Managing Gastric Disorders And Peptic Ulcers Through Ramadan

Fasting in the month of Ramadan can improve a person’s health, but if the correct diet is not followed, one is prone to acquire some ailments related to the digestive health. Dyspeptic symptoms are frequently encountered during Ramadan including GERD, indigestion, bloating and heartburns, particularly after eating too much at lftar or Suhoor meals. Eating in moderation and elimination of foods that can trigger gastroesophageal reflux is helpful.

Gastrointestinal problems tend to be more common and severe in people with diabetes compared with the nondiabetic population. Therefore, extra vigilance is needed for the people with diabetes who are allowed to fast after consulting their physicians.

When people with peptic ulcers fast for long, the acids in the stomach can cause pain – this is a common issue with such cases. The condition is not fatal and can be managed with right medical support and care. A peptic ulcer is an open sore in the upper digestive tract. There are two types of peptic ulcers, a gastric ulcer, which forms in the lining of the stomach, and a duodenal ulcer, which forms in the upper part of the small intestine. Stomach ulcers occur when the thick layer of mucus that protects your stomach from digestive juices is damaged. This makes the digestive acids to eat away at the lining tissues of the stomach. The most common symptom is a burning sensation or pain in the area between your chest and belly button. Normally, the pain will be more intense when your stomach is empty and it can last for a few minutes or several hours. Other, less specific symptoms of stomach ulcers include bloating, burping, acid reflex, heartburn (burning sensation in the chest). The pain lessens when you eat or drink.

Some foods can make ulcers worse, while some provide a preventive and healing effect. Greasy and acidic foods are most likely to irritate your stomach, as are spicy foods. To reduce ulcer pain, avoid coffee, including decaffeinated coffee, carbonated beverages (soda), chilies and hot peppers, processed foods.

Adopt a moderate approach when breaking your fast, eat in smaller portions, but more frequently. For instance, start off with dates and light food before giving it a rest after Maghrib prayers, followed by the main meal prior to Taraweeh prayers. Do not sleep straight away after Suhoor as this can result in acid reflux. Drink lots of water to replenish the daily losses, which we unconsciously lose via breathing, sweating and going to the toilet.

For patients who are on long term medications, discuss with your doctor about any necessary changes, for example, splitting the dose to optimize the medication effect. Do not let fasting affect your compliance towards your medication.

Avoid

  • Fried, fatty and acid-containing foods and fruits (e.g. citrus fruits like lemons, limes, grapefruits and oranges) along with tomato-based products (tomato is technically a fruit containing a lot of acid).
  • Extra-spicy foods and tinned/processed foods, especially tomato-based products. Processed foods with a long-shelf life typically have a lot of chemicals, including preservatives, which could further exacerbate gastritis.
  • Foods containing too much sugar and refined carbohydrates.
  • Over-eating during breaking of fast and Suhoor and delaying breaking of fast.
  • Caffeine-containing drinks like tea, coffee, sodas, etc. These make you pass more urine, taking with it valuable mineral salts that your body would need during the long day of fasting.
  • Smoking is associated with gastritis and peptic ulcer disease. So, Ramadan is a brilliant opportunity to cut down on cigarettes. Smoking also slows the healing of existing ulcers and contributes to ulcer recurrence. Try and eliminate this habit.

Eating habits to consider

  • Carbohydrates or slow-digesting food at Suhoor so that the food lasts longer, making you less hungry as well as more energetic for the day.
  • Dates are an excellent source of sugar, fibre, carbohydrates, potassium and magnesium.
  • Almonds are rich in protein and fibre. Ground almonds and milk make a healthy drink.
  • Bananas are a good source of carbohydrates, potassium and magnesium.
  • Eat oven-grilled foods rather than fried and fatty foods.
  • Eat in moderation and in smaller quantities, and break the fast early.
  • Don’t forget to take your prescribed medications during the break of fast or Suhoor.
  • Drink water, non-acidic fruit juices and drinks containing potassium as much as possible between break of fast and bedtime so that your body may adjust fluid levels for the next day

Dr. Amal Premchandra Upadhyay 

Consultant Gastroenterologist & Hepatologist 

Aster Hospital, Mankhool 

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