardiovascular issues: Patients with heart disease can get stressed with changes in sleep patterns and eating schedules, which can also affect medication timing. This could trigger episodes of breathlessness, palpitations, or chest pain.
Medication Issues: Patients may stop essential drugs (like those for hypertension, diabetes, or cholesterol) without medical advice, risking serious health events. We often find that patients with respiratory issues such as asthma tend not to use inhalers while fasting and are liable to go into breathing or respiratory distress.
Dr. Alsisi pointed out that patients who are vulnerable to such triggers must not fast. “Islam permits people who are ill with chronic conditions to abstain from fasting, lest it makes them seriously ill. Even if one is fasting, it is always advisable to consult your doctor before Ramadan, take advice on adjustment of medication and doses. I will advise a patient to fast under advisement and keep all medical reports and medicine schedules ready. In case of any feeling of discomfort, it is better not to second guess and reach the hospital emergency and be under the supervision of doctors. Carry your medicine schedule, copies of tests and reports so that action can be immediate,” he said.
Dr. Alsisi added that their emergency room is equipped with facilities to immediately stabilize patients. “We check if the patient requires oxygen, anaphylactic care, insulin to reduce high blood sugar levels, or glucose drips to correct low blood sugar, or any other procedure. The patient is provided with immediate help and, if required, kept under observation in the ICU.”
Dos and Don’ts for Chronic Patients Fasting During Ramadan
DO
Take your medication as directed by your consulting doctor. Pills taken during fasting hours break the fast, but emergency or IV medications are permitted for the ill.
Hydrate well. Drink plenty of water and eat water-rich foods between Iftar (breaking the fast) and Suhoor (pre-dawn meal).
Eat balanced meals: Avoid excessive sweets, fried foods, and caffeine. Focus on complex carbs, fiber, proteins, fruits, and vegetables. Overeating the wrong foods during Iftar can cause sudden sugar spikes or indigestion.
Consult a doctor: Adjust medication schedules with a healthcare provider before Ramadan starts.
DON’T
Self-medicate: If you feel unwell during Ramadan, it is advisable to reach an emergency room, especially if you have a history of chronic conditions.
Alter your medication schedule on your own: Always readjust timing and dosage for Iftar and Suhoor under medical guidance.
Overeat: Choose your nutrition wisely during Suhoor, focusing on carbohydrate-dense and high-fiber foods, along with fruits and vegetables that have high water content.
Eat excessive oily and processed foods: These can trigger high blood sugar, cause indigestion, or gastrointestinal issues. Avoid too much protein or potassium-rich foods if you suffer from CKD.
