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©The Author(s) 2024.
World J Hepatol. Aug 27, 2024; 16(8): 1070-1083
Published online Aug 27, 2024. doi: 10.4254/wjh.v16.i8.1070
Published online Aug 27, 2024. doi: 10.4254/wjh.v16.i8.1070
Table 2 Publications focusing on liver cirrhosis and Ramadan fasting
Ref. | Type of publication | Patients assessed | Findings |
Elnadry et al[17], 2011 | Observational and comparative | Chronic hepatitis and cirrhotics (child A and B), n = 202; Fasting group, 103 patients, 57 chronic hepatitis and 46 cirrhotics. Non-fasting group included 99 patients, 52 with chronic hepatitis, and 47 cirrhotics | Dyspeptic symptoms were higher in the fasting group. GI bleeding during Ramadan was higher in the fasting group compared to the non-fasting, but variceal bleeding was significantly higher in the non-fasting group. The chronic hepatitis fasting group showed non-significant changes pre-, during, and post-Ramadan regarding liver functions. Fasting cirrhotic group patients: The frequency of deterioration to Child class C was high |
Elfert et al[64], 2011 | Observational and non-comparison | Cirrhotics (Child A, B, and C), n = 216 | Twenty-seven patients discontinued their fast due to fatigue. Variceal bleeding and encephalopathy were reported in 8 and 6 patients, respectively. Ramadan fasting had no significant effect on PV diameter or portal blood flow. Male sex, Child class A, and absence of GI bleeding were independent factors in the reduction of liver enzymes and serum glucose during Ramadan fasting. Older age, DM, and Child class C were independent factors in the elevation of serum bilirubin and creatinine during Ramadan fasting |
Mohamed et al[65], 2016 | Observational and non-comparison | Cirrhotics (Child A, B, and C), n = 40 | Cirrhotic patients showed significant short-term changes in the portal blood flow (increases CI). Seven patients developed complications including 2 cases of variceal bleeding. Due to deteriorations reported in liver functions Child class C patients should not fast |
Mohamed et al[66], 2018 | Observational and comparative | Cirrhotic (Child A and B) and healthy volunteers; n = 72; comprised cirrhotic fasting (n = 34), cirrhotic non-fasting (n = 8) and healthy volunteers (n = 30) | Patients with cirrhosis showed changes in their portal hemodynamics with increased CI. MELD score and serum albumin showed significant changes in comparison to healthy subjects |
Emara et al[15], 2021 | Review and practice recommendations | Cirrhotic patients. Analysis of the evidence for the above-mentioned studies | Cirrhotic patients Child A can observe RF especially if following NAFLD guidelines provided that certain evaluations are done in advance together with close observation during Ramadan. Cirrhotic patients Child B and C should not fast. The risk of decompensation is high |
Al-Jafar et al[55], 2023 | Systematic review and meta-analysis | Healthy individuals and patients with different comorbidities including cirrhosis and NAFLD. Analysis of many studies | RF was associated with reductions in anthropometric measures in all patients including cirrhotics. These changes start to appear in the second week of Ramadan and diminish 3 weeks after Ramadan |
- Citation: Emara MH, Soliman H, Said EM, Elbatae H, Elazab M, Elhefnawy S, Zaher TI, Abdel-Razik A, Elnadry M. Intermittent fasting and the liver: Focus on the Ramadan model. World J Hepatol 2024; 16(8): 1070-1083
- URL: https://www.wjgnet.com/1948-5182/full/v16/i8/1070.htm
- DOI: https://dx.doi.org/10.4254/wjh.v16.i8.1070