The evaluation of Ramadan fasting experience of patients with gastric cancer who underwent curative resection

Abstract

Objective: Patients who had curative treatment after a malignant disease frequently ask about their religious practices and especially Ramadan fasting. The aim of this study is to evaluate the survivors of gastric cancer patients whether they keep Ramadan fasting and the health conditions they experienced during the month of Ramadan. Materials and Methods: For this cross sectional observational study, first the files of patients who had gastrectomy due to malignancy between January 2011 and January 2018 in Gaziosmanpasa University Hospital were examined retrospectively. The surviving patients were scheduled for a meeting and a questionnaire was conducted in outpatient setting. Patients who were conceiving to fast in next Ramadan were invited for at least 2 visits again within one month before and one month after Ramadan. On their arrival, their weight was measured, laboratory test including albumin, haemoglobin, haematocrit, BUN and creatinine levels were obtained. Results: 11 (21%) of the 52 interviewed patients kept fasting in 2019 Ramadan. 5 of these patients were able to complete fasting (30 days) and 6 of them could partially (between 1-7 days). There was no weight loss in fasting patients after Ramadan (p> 0.05). In addition, no significant change was found in albumin, haemoglobin, haematocrit and creatinine values after Ramadan (p> 0.05). However increase in BUN level was statistically significant (p <0.05). Conclusion: Health professionals are likely to see fasting patients all over the world and they must be familiar with the physiological and psychological effects of fasting considering the spiritual and religious needs of the patients.

Keywords

• fasting
• gastrectomy
• ramadan
• spirituality

Küratif rezeksiyon uygulanan mide kanserli hastaların Ramazan oruç deneyimlerinin değerlendirilmesi

Abstract

Amaç: Malign bir hastalık için tedavi gören hastaların tedavi sonrası akıllarında dini uygulamalar ve özellikle Ramazan orucu hakkında sorular oluşmaktadır. Bu çalışmanın amacı mide kanser ameliyatı olmuş hastaların Ramazan orucu tutup tutamadıklarını ve Ramazan ayı boyunca yaşadıkları deneyimleri değerlendirmektir. Gereç ve Yöntemler: Bu kesitsel, gözlemsel çalışma için öncelikle Gaziosmanpaşa Üniversitesi Hastanesi'nde Ocak 2011-Ocak 2018 tarihleri arasında malignite nedeniyle gastrektomi geçiren hastaların dosyaları geriye dönük olarak incelendi. Hayatta olan hastalar aranarak çalışma hakkında bilgi verildi, katılmak isteyen hastalara hazırlanan anket çalışması uygulandı. Önümüzdeki Ramazan ayında oruç tutmayı isteyen hastalar, Ramazan'dan bir ay önce ve bir ay sonra en az 2 ziyarete davet edildi. Geldiklerinde ağırlıkları ölçüldü, albümin, hemoglobin, hematokrit, BUN ve kreatinin düzeylerini içeren laboratuvar testleri yapıldı. Bulgular: Çalışmaya katılan 52 hastadan 11'i (% 21) 2019 Ramazan ayında oruç tuttu. Bu hastalardan 5'i (30 gün) Ramazan orucunu tamamlayabilirken, 6'sı kısmen (1-7 gün arasında) oruç tutabilmiştir. Ramazan sonrası oruç tutabilen hastalarda kilo kaybı olmadı (p> 0.05). Ayrıca Ramazan sonrası albümin, hemoglobin, hematokrit ve kreatinin değerlerinde anlamlı bir değişiklik saptanmadı (p> 0.05). Ancak BUN düzeyindeki artış istatistiksel olarak anlamlıydı (p <0.05). Sonuç: Sağlık çalışanları dünyanın her yerinde oruç tutan hastaları görmektedir. Oruç tutmanın fizyolojik ve psikolojik etkilerini, hastaların ruhsal ve dini ihtiyaçlarını da göz önünde bulundurarak iyi bilmek gerekmektedir.

Keywords

• oruç
• gastrektomi
• ramazan
• maneviyat

References

1. 1. WHO report on cancer: setting priorities, investing wisely and providing care for all. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO.
2. 2. Kim JH, Kim SS, Lee JH, Jung DH, Cheung DY, Chung WC, Park SH. Early Detection is Important to Reduce the Economic Burden of Gastric Cancer. J Gastric Cancer. 2018 Mar;18(1):82-89.
3. 3. Kim TH, Kong SH, Park JH, Son YG, Huh YJ, Suh YS, Lee HJ, Yang HK. Assessment of the Completeness of Lymph Node Dissection Using Near-infrared Imaging with Indocyanine Green in Laparoscopic Gastrectomy for Gastric Cancer. J Gastric Cancer. 2018 Jun;18(2):161-171.
4. 4. Trepanowski JF, Bloomer RJ. The impact of religious fasting on human health. Nutr J. 2010;9(1):57.
5. 5. Pakkir Maideen NM, Jumale A, I.H. Alatrash J, Ahamed Abdul Sukkur A. Health Benefits of Islamic Intermittent Fasting. J Fasting Health. 2017; 5(4): 162-171.
6. 6. Gnanou JV, Caszo BA, Khalil KM, Abdullah SL, Knight VF, Bidin MZ. Effects of Ramadan fasting on glucose homeostasis and adiponectin levels in healthy adult males. J Diabetes Metab Disord. 2015; 14(1):55.
7. 7. Patterson RE, Laughlin GA, LaCroix AZ, Hartman SJ, Natarajan L, Senger CM, et al. Intermittent fasting and human metabolic health. J Acad Nutr Diet. 2015; 115(8):1203-12.
8. 8. Asegaonkara SB, Kareemb I, Bavikar J et al. Effect of Ramadan Fasting on Renal Function Markers in Healthy Adults From Aurangabad. WIMJOURNAL 2014; 1(1): 2349-2910.

9. 9. Zahid J. Mohammed The Influence of Ramadan Fasting on Some Hematological and Biochemical Parameters in Healthy Adult Males Iraqi National J. for Nursing Specialties. 2011;24(1):45-51.
10. 10. Sadeghirad B, Motaghipisheh S, Kolahdooz F, Zahedi MJ, Haghdoost AA. Islamic fasting and weight loss: a systematic review and meta-analysis. Public Health Nutr. 2014 Feb;17(2):396-406. doi: 10.1017/S1368980012005046. Epub 2012 Nov 27. PMID: 23182306.
11. 11. Al Hourani HM, Atoum MF, Akel S, Hijjawi N, Awawdeh S. Effects of Ramadan fasting on some haematological and biochemical parameters. Jordan Journal of Biological Sciences. 2009; 2(3):103-8.
12. 12. Alam, I., Gul, R., Chong, J. et al. Recurrent circadian fasting (RCF) improves blood pressure, biomarkers of cardiometabolic risk and regulates inflammation in men. J Transl Med 17, 272 (2019). https://doi.org/10.1186/s12967-019-2007-z
13. 13. Rogers C. Postgastrectomy nutrition. Nutr Clin Pract. 2011 Apr;26(2):126-36. doi: 10.1177/0884533611400070. PMID: 21447764.
14. 14. Twycross R. Introducing palliative care. 3rd ed. Oxford: Radcliffe Medical Press, 1999
15. 15. Koenig HG. Religion, spirituality and medicine: application to clinical practice. JAMA 2000; 284: 1708-1709
16. 16. Hummer R, Rogers R, Nam C, Ellison C. Religious involvement and US adult mortality. Demography 1999; 36: 273-285.