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Religious Fasting of Muslim Patients After Metabolic and Bariatric Surgery: A Modified Delphi Consensus Publisher Pubmed



Kermansaravi M1 ; Omar I2 ; Mahawar K3 ; Shahabi S4 ; Bashir A5 ; Haddad A5 ; Abbass A6 ; Abbas SI7 ; Abbas M8 ; Abouzeid T6 ; Akin F9 ; Aghajani E10 ; Aminian A11 ; Alansari M12 Show All Authors
Authors
  1. Kermansaravi M1
  2. Omar I2
  3. Mahawar K3
  4. Shahabi S4
  5. Bashir A5
  6. Haddad A5
  7. Abbass A6
  8. Abbas SI7
  9. Abbas M8
  10. Abouzeid T6
  11. Akin F9
  12. Aghajani E10
  13. Aminian A11
  14. Alansari M12
  15. Asghar ST13
  16. Balta AZ14
  17. Bukhari W15
  18. Elfawal MH16
  19. Gado W17
  20. Gawdat K6
  21. Gee T18
  22. Ghavami B19
  23. Goel R20
  24. Alhadad M21
  25. Alhadhrami B22
  26. Alhaifi M23
  27. Alhamdani A24
  28. Hassan I25
  29. Illan SJ26
  30. Inam A27
  31. Ismaeil A28
  32. Kayyal Y29
  33. Mohammad K30
  34. Khan AU31
  35. Khoursheed M32
  36. Khwaja H33
  37. Kular KS34
  38. Layani LA35
  39. Mahdy T37
  40. Maher M38
  41. Mansoor E39
  42. Mirza S31
  43. Niam MS40
  44. Omarov T41
  45. Pazouki A1
  46. Alqahtani AR42
  47. Qassem M6
  48. Rezvani M43
  49. Sabry K6
  50. Salim S44
  51. Shabbir A45
  52. Skalli M47
  53. Taha O48
  54. Talebpour M49
  55. Taskin HE50
  56. Taskin M50
  57. Yunus T51
  58. Jazi AHD4
  59. Kassir R52
  60. Nimeri A53
Show Affiliations
Authors Affiliations
  1. 1. Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-E Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Wirral University Teaching Hospital, NHS Foundation Trust, Birkenhead, Wirral, United Kingdom
  3. 3. Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, SR4 7TP, United Kingdom
  4. 4. Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
  5. 5. Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Queen Noor Street, Amman, 11152, Jordan
  6. 6. Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, 11591, Egypt
  7. 7. Iranian Hospital, Alwasl Road, Dubai, United Arab Emirates
  8. 8. University Hospitals Cleveland Medical Center, Cleveland, OH, United States
  9. 9. Bariatric and Metabolic Surgery, Istanbul, Turkey
  10. 10. Department of Surgery, Aleris Hospital, Fredrik Stangs gate 11-13, Oslo, 0264, Norway
  11. 11. Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, United States
  12. 12. Robotic Surgery Academy, International Modern Hospital, Baghdad, Iraq
  13. 13. Capital Hospital, CDA, Islamabad, Pakistan
  14. 14. Faculty of Health Sciences, Istanbul Rumeli University, Istanbul, Turkey
  15. 15. International Medical Center, Jeddah, Saudi Arabia
  16. 16. Makassed General Hospital, Beirut, Lebanon
  17. 17. Endocrine and Bariatric Surgery Unit, Mansoura University, Mansoura, Egypt
  18. 18. Department of Medical Science, School of Healthcare and Medical Sciences, Sunway UniversityJalan UniversitySelangor Darul Ehsan, Petaling Jaya, Bandar Sunway, 47500, Malaysia
  19. 19. Vinet Lausanne, Switzerland
  20. 20. Wockhardt Hospitals, Mumbai, India
  21. 21. Healthpoint Hospital, Mubadala Health Care, Abu Dhabi, United Arab Emirates
  22. 22. Royal Hospital, Muscat, Oman
  23. 23. Alhaifi Private Clinic, Kuwait, Kuwait
  24. 24. Wellington Hospital, Wellington, United Kingdom
  25. 25. Sidra Hospital, Kuwait, Kuwait
  26. 26. International Center of Excellence in Bariatric and Metabolic Surgery, Hospital BC, Tijuana, Mexico
  27. 27. In Charge Metabolic, Thoracic and General Surgery Unit III, Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
  28. 28. Faculty of Medicine, Aswan University, Aswan, Egypt
  29. 29. Cork University Hospital, Cork, Ireland
  30. 30. Ministry of Health, Kuwait, Kuwait
  31. 31. Walsall Healthcare NHS Trust, Walsall, United Kingdom
  32. 32. Health Sciences Center, Department of Surgery, Kuwait, Kuwait
  33. 33. Chelsea and Westminster Hospital, London, United Kingdom
  34. 34. Founding President MGB-OAGB Club, Kular Research Institute, Bija, India
  35. 35. HOD Surgical Bariatric Department, Dubai, United Arab Emirates
  36. 36. Shalimar Medical and Dental College, Lahore, Pakistan
  37. 37. Sharjah University Hospital, Mansoura Faculty of Medicine, Sharjah, United Arab Emirates
  38. 38. South City Hospital, Karachi, Pakistan
  39. 39. Private Practice, Durban, South Africa
  40. 40. Faculty of Medicine, Brawijaya University, Dr Saiful Anwar General Hospital, Malang, Indonesia
  41. 41. First Surgical Disease Department, Azerbaijan Medical University, Baku, Azerbaijan
  42. 42. New You Medical Center, King Saud University, Obesity Chair, Riyadh, Saudi Arabia
  43. 43. Inova Fair Oaks Hospital, COE Bariatric Center, 14904 Jefferson Davis Hwy, Suite 205, Woodbridge, 22191, VA, United States
  44. 44. Alsadir Teaching Hospital, Najaf, Iraq
  45. 45. Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  46. 46. Department of Surgery, University Surgical Cluster, National University Health System, Singapore, Singapore
  47. 47. CHU de Montpellier, Montpellier, France
  48. 48. Bariatric Unit, Plastic and Obesity Surgery Department, Assiut University Hospital, Assiut, Egypt
  49. 49. Department of General Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  50. 50. Cerrahpasa Medical Faculty, Department of Surgery, Istanbul University Cerrahpasa, Istanbul, Turkey
  51. 51. Evercare Hospital, Lahore, Pakistan
  52. 52. Department of Digestive Surgery, CHU Felix Guyon, Saint Denis, Reunion
  53. 53. Chief, Bariatric and Metabolic Surgery Carolinas Medical Center, Ballantyne and Gastonia Director, Atrium Health University of North Carolina-Charlotte Campus Director, Bariatric Fellowship Program Carolinas Medical Center-Mercy, Atrium Health Weight Management Charlotte, Concord, Charlotte, NC, United States

