# Navigating Ramadan Fasting Following Laparoscopic Sleeve Gastrectomy: Clinical Insights and Patient Experiences

## TL;DR

This study explores how safely patients who had laparoscopic sleeve gastrectomy can fast during Ramadan, finding that waiting at least 12 months post-surgery is optimal.

## Contribution

The study provides clinical insights and patient experience data on fasting after laparoscopic sleeve gastrectomy during Ramadan.

## Key findings

- Fasting success rates improved significantly for patients who fasted ≥12 months post-surgery.
- GERD prevalence increased over time, especially in patients ≥12 months post-surgery.
- No cases of dehydration requiring hospitalization were observed.

## Abstract

Background and objective

Fasting during Ramadan presents unique challenges for post-bariatric surgery patients. The effects of fasting after laparoscopic sleeve gastrectomy (LSG) remain unclear, particularly regarding symptom prevalence and fasting success rates. This study aimed to evaluate the optimal timing for fasting after LSG and provide guidance for safely observing Ramadan.

Methods

We conducted a retrospective observational study at a tertiary care hospital in Egypt, analyzing patient experiences with fasting after LSG. The study involved 100 patients who had undergone LSG at different intervals before Ramadan (three, six, nine, and 12+ months). Patients completed surveys assessing fasting success rates, symptom prevalence (gastroesophageal reflux disease (GERD), vomiting, dumping syndrome), and medical interventions required. The primary outcome was the ability to complete Ramadan fasting without hospitalization or intravenous fluid administration. Secondary outcomes included symptom patterns, nutritional status, and hydration practices.

Results

Fasting completion rates significantly improved with time since surgery, with patients fasting ≥12 months post-LSG exhibiting the highest success rates. GERD prevalence increased over time, particularly in the ≥12 months group, while vomiting and dumping syndromes remained stable. No deficiencies in calcium, vitamin D, or vitamin B were observed, and no cases of dehydration required hospitalization. Older patients experienced more symptoms than younger individuals, and prior fasting experience positively influenced fasting success.

Conclusions

Post-LSG fasting during Ramadan is safest when initiated at least 12 months after surgery. Long-term monitoring, individualized medical guidance, and hydration strategies are essential to ensure safe fasting in post-bariatric patients.