Fatwa ID: 03069
Answered by: Maulana Shadman Ahmed
Assalamu Alaikum Wa Rahmatullah
As a Crohn's patient I need some guidelines to direct me to when I should fast and if or when I shouldn't.
In previous Ramadhan's I have fasted and faced minor consequences following Ramadhan such as extreme weakness which lead to muscles being strained regularly, some breathing problems and falling underweight all of which normally settle down after I gain some weight back across the following months.
My difficulty is in understanding whether I should continue this approach or not as my non-muslim gastroenterologist is always advising me against fasting during this flare phase, but I cannot see any dire long-term consequence from going ahead and fasting.
How do I go about assessing confidently whether I should fast on a day or not?
My current scenario for this year is that according to the NHS BMI calculator which is what my doctors check me against, I am slightly underweight (yellow area). I do get weak very quickly if I do not eat regularly but as I have had to focus on putting on weight, I cannot be sure if my body will adjust to fasting conditions until I give it a go. I have around ½ stone before I am officially in the underweight warning area.
I am not aware of any life-threatening conditions if I was to fast. The after-effects are more often weakness related and longer recovery times and minor issues like frequent muscle strain from normal activities.
I can carry out my normal duties as long as I take everything very slowly and ensure lots of rest throughout the day and as long, I do not face any severe flare-ups, however, any exertion would impact me significantly. By exertion, I mean having to do any outings like shopping, appointments or anything physical.
I tend to have loose stools daily which means I am easily dehydrated. Again, unless I have a set back of a few days of flare-up, this is usually manageable and ask long as I don't go out into the sun than it shouldn't cause an issue.
My current medication scenario is that I am on methotrexate for both Crohn's disease and inflammatory arthritis.
In The Name Of Allah, The Most-Merciful, The Most Kind
If you feel that you can fast on a certain day without any severe repercussions, then you should fast as the reward and merit of a single fast of Ramadan is too many to leave off. The symptoms that you stated are not such that they will prevent you from fasting. Some research even suggests that fasting is a treatment form some of Crohn’s disease.
Take as much as possible to make your fast easy upon you such as drinking enough fluids at suhoor for dehydration and not exerting yourself too much in the day.
If you feel the flare is very intense and you cannot fast the next day, then you will be excused from fasting that day due to the hardship of the sickness. In addition, please see if you can consult a practising Muslim gastroenterologist for specific advice on if fasting makes your sickness more severe or not. [al-Bahr al-Raiq, volume 2, page 398]
Only Allah knows best
Written by Maulana Shadman Ahmed
Checked and approved by Mufti Mohammed Tosir Miah
Darul Ifta Birmingham
وَفِي الْمُجْتَبَى حَدُّ الْمَرَضِ الْمُسْقِطِ لِلْقِيَامِ وَالْجُمُعَةِ وَالْمُبِيحِ لِلْإِفْطَارِ وَالتَّيَمُّمِ زِيَادَةُ الْعِلَّةِ أَوْ امْتِدَادُ الْمَرَضِ أَوْ اشْتِدَادُهُ أَوْ يَجِدُ بِهِ وَجَعًا اهـ