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International Survey on Complications of Religious Fasting After Metabolic and Bariatric Surgery Publisher Pubmed



Kermansaravi M1 ; Husain FA2 ; Bashir A3 ; Valizadeh R4 ; Abbas SI5 ; Abouzeid T6 ; Amini M7 ; Davarpanah Jazi AH8 ; Elfawal MH9 ; Gado W10 ; Gee T11 ; Habeeb TAAM12 ; Al Hadhrami B13 ; Inam A14 Show All Authors
Authors
  1. Kermansaravi M1
  2. Husain FA2
  3. Bashir A3
  4. Valizadeh R4
  5. Abbas SI5
  6. Abouzeid T6
  7. Amini M7
  8. Davarpanah Jazi AH8
  9. Elfawal MH9
  10. Gado W10
  11. Gee T11
  12. Habeeb TAAM12
  13. Al Hadhrami B13
  14. Inam A14
  15. Vaziri NM7
  16. Mokhber S15
  17. Almomani H16
  18. Omerov T17
  19. Pazouki A1
  20. Rezapanah A18
  21. Rezvani M19
  22. Sadat Mansouri M20
  23. Sewefy AM21
  24. Taskin HE22
  25. Yunus T23
  26. Kassir R24
  27. Nimeri A25
Show Affiliations
Authors Affiliations
  1. 1. Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Minimally Invasive Surgery Research Center, Rasool-E Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Surgery, Banner University of Arizona-Phoenix, Phoenix, United States
  3. 3. Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Amman, Jordan
  4. 4. Urmia University of Medical Sciences, Urmia, Iran
  5. 5. Iranian Hospital, Alwasl Road, Dubai, United Arab Emirates
  6. 6. Department of Surgery, Ain-Shams University, Cairo, Egypt
  7. 7. Laparoscopy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  8. 8. Minimally Invasive Surgery Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  9. 9. Makassed General Hospital, Beirut, Lebanon
  10. 10. Endocrine and Bariatric Surgery Unit, Mansoura University, Mansoura, Egypt
  11. 11. Department of Medical Science, School of Healthcare and Medical Sciences, Sunway University Jalan University, Selangor Darul Ehsan, Bandar Sunway, Petaling Jaya, Malaysia
  12. 12. Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
  13. 13. Royal Hospital, Muscat, Oman
  14. 14. In Charge Metabolic, Thoracic and General Surgery Unit III, Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
  15. 15. Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
  16. 16. NMC Royal Hospital, Abu Dhabi, United Arab Emirates
  17. 17. First Surgical Disease Department, Azerbaijan Medical University, Baku, Azerbaijan
  18. 18. Department of Surgery, Mashhad University of Medical Sciences, Mashhad, Iran
  19. 19. Inova Fair Oaks Hospital, COE Bariatric Center, 14904 Jefferson Davis Hwy, Suite 205, Woodbridge, 22191, VA, United States
  20. 20. Pars Private Hospital, Tehran, Iran
  21. 21. Department of Surgery, Minia University Hospital, Minia, Egypt
  22. 22. Cerrahpasa Medical Faculty, Department of Surgery, Istanbul University Cerrahpasa, Istanbul, Turkey
  23. 23. Evercare Hospital, Lahore, Pakistan
  24. 24. Department of Digestive Surgery, Centre Hospitalier Universitaire Felix Guyon, St Denis de La Reunion, France
  25. 25. Department of Surgery, Center for Metabolic and Bariatric Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States

Source: Scientific Reports Published:2023


Abstract

Religious fasting in Ramadan the 9th month of the lunar year is one of five pillars in Islam and is practiced for a full month every year. There may be risks with fasting in patients with a history of metabolic/bariatric surgery (MBS). There is little published evidence on the possible complications during fasting and needs stronger recommendations and guidance to minimize them. An international survey was sent to surgeons to study the types of complications occurring during religious fasting in patients with history of MBS to evaluate the risk factors to manage and prepare more evidence-based recommendations. In total, 21 centers from 11 countries participated in this survey and reported a total of 132 patients with complications occurring during religious fasting after MBS. The mean age of patients with complications was 36.65 ± 3.48 years and mean BMI was 43.12 ± 6.86 kg/m2. Mean timing of complication occurring during fasting after MBS was 14.18 months. The most common complications were upper GI (gastrointestinal) symptoms including [gastroesophageal reflux disease (GERD), abdominal pain, and dyspepsia], marginal ulcers and dumping syndrome in 24% (32/132), 8.3% (11/132) and 23% (31/132) patients respectively. Surgical management was necessary in 4.5% of patients presenting with complications (6/132) patients due to perforated marginal or peptic ulcer in Single Anastomosis Duodenoileostomy with Sleeve gastrectomy (SADI-S), one anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG), obstruction at Jejunojenostomy after Roux-en-Y gastric bypass (RYGB) (1/6) and acute cholecystitis (1/6). Patients after MBS should be advised about the risks while fasting including abdominal pain, dehydration, and peptic ulcer disease exacerbation, and a thorough review of their medications is warranted to minimize complications. © 2023, The Author(s).
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