Leicester researchers have co-developed the first global guidance for managing digestive conditions during Ramadan

Researchers have developed a clinical guide for managing patients with gastrointestinal and liver conditions during Ramadan. 

The guide fills a critical gap in global healthcare provision for those observing the religious holiday when fasting or abstaining from food or drink takes place for up to 30 days between the first light of dawn until the setting of the sun.

Dr Mohammad Farhad Peerally, Associate Professor from the SAPPHIRE (Social Science and Applied Healthcare and Improvement Research) Group, at the University of Leicester, and Consultant Gastroenterologist at Kettering General Hospital, co-led the work which has now been published in The Lancet Gastroenterology & Hepatology 

Dr Peerally said: “This review represents more than three years of collaborative work with international experts in gastrointestinal and liver medicine.

“Working alongside colleagues from the Universities of Imperial College London, Glasgow and the University of Ontario in Canada, among others, our guidance now synthesises the best available evidence to support both primary care physicians and hospital specialists in making informed decisions about patient care during Ramadan.

“Many patients with stable gastrointestinal conditions can safely fast during Ramadan with appropriate medical supervision. However, others may be at high risk of complications. Our guidance helps clinicians across all healthcare settings identify who can safely fast and provides practical advice on supporting these patients."

The research team developed a comprehensive risk stratification system which categorized patients into three groups: those who can safely fast, those who require careful medical assessment and monitoring during fasting, and those at high risk who should be advised against fasting. 

This practical framework considers multiple factors including disease severity, medication requirements, and overall clinical stability. The guidance includes specific recommendations for managing common conditions such as inflammatory bowel disease, liver cirrhosis, and fatty liver disease during Ramadan, with detailed advice on medication adjustments and monitoring protocols.

The work represents a significant step forward in providing culturally sensitive, evidence-based care for Muslim patients with gastrointestinal and liver conditions. 

While highlighting important gaps in current knowledge that warrant further investigation, the research team hopes it will serve as a valuable resource for healthcare professionals worldwide and lead to improved patient outcomes during Ramadan.

Co-lead Dr Salman Waqar, General Practitioner and Senior Research Fellow at Imperial College London, added: “With over 90% of the 2 billion Muslims worldwide reporting observance of Ramadan, this work has significant global impact towards improving patient safety and unmet needs. We hope to work with colleagues across the world to tackle the research gaps we've identified and to address the public health benefits that Ramadan fasting could bring through sustained lifestyle modification."