Effects of Ramadan Fasting on Muslim Patients with Liver Cirrhosis: A Comparative Study

Salem Youssef Mohamed, Mohamed H Emara, Bassim A Gabballah, Ehab Fawzy Mostafa, Mohamed Abdelaziz Maaly


Background: Patients with liver cirrhosis seem to be at increased risk of complications during fasting. This study aimed to assess the effect of Ramadan fasting on liver functions and portal hemodynamics among patients with liver cirrhosis in comparison with healthy subjects.

Materials and Methods: Participants were divided into three groups. Group I: patients with liver cirrhosis who fasted during Ramadan (n = 34), group II: patients with cirrhosis who did not fast (n = 8), and group III: healthy volunteers who fasted (n = 30). This study was done from May 2017 to July 2017 and the month of Ramadan began on May 27th to June 26th, 2017. Portal hemodynamics were evaluated by portal vein diameter, congestion index (CI), and portal flow velocity. Laboratory investigations were determined before, during, and after Ramadan as an indicator of the changes in the liver functions.

Results: There were no dropouts during the study. Among the three groups, portal vein parameters showed statistically non-significant differences. Model for End-Stage Liver Disease (MELD)  score and serum albumin levels showed a significant difference when the group I and II compared separately to group III (P = 0.000), while there were no differences between group I and group II (P = 0.6 and 0.57, respectively). For portal vein CI, there was a significant difference between the patients with cirrhosis (fasting; group I and non-fasting; group II) and healthy subjects (group III) (p = 0.000), while the CI did not change significantly between the groups I and II (p = 0.54).

Conclusions: Patients with cirrhosis showed changes in their liver functions and portal hemodynamics irrespective of their fasting status and these differences were more pronounced in portal vein CI, MELD score, and serum albumin when compared with healthy subjects.


Cirrhosis, Ramadan fasting, MELD score, Portal vein, congestion index

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