It is critical to identify individuals who are unable to fast safely and advise them accordingly
Ramadan is the largest Muslim celebration, involving a month of fasting, worship, and abstinence to improve one’s spiritual and physical well-being and strengthen one’s relationship with God.
Studies have shown that fasting impacts the body and mind. It has the potential to improve one’s health if done correctly. On the other hand, if done incorrectly, it can harm one’s health, particularly in patients’ health and disease management.
“In Islam, there are several categories of people who are not required to fast. People who are exempted in the context of healthcare are those who are unable to fast due to their medical condition,” explained pharmacist Fahmi Hassan.
He is currently pursuing his PhD in the field of Social Pharmacy.
He previously held the position of Senior Assistant Director of Pharmaceutical Services Programme under the Ministry of Health (MoH).
Fasting can be very personal and an essential for some patients. As a result, they may choose to disregard medical advice and fast. Healthcare providers must be aware of these circumstances and respond appropriately.”
Responsibility of healthcare professionals
Despite being exempt from fasting, many Muslim patients with acute or chronic medical conditions strongly desire to participate. They will choose to fast, which could harm their health if not adequately addressed.
“Some people may not even tell their doctors about their condition because they are afraid it will prevent them from fasting.
Not taking medications as prescribed during Ramadan is also an issue, which can aggravate their health conditions, as they fear invalidating their fasting.
As such, healthcare professionals, doctors, and pharmacists play an essential role in assisting Muslim patients with acute or chronic medical conditions to fast safely during Ramadan by addressing required medicine management and lifestyle changes to avoid potential fasting hazards.
To have an informed discussion with their Muslim patients, both Muslim and non-Muslim healthcare professionals must be aware of the types of medication, conditions, and procedures that may or may not invalidate fasting.
Patients can achieve successful health outcomes and safe fasting with careful support, advice, and shared decision-making about treatment plans.
Another important aspect is to inform and educate patients about the warning signs and symptoms of worsening conditions, what to do if they occur, and when to seek medical help.
“This is something that is frequently overlooked during consultations,” Fahmi explained.
It is also critical for doctors and pharmacists to identify individuals who are unable to fast safely and advise them accordingly.
“A recommendation of not fasting should come from healthcare professionals, and they should also know how to interact with the patient if they are not fit to fast. Help them understand risks and danger if they observe the fast.”
Health monitoring and medication management
Fasting is usually exempt for chronic illnesses like diabetes and gastric ulcers. However, if they insist on fasting, they must be examined and ensure that their condition is appropriately managed and monitored by their doctors.
According to Fahmi, these patients should take extra care of their health and consult GPs or pharmacists before fasting.
“It is best to take care of your health a month or two before Ramadan. Start taking your medication regularly to control your blood pressure, diabetes, blood glucose and other health conditions. It is so that you don’t experience any adverse side effects during fasting.
“The goal of fasting is not to make you suffer; you should not be sick during fasting, and it should not affect your health badly.”
Based on his experience working in the pharmacy department, Fahmi shared that fasting mainly affects those with diabetes mellitus because of their inability to regulate blood sugar properly.
“Patients must make an effort to visit and consult a doctor or pharmacist before fasting starts,” stressed Fahmi.
As there are various chronic diseases and different levels of severity, an individualised approach is needed in treating and managing fasting Muslim patients during Ramadan.
While some medication dosages or frequency can accommodate the general fasting routine, this is not possible with most medications.
“So, it is crucial for medication management recommendations to be tailored to each patient’s health condition.
“Healthcare professionals should be aware of whether or not medications can be adjusted and how to adjust the timing or dosage.”
Practice a healthy and balanced diet
“Do not overlook the importance of eating a healthy diet while fasting,” Fahmi cautioned.
Each day of Ramadan begins with sahur, a pre-dawn meal that includes enough food and water to keep a person going through a long day of fasting.
Families break the fast together at sunset with an evening meal known as Iftar, usually high in calories and served with plenty of fluids.
“However, people often neglect their healthy diet when fasting. They tend to eat anything at night because they haven’t eaten in 12 hours.
“It is essential for people who are fasting, regardless of whether they have a health condition or not, to take care of their diet,” said Fahmi.
Maintaining a well-balanced, healthy diet high in fibre and low in salt and glycemic index is highly recommended.
“Make sure you have enough carbohydrates, protein, and fibre in your meal plan. Also, limit your food intake at night.
“To correctly manage your condition, eat several small meals rather than one large meal.
“People tend to experience stomach discomfort, such as gastric stomach pain if they don’t follow a proper diet plan,” he added. — The Health