High rate of acute pancreatitis during the Ramadan fast

BACKGROUND: During the Ramadan fast Muslims celebrate a month of prayer, dawn-to-dusk fasting, and nightly feasts. We aimed to assess whether acute pancreatitis (AP) is more common during the Ramadan fast in individuals who celebrate it. PATIENTS AND METHODS: The study was carried out at the emergency department of Rabin Medical Center, Israel. We compared the occurrence of AP in a fasting population and a nonfasting population during the Ramadan versus the rest of the year. RESULTS: Over the 10-year study period, 1167 patients were admitted to the emergency department with AP. Of these, 1069 (91.6%) were nonfasting and 98 (8.4%) were fasting. Of these, 17/98 (17.3%) fasting patients and 95/1069 (8.8%) nonfasting patients were admitted with AP during the Ramadan [relative risk: 1.12; 95% confidence interval (CI): 1.004-1.2; odds ratio (OR): 2.15; 95% CI: 1.23-3.8; P=0.01]. During the Ramadan, the rate of AP out of referrals was 0.1% (17/15 068) in fasting patients versus 0.004% (95/213 913) in nonfasting individuals (OR: 2.54; 95% CI: 1.5-4.25). During the other months of the year, the rate of AP out of referrals was 0.009% (81/86 072) in fasting patients versus 0.008% (974/1 202 405) in nonfasting individuals (OR: 1.16; 95% CI: 0.92-1.45; P<0.001). CONCLUSION: We found a high rate of AP in the fasting population during the Ramadan. Physicians should be aware of this link and suspect it for fasting patients presenting with epigastric pain during the Ramadan fast.