DR. LEKHA KAWAL KAPOOR
Specialist 'A' ENT - Al Zahra Hospital Sharjah
Ramadan is the ninth month of the Hijri calendar and is considered as the holiest month of the year. In this month adult Muslims are required to fast from dawn until dusk every day. Those who are ill, elderly, diabetic, pregnant, menstruating or breastfeeding and children before puberty are not required to fast, although many still do out of choice.
This year Ramadan is predicted to start on the 6th of June, which includes the longest days of the year. With the searing and sweltering hot temperatures, the daily fasting period of about 15 hours will pose various health challenges and risks to the fasting people.
During the fasting hours the body is deprived of water and food. In the absence of carbohydrates the energy giving foods, the body relies on alternative source of fat for the provision of energy.
The common ENT related health problems seen in Ramadan would be the following:
1) Tiredness associated with dehydration:
Along with fasting, water and salts are lost further through breathing, perspiring and urinating.
Many clinical researches have shown increased incidence of dehydration during Ramadan especially during the summer months1. Children, elderly and the individuals with underlying diseases like Diabetes, hypertension etc is more likely to suffer from dehydration.
This dehydration can produce headaches, nausea, tiredness and malaise.
It can be avoided by drinking about 2-3 liters of water in the non-fasting hours. Also we need to avoid excess of caffeinated products like coffee, tea, cola, chocolate, etc. as these might increase the risk of dehydration.
Most commonly headaches are seen in Ramadan due to dehydration, inadequate sleep, poor rest, excessive hunger or deprivation of addictive substances like tobacco smoking or caffeinated drinks like coffee. Also there is a three times increased risk of getting Migraine related headaches during Ramadan2.
Eating a moderate and balanced diet and avoiding skipping breakfast meals in the morning could reduce the risk of headaches. Also drinking adequate liquids and in some individuals taking prescribed analgesics at Suhoor might help.
This could happen due to dehydration and related biochemical derangement in the body like high levels of hematocrit, serum protein, urea, creatinine, uric acid and electrolyte imbalance could lead to Dizziness3. This is more commonly seen in outdoor heavy work laborers due to the nature of their jobs. Also again children and elderly would be more prone to these.
To avoid dizziness we will need to rest adequately, avoid heavy work in the day hours and again eat and drink healthy during the non-fasting hours.
4) Sore Throat (pharyngitis):
There is an increased risk of sore throat (pharyngitis) during the month of Ramadan4. This has been largely related to excessive intake of fried and spicy foods during the iftar period. Also an excessive intake of carbonated drinks and caffeinated products increase your risk to gastro-esophageal reflux which in turn makes you prone to sore throat, coughing and related symptoms like heart burn, bloating etc.
We need to intelligently choose our iftar foods and need to avoid excessively spicy, fried foods and include more of nonacidic fruits and vegetables in our suhoor and iftar meals. Also we need to avoid carbonated and caffeinated products. People who are more prone to gastro esophageal reflux like those with known hiatus hernia should take prescribed anti-reflux medications regularly during the fasting month.
To summarize we need to take extra care of ourselves during this special holy month of Ramadan to avoid health related problems. We can take the following precautions:
- Avoid skipping Suhoor
- Eat moderate amounts of healthy and balanced meals including slow digesting foods especially at Suhoor
- Avoid very rich, spicy, oily, processed and fast burning foods
- Avoid carbonated and caffeinated products
- Include adequate amount of fruits and vegetables in your meals
- If you are a smoker and want to quit it is a good idea to start reducing the smoking at least a couple of weeks before Ramadan, so the transition could be smoother and you could avoid the withdrawal symptoms
- Effects of Ramadan Fasting on Some Haematological and Biochemical Parameters Huda M. Al Hourani, Manar F. Atoum , Salem Akel , Nawal Hijjawi , Sally Awawdeh. Jordan Journal of Biological Sciences Volume 2, Number 3, September 2009 ISSN 1995-6673 Pages 103- 108.
- Judy Siegel-Itzkovich - Beduin doctor: Migraines common during Ramadan fast - The Jerusalem Post, August 9, 2010.
- Schmahl FW, Metzler B, "The health risks of occupational stress in Islamic industrial workers during the Ramadan fasting period", Polish Journal of Occupational Medicine 1991 4:3 219-28.
- Jalisi, M. and Zaidi, S.H. A short book of ear, nose and throat diseases. 5th ed. Karachi, Azam Sons, 1985, p. 198.