The effect of Ramadan fasting on duodenal ulcer perforation: a retrospective analysis

Aims: The aim of this study is to evaluate the relation between Ramadan fasting and duodenal ulcer perforation, and to assess the risk factors for peptic disease in fasting Muslims. Settings and Design: Retrospective analysis was conducted for all patients, who underwent surgery especially in Ramadan for duodenal ulcer perforation in the emergency service between 1998 and 2003. Methods and Materials: Demographics, concomitant diseases, and predisposing factors were analyzed. Comparisons were done between patients, who were operated in Ramadans within a 5-year period (5 months during the study period) (Group 1) and on the remaining periods (55 months during the study period) (Group 2). Statistical analysis: Chi-square and Fischer’s exact chi-square tests, Student’s t-test and Mann–Whitney U-test were used. Results: Two hundred and sixty patients were included (50 in Group 1 and 210 in Group 2) in the study. The number of surgeries per month was statistically high in Group 1 than in Group 2 (10 patients per month vs 3.8 patients per month, P < 0.018). Predisposing factors play a major role and may be the reason for the difference. Conclusion: This study suggests that the incidence of duodenal ulcer perforation is relatively high in Ramadan among the people, who are fasting and have predisposing factors (especially history of dyspepsia). Therefore, we believe that people with predisposing factors and dyspeptic symptoms must be well informed and need special