Source: Obesity Surgery Published:2021


Abstract

Background: Fasting during Ramadan is one of the five pillars of the Muslim faith. Despite the positive effects of fasting on health, there are no guidelines or clear recommendations regarding fasting after metabolic/bariatric surgery (MBS). The current study reports the result of a modified Delphi consensus among expert metabolic/bariatric surgeons with experience in managing patients who fast after MBS. Methods: A committee of 61 well-known metabolic and bariatric surgeons from 24 countries was created to participate in the Delphi consensus. The committee voted on 45 statements regarding recommendations and controversies around fasting after MBS. An agreement/disagreement ≥ of 70.0% was regarded as consensus. Results: The experts reached a consensus on 40 out of 45 statements after two rounds of voting. One hundred percent of the experts believed that fasting needs special nutritional support in patients who underwent MBS. The decision regarding fasting must be coordinated among the surgeon, the nutritionist and the patient. At any time after MBS, 96.7% advised stopping fasting in the presence of persistent symptoms of intolerance. Seventy percent of the experts recommended delaying fasting after MBS for 6 to 12 months after combined and malabsorptive procedures according to the patient’s situation and surgeon’s experience, and 90.1% felt that proton pump inhibitors should be continued in patients who start fasting less than 6 months after MBS. There was consensus that fasting may help in weight loss, improvement/remission of non-alcoholic fatty liver disease, dyslipidemia, hypertension and type 2 diabetes mellitus among 88.5%, 90.2%, 88.5%, 85.2% and 85.2% of experts, respectively. Conclusion: Experts voted and reached a consensus on 40 statements covering various aspects of fasting after MBS. Graphical abstract: [Figure not available: see fulltext.] © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.