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Potential Health Complications & Possible Remedies While Fasting


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Heartburn (indigestion)

From "Ramadhaan Health Guide" supported by the NHS


The stomach is an acidic environment, designed to digest food and
kill bacteria. The stomach and oesophagus (gullet) are normally
protected from this acid by the body’s own special juices and ‘valves’
between these two organs. If either too much acid is produced or the
valve at the bottom of the oesophagus is ‘faulty’, you may experience
heartburn. Fasting usually reduces the amount of acid produced, but
thoughts of food or the smell of it make the brain order the stomach to
produce more acid. Hence if there is a net increase in acid, heartburn
could be a problem during the fast.


Those who are on regular medication for indigestion, such as antacids
(eg Gaviscon), antihistamines (eg Zantac) or proton pump inhibitors
(eg Losec, Zoton or Nexium) are advised to continue taking them, at
the pre-dawn meal for instance. The control of heartburn or belching
can be aided by eating in moderation and avoiding oily, deep-fried
or very spicy food. Reducing your caffeine intake and/or stopping
smoking can also be of benefit, if relevant. Preparations such as
peppermint oil may help reduce belching or colic. Sleeping with your
head raised on a few pillows and long-term weight loss may also help
prevent heartburn. 


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Poor control of diabetes

Those injecting insulin are advised not to fast, as the potential
risk to health, both in the short and long term, of not taking
insulin is too great.


People who have their diabetes under control using tablets
should ensure that they visit their GP prior to Ramadan, in
order to discuss any possible changes to their drug regime
which would facilitate a safe fast. If not, such patients are
at risk of poor control of their diabetes during and outside the
fasting times.


Regular self-monitoring of your blood glucose is strongly
advised. Low blood sugar levels (a ‘hypo’) are dangerous,
and if untreated may lead to fainting or fits, and hence must be
strictly avoided. Feeling dizzy, sweaty and disorientated may
all suggest a hypo. If this is suspected, you should immediately
have a sugary drink, or place sugar or a sugar-rich sweet below
the tongue. 


Long-acting tablets, such as Glibenclamide, increase the risk
of having a hypo, and should be changed to a shorter-acting
variety before you embark on a fast.


Diabetics with further complications, such as angina or heart
failure, stroke, retinopathy (eye disease), nephropathy (kidney
disease) or neuropathy (nerve disease of feet/hands with
numbness/loss of feeling) should seek careful advice from their
doctor before starting a fast. 

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This is a common problem and has many causes.
Headaches during a fast could commonly be due to
dehydration or hunger, inadequate rest, or the absence of
addictive substances such as caffeine or nicotine.
A moderate and balanced diet, especially not missing
the pre-dawn meal, consuming adequate quantities of
fluid and if necessary taking a dose of painkillers such
as paracetamol, may all go a long way towards either
preventing or reducing the risk of developing a disabling
headache. Headaches can also be prevented by sensible
measures such as not exposing oneself to direct sunlight,
wearing a hat when out, using sunglasses to reduce the
effect of glare from the
sun and relieving any
tense muscles with a
short, gentle massage.


Those with a history of frequent and/or disabling
migraines should aim to gain adequate control with
lifestyle and/or medical treatment if required, prior to
starting a fast.


Despite the above measures, if you have a persistent,
disabling headache, you should see a doctor. 

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Constipation could be a very irritating problem for
someone undertaking a fast.


Maintaining good hydration
outside the fast, eating healthily, with lots of fruit and
vegetables in your diet, increasing the fibre content of
your food using bran, and being active all help to keep
your bowel motions as regular as would otherwise
be expected.


If the problem persists, a short course of bulk laxatives
may help.

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Complications of any common chronic diseases

Diabetes has been discussed above.


Other common diseases such as high blood pressure and
asthma are controlled using medication that needs to be
taken regularly every day of the year. This is necessary
in order to avoid possible complications from the
inadequate control of disease, such as a stroke or an
asthma attack. A consultation with your doctor should
provide an opportunity to discuss any potential options
for completing a fast safely, while continuing to control
your disease.

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Should a person with high or low blood 
pressure fast?


Those with well-controlled high blood pressure may
fast with lifestyle alterations and/or medication.
Their GP may require a change to their medication
in order to help them take tablets outside the times
of fasting.


A person with so-called ‘low blood pressure’ who is
otherwise well and healthy may fast. An adequate
intake of fluid and salts in the diet is advised.

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