Effects of Ramadan fasting on acute upper gastrointestinal bleeding due to peptic ulcer

MH Emami, H Rahimi


BACKGROUND: As, acid negatively affects duodenal and gastric mucosal defense, we designed this study to investigate if fasting during Ramadan can promote peptic ulcer and its complication, acute upper gastrointestinal bleeding.
METHODS: All patients files who had admitted to hospital with acute upper gastrointestinal bleeding from 10th day of Ramadan till one month later, in 2002 to 2004 were reviewed. Patients were divided into two groups: fasting group who were fasting, at least 10 days before admission and non-fasting group.
RESULTS: A total of 236 patients were included in the study; fasting group involved 108 subjects and non-fasting group 128 ones. Both groups were matched regarding sex, predisposing factors and underlying diseases. Fasting group showed more frequent duodenal ulcer (38%) compared to non-fasting group (19.5%) (P = 0.002). The frequency of esophageal varices was significantly higher in non-fasting group. There was no correlation between fasting and other causes of gastrointestinal bleeding. In fasting group 38%, and in non-fasting group 18.9%, had previous dyspeptic symptoms (P = 0.001). Two groups were similar regarding prognostic factors.
CONCLUSION: It seems Ramadan fasting can increase acute upper gastrointestinal bleeding due to duodenal ulcer, but it does not make its prognosis poorer than that in non-fasting patients. Dyspeptic symptoms could be considered as alarming signs for patients who want to fast during Ramadan.
KEYWORDS: Ramadan, fasting, acute upper gastrointestinal bleeding, duodenal ulcer.

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