Improve the health of Muslim patients by learning Ramadan

In caring for each patient, having a basic understanding of their culture and values ​​can go a long way in building confidence and improving their experiences and outcomes. This is especially true during the month of Ramadan, which is the holiest month of the year on the Muslim calendar. Ramadan’s core understanding promotes joint decision-making with improved collaboration between providers and patients, and facilitates better care for sick Muslim patients during the holidays, which run from April 2 to May 2 this year.

Provide care during the month of Ramadan

Not everyone knows the intricacies of the month of Ramadan and what it means, so a brief explanation can benefit medical professionals in this holy month. Ramadan is a month in which many Muslims fast from morning to sunset, pray, pray, give alms, think for themselves, and focus on strengthening their character and self-control. It ends with the celebration of Eid al-Fitr. When treating patients, it is important to remember to never assume about the patient’s practice – instead ask the patient about their compliance.

Ramadan is observed from morning to sunset by abstaining from food, drink, smoking and sexual intercourse during fasting hours. Islam follows a 12-month calendar; Ramadan is the ninth month and is one of the five pillars of Islam. The Islamic year is about 11 days shorter than the Western Gregorian calendar, so Ramadan falls at different times of the calendar year. Ramadan causes shorter fasts in winter due to the shorter days. The summer days of Ramadan are much longer and thirst is more difficult for many. Fasting Muslims usually eat breakfast in the morning to start fasting in the morning and iftar for iftar at sunset. With the exception of fasting, anyone who is on a journey is pregnant, breastfeeding, or menstruating; pre-adolescent children or those with acute or chronic illness that may be exacerbated by fasting.

Despite these exceptions, some patients may still be fasting. Providers need to know that patients can have a day of fasting if they are unable to attend the fast. They can also feed someone who is not fast enough. There are also procedures that invalidate the patient’s fast. Physicians should be aware of these conditions, as breaking the fast can cause serious harm to the patient. Invalid procedures include the use of oral medications, asthma inhalers, most endoscopic procedures, general anesthesia, IV fluids, parenteral nutrition, and intentional vomiting. It is important to partner with the patient and their family to discuss these and other pictures that break the fast. In some cases, you may need to adjust the time of your medication or procedure to adjust your fasting hours. Most Muslim scholars consider it permissible: ear, nose and eye drops, anal suppositories, enemas and blood transfusions.

When providers are equipped with the theological understanding and appreciation of different schools of jurisprudence, they are better positioned to offer their patients more options, make joint clinical and partnership decisions, and schedule certain procedures and medications during off-hours or after Ramadan. .

Ramadan is not only a physical mission, but also a spiritual one. Patients may disrupt sleep cycles from waking up early for breakfast and tending to life responsibilities, such as work or school, on a fasting stomach. Holy Month allows providers to work with individual patients to achieve specific health goals. It is important for health care providers to teach fasting patients how to water and drink enough fluids, eat nutritious foods, maintain good sleep hygiene, fast safely, and follow proper medication and treatment of comorbidities. By using the discipline and self-control that Ramadan requires, physicians can help fasting patients achieve their health goals, such as quitting smoking or drinking alcohol and maintaining meaningful and supportive relationships with family and friends. Patients should be encouraged to maintain healthy habits that are established during the month of Ramadan for the post-Ramadan period and beyond.

Management of chronic conditions during the month of Ramadan

With chronic comorbidities, Muslim patients are at risk for serious complications such as degradation, hypoglycemia, hyperglycemia, and diabetic ketoacidosis. Fasting Muslims may not follow the prescribed medication and may refuse treatment or diagnosis during the month of Ramadan that invalidates the fast. Muslims with advanced diabetes are exempt from fasting, but some may still be able to fast. The International Diabetes Federation and Diabetes and Ramadan have developed risk guidelines for fasting among people with type I or II diabetes, which take religious considerations into account when making medical recommendations. High-risk groups are strictly prohibited from fasting. Recommendations include a pre-Ramadan medical examination for the latest HbA1C test and counseling that teaches the patient about diabetes management during the month of Ramadan, which includes proper diet, nutrition, exercise during fasting, and recognition of symptoms of hypoglycemia and hyperglycemia. Patients are advised to eat small meals several times during iftar instead of one large meal between iftar and morning, to change the amount of medication, to check blood glucose several times during the day, and if the blood sugar is above or below the norm. fall more, fast immediately. they become a sign of hypoglycemia or hyperglycemia.

Patients with unstable angina, heart failure, heart surgery or myocardial infarction should refrain from fasting. Heartburn, bloating, and indigestion are common gastrointestinal symptoms that occur during fasting and can be caused by overeating at night. This can be prevented by eating small meals and avoiding trigger foods. Patients with active peptic ulcer and uncontrolled asthma should abstain from fasting. Patients with kidney or dialysis disease are advised to increase fluid intake and schedule dialysis sessions on non-diurnal days.

Other considerations

Understanding the relationship between fasting and these medical conditions will help the medical team to ensure safe and proper care for patients. It is also important for medical professionals to understand the depth and breadth of the Muslim experience in the United States. The September 11 terrorist attacks, the ensuing wars, and the rise of Islamophobia in some segments of society have shaped, in part, the Muslim experience. and serves as an important social determinant of health. Some medical professionals may have created indirect prejudices and may be unaware of the inadequate care they provide to their Muslim patients, especially during the vulnerable period of fasting throughout Ramadan.

The recommendations we offer do not cover everything – you can consult with local religious leaders either at your hospital or in the community. The great cultural diversity of the American Muslim community should also be appreciated in this context, as the coverage of regional cultural practices loaded with religious theology could add to the norms of Ramadan that American Muslims practice, which could be further considered. require medical staff.

Odil Afridi, MS, is a fourth-year medical student at New York Medical College who is interested in multiculturalism in medicine, history, civilization, and Islamic theology. After graduating from university, he began residency studies in diagnostic radiology. Mill Etienne, MD, MPH, is an associate professor of neurology and medicine at the New York Medical College, where she teaches medicine from many cultures and is also vice chancellor for diversity and inclusion and vice dean for student affairs.

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