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Fasting and Irritable Bowel Syndrome

Fasting and Irritable Bowel Syndrome

 A healthy diet is important for all of us. However, some people with IBS find certain foods of a normal healthy diet can trigger symptoms or make symptoms worse. Evidence is emerging that using the FODMAP diet may improve IBS bowel symptoms (see reference below). Current national guidelines about IBS include the following points about diet, which may help to minimise symptoms:
·    Have regular meals and take time to eat at a leisurely pace.
·    Avoid missing meals or leaving long gaps between eating.
·    Drink at least eight cups of fluid per day, especially water or other non-caffeinated drinks such as herbal teas.
·    Restrict tea and coffee to three cups per day (as caffeine may be a factor in some people).
·    Restrict the amount of fizzy drinks that you have to a minimum.
·    Don't drink too much alcohol. (Some people report an improvement in symptoms when they cut down from drinking a lot of alcohol, or stop smoking if they smoke.)
·    Consider limiting intake of high-fibre food (but see the section above where an increase may help in some cases).
·    Limit fresh fruit to three portions (of 80 g each) per day.
·    If you have diarrhoea, avoid sorbitol, an artificial sweetener found in sugar-free sweets (including chewing gum) and in drinks, and in some diabetic and slimming products.
·    If you have a lot of wind and bloating, consider increasing your intake of oats (for example, oat-based breakfast cereal or porridge) and linseeds (up to one tablespoon per day). You can buy linseeds from health food shop
·    Maintain good physical fitness to improve bowel function and help reduce stress

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Ramadan & The Medicines you take

Ramadan & The Medicines you take


During Ramadan, some alterations take place in the functioning of our body. Changes in the circadian rhythm (internal body clock) of biochemical, physiological and behavioural processes also occur. As a result drug absorption, their bioavailability, toxicity as well as interaction between food and drug may be affected.

The situation may be compounded when medications are taken indiscriminately. It has been found that many patients with chronic illness often insist on fasting and do not take their medications or take all the drugs in one single dose leading to emergency hospitalization.

Patients who take their medicine two or three times a day may switch to slow-release once daily formulations. for example, patients taking drugs for high blood pressure (two or three times a day) may change over to once daily preparations. Similarly, asthmatic patients who are taking theophylline two or three times may change to slow-release once daily formulations.

Again, the absorption of some drugs are also affected by food and the quality of food. for instance, Rifampicin (a drug used in tuberculosis) should be taken in empty stomach and during Ramadan, it should be taken 30 minutes before pre-dawn meal. Moreover, quality of certain food also decrease absorption such as spicy, fatty foods taken during Ramadan decreases the absorption of certain drugs.

Intake of beverages like tea, coffee, orange juices, and smoking at the time of breaking fast can increase gastric acidity resulting in gastro-intestinal side effects. Thus, many medications need readjustment during Ramadan.

For such situations a doctor should be consulted. Fortunately many drugs are available in slow-release once daily formulations for better patient's compliance particularly during Ramadan. Studies have shown that many patients arbitrarily change the dose and timing of their medications without taking medical advices. Moreover, many patients are also not aware of the medications they can take during Ramadan without breaking the fast.

The choice of drugs and the route of administration remain a matter of concern for many patients and doctors. To settle the difference of opinions and to standardise the choice of route of administration a religious-medical seminar was held in Morocco, participated by distinguished Muslim Jurists, Religious experts, medical practitioners and pharmacologists and specialists in other human sciences.

In the seminar entitled "An Islam view of certain contemporary medical issues" the main focus was on the substances and actions that nullify fasting.

In the discussion it was agreed unanimously that the following routes of administration of drugs do not nullify fasting:
1.    Anaesthetic agents.
2.    All substances absorbed into the body through skin such as cream, ointments, medicated plaster etc.
3.    Anal injections.
4.    Eye and ear drops.
5.    Insertion into the vagina of pessaries, vaginal washes, medical ovules etc.
6.    Injection through the skin, muscle and joints or veins (excepting I.V. feeding).
7.    Inhalers for asthma.
8.    Mouth washes, gurgles, oral sprays provided nothing is swallowed.
9.    Nitroglycerine tablets placed under the tongue for treatment of angina (heart pain).
10.    Nasal sprays and drops.
11.    Oxygen.
12.    Surgery involving general anaesthesia.

In conclusion, Ramadan is a period of altered body rhythm and life habits. Accordingly, drug dosing needs to be adjusted. The timing of intake of medicine (before, during or after food) influence the absorption of drugs. Ramadan is further characterized by repeated fasting and breaking of fast and altered circadian rhythm that last four weeks.

These changes influence the chronobiological parameters (i.e, the route of administration/the dosing, absorption, food-drug interaction and bioavailability etc) which can last beyond the end of the Ramadan.

Therefore, return to the pre-Ramadan bodily functions may take some more time. This fact should be kept in mind both by the patients and medical practitioners.

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Healthy Habits to follow in Ramadan


Healthy Habits to follow in Ramadan

1.    Drink 8 glasses of water daily from Iftar to Suhour to prevent dehydration and constipation
2.    Sleep for 6-8 hours a day to get sufficient mental and physical rest. Less sleep means you will feel tired during the day which in turns leads to less productivity and activity
3.    Have a balanced varied Iftar which incorporates dates, soup, salad, a main dish, fruits and a small piece of Ramadan sweet
4.    Walk or participate in some kind of physical activity
5.    Have Suhour to fill your body with energy and help regulate your blood sugar

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