Ramadan fasting with IBS: Hepatologist explains when it’s safe to continue and when your gut says stop
Ramadan is often described as a month of discipline, devotion and deep community spirit. From the pre-dawn meals to the shared iftar gatherings, it is a routine that reshapes daily life. However, for those living with Irritable Bowel Syndrome (IBS), the change in routine can bring anxiety.
IBS is a functional gut disorder that can cause abdominal pain, bloating, diarrhoea, constipation, or a combination of symptoms. Stress, irregular eating habits, poor sleep and certain foods are well-known triggers, all of which may shift during Ramadan.
Dr Chetan Kalal, Hepatologist and Liver Transplant Physician, Saifee Hospital, says the key lies in personal assessment. “The safety of fasting depends largely on how stable your IBS has been,” he explains. “If symptoms have been mild and controlled for several months, many patients are able to fast without major complications.”
For those whose IBS is predictable and relatively stable, fasting can sometimes even reduce daytime discomfort. Fewer meals may mean fewer triggers. If longer gaps between meals are already well tolerated, the transition into Ramadan may feel manageable. Dr Kalal informs, “Patients who are not experiencing frequent flare-ups, significant dehydration, or persistent abdominal pain often cope well, provided they plan their meals carefully.” Hydration and food choices become crucial. The long hours without fluids can affect gut sensitivity, so what happens between sunset and dawn matters greatly.
When you should pause
However, fasting is not advisable for everyone. Those experiencing frequent diarrhoea, severe bloating, ongoing abdominal pain, or dehydration should proceed with caution. “Repeated fluid loss can worsen symptoms and may lead to weakness,” Dr Kalal warns. “If IBS is unstable, fasting can aggravate the gut rather than calm it.” Sleep disruption during Ramadan can also intensify symptoms. Late-night meals and early suhoor wake-up calls may interfere with restorative rest, and poor sleep is a recognised IBS trigger.
Practical tips for a calmer gut
If you plan to fast, Dr Kalal recommends a mindful approach:
- Break your fast gently with small, simple foods.
- Avoid heavy, fried or very spicy dishes at iftar.
- Limit caffeine, which may stimulate the gut.
- Stay well hydrated between sunset and dawn. Choose lighter, balanced options at suhoor.
Continue prescribed medication after discussing timing adjustments with your doctor.
“Overeating at iftar is one of the most common triggers,” he adds, “Moderation is key.”
Faith allows flexibility
Importantly, Islamic teachings provide clear exemptions when fasting harms health. Protecting one’s wellbeing is not considered a failure of faith. “Ramadan is meant to bring peace and spiritual growth,” Dr Kalal says. “If fasting causes significant distress or medical risk, taking a break is a responsible decision.” Listening to your body is essential. With preparation, medical guidance and thoughtful choices, many people with IBS can observe Ramadan safely. But if symptoms continue or rise, prioritising health is both medically sound and spiritually permitted.
