The Impact of Fasting during the Holy Month of Ramadan on Incidence of Acute Appendicitis

Background: Fasting during the holy month of Ramadan (fasting) for Muslims is a religious duty. The impact of fasting on some diseases has been reported in medical literature. This study evaluated the effects of fasting on appendicitis. In this population-based descriptive study, we investigated whether the incidence of acute appendicitis differs during fasting com-pared to other non fasting lunar months. Patients and Methods: A retrospective study was carried out on patients with pathologically documented diagnosis of acute appendicitis attending our surgery department during three consecutive Hijri years, from November 5, 2000 to December 4, 2002. The annual incidence of acute appendicitis was com-pared between three months, before, during and after Ramadan. Results: The total number of documented appendicitis were 414, 423 and 407 for three consecutive years of 2000 to 2002 (1421 to 1423, Islamic lunar years) respectively. The overall incidence of acute appendicitis in people aged from 15 to 70 years was 171.53/100,000 per year. Compared with the mean monthly oc-currence of appendicitis, a statistically significant reduction in the incidence of appendicitis was found during Ramadan, whereas, the frequency of acute appendicitis increased significantly in the month following Ramadan (p<0.001). Conclusion: The incidences rate of acute appendicitis was significantly lower in the holy month of Ramadan, which was most likely due to the fasting. Bowel resting could reduce the risk of appendicitis but more investigation is recommended