Effect of Ramadan Fasting Upon Perforated Peptic Ulcer Patients: A Descriptive Analysis

Abstract

Background: Perforated peptic ulcer (PPU) is relatively rare, but life threatening with the mortality varying from 10% to 40%. While common causes of peptic ulcer disease are H. Pylori, increased inadvertent use of NSAIDS, smoking and stress of modern life, the specific etiologic agent cannot be incriminated in the causation of its perforation.Objective: The aim of this study is to evaluate the effect of perforated peptic ulcer in fasting Muslims.Methods: This prospective analysis was conducted for the risk factors associated with perforated peptic ulcer (PPU) in patients attending Surgical Emergency hospital & Sulaimaniyah Teaching Hospital on 312 cases (246 male & 66 females) during the period of one month before Ramadan (Shaban), holy Ramadan and one month after Ramadan (Shawal) for ten successive years from 2006 to 2015. Descriptive analysis and Chi square test was used to find an association between studying variables.Result: The number of PPU per month was higher in Ramadan, 16.6 patients per month vs. 7.3 patients per each other month and also high among group 1 fasting patients. Predisposing factors played a major role in these differences.Conclusion: This study found that the incidence of PPU is relatively high among people who have predisposing factors, including young adults age, but earlier in non-fasting people , male gender, but no difference between the two groups in those using non -steroidal anti-inflammatory drugs, history of dyspepsia. Those patients have previous peptic ulcer disease diagnosed on esophagogastroduodenoscopy more prone to perforation. Long period day after day fasting, but not daytime length duration may increase PPU.Recommendations: This study recommends that the people with these risk factors must be well informed and need special care to avoid such complications. This study also suggests further studies regarding this subject.