Ramzan for Patients with Chronic Liver Disease

Abstract

With the holy month of Ramzan fast approaching us, Muslim’s from all around the world would be engaged in various religious activities including fasting. Ramzan is the 9th month of the Islamic calendar and during which fasting is obligatory for all muslims. During a fast a Muslim not only abstains themselves from food and water but also from smoking and oral medications [1]. A typical fast last around 12-18 hours [2] At present the impact of fasting on patients with chronic liver disease regardless of its etiologic is scarce. Here we wish to highlight the effects of fasting in the month of ramzan and the precautionary measures that need to be taken in this month in patients diagnosed with chronic liver disease (regardless of its etiology). Cirrhotics are particularly at risk of protein energy malnutrition (PEM), upper gastrointestinal bleed, worsening of their liver functions along with encephalopathy and discontinuation of their medications during fasting [3]. Along with this, fasting in the tropics or during the summer season may place these patients at risk of renal dysfunction [3]. Generally, it is recommended that patients having Child Pugh score C (CPS) cirrhosis should avoid fasting [3].