Omar Malick was diagnosed with Inflammatory Bowel Disease (IBD) at 16 years old and also fasts during Ramadan. In last year's Summer Issue of Connect Magazine, he shared his story and his top five tips for people fasting whilst living with Crohn's and Colitis.
Omar's top tips...
1. Know your body
No one knows your body better than yourself. If you truly feel like you can fast – maybe your Crohn's or Colitis isn’t severe or you’re in remission – then try, but don’t feel bad or guilty if it’s not happening.
2. Eat well at night
It’s a challenge to ensure that when you do get to open the fast it adequately provides the nutrients you’ve missed out on during the day. Those of with us with IBD often don’t have the same reserves as other people, so we can very quickly go from just managing to really struggling.
3. But go easy on the samosas
And, importantly, we’re all guilty of overindulging when it comes to breaking the fast. Sweets and fried food can often be a huge temptation, but because of Crohn's and Colitis we need to be careful. Go easy on the sugars and the samosas, or you will struggle later in the evening or the next day.
4. Don't let it break you
If you have to break a fast for health reasons, don’t be disheartened. I’ve been told that if you break for reasons outside your control it still counts because the intent was there.
5. Find other ways to be involved
Praying, going to mosque, reading the Quran, taking the month to reflect and improve oneself, and doing charitable work are all other ways to feel involved in Ramadan if you are unable to fast.
Consultant Gastroenterologist, Dr Barney Hawthorne offers some tips on fasting with Crohn's and Colitis.
Is it safe for me to fast?
Yes, for the vast majority of patients with Crohn’s Disease and Ulcerative Colitis. Some exceptions are:
- If there are high fluid losses – either because you have an ileostomy that gives a high-volume output (more than 1.5 litres per 24 hours), or because of high losses from a fistula (a connection from the bowel to the abdominal wall) that has similar high output, or severe diarrhoea
- If there is severe malnutrition, or inability to eat a large meal in a short time
- If there is very active disease resulting in severe pain, fever, fatigue, vomiting or diarrhoea
- If there is a need to take medication by mouth during the day. With drugs taken once or twice a day it may be possible to take them before sunrise or after sunset. If in doubt, consult your doctor.
Will fasting put my IBD into remission?
There is no evidence that fasting improves inflammation in IBD. This ‘myth’ may have arisen as sometimes symptoms related to eating – for example, abdominal pain or diarrhoea – improve on stopping eating. The result is malnutrition, weight loss and the disease will still be there but the ability to recover will be impaired.
There may be some indirect benefit from religious observance, and fellowship with other Muslims may have psychological benefits (the same applies for other faith groups), and this in turn has been shown to improve disease activity. Of course, if the fasting causes physical deterioration this outweighs these indirect benefits.