During Ramadan, there is a significant decrease in water consumption over a long period of time. The unrelenting heat, harsh sunlight and longer days do not make it easy for people who fast. When you add dehydration, fatigue and weakness to the equation, you can have several health complications, including kidney stones and urinary tract infections (UTIs) in both men and women. Symptoms of mild to moderate dehydration are increased thirst, headache, lightheadedness, constipation, dry skin and mouth. We receive a number of patients who come to us with dehydration during Ramadan. All individuals planning to fast need to recognize the issue in advance of the fasting period and adopt the right measures to reduce the incidence of the problem to have a safe and healthy holy month.
The incidence of kidney, ureter or bladder (KUB) stones and urinary tract (UTIs) infections can increase in individuals towards the last days of Ramadan. Stones are commonly seen in people who consume less than the suggested eight to ten glasses of water a day. When there is not enough water to dilute the uric acid, which is found in urine, the pH (alkaline) level within the urine lowers and becomes more acidic. A highly acidic environment in the kidneys is linked to the incidence of kidney stones.
Urinary tract infections are a particularly common problem in women fasting during Ramadan. If left unchecked, UTIs can affect the kidneys. UTI symptoms include burning sensations while urinating, lower abdominal pain, blood in urine and mid-to-lower back pain, increased frequency of urination and pain. The problem occurs when bacteria make their way into the bladder. The heat and humidity encourage the growth of the bacteria, causing an infection that compromises the bladder. The other important cause is the lack of water to flush out the bacteria before it affects the bladder. Besides, constipation also contributes to overgrowth of bacteria.
People with diabetes are particularly vulnerable to various bacterial, viral and fungal infections. The most common cause of chronic renal disease is uncontrolled diabetes, placing patients, particularly women, at high risk for recurrent and complicated urinary tract infections. Diabetic patients who opt to fast during Ramadan must be clearly counseled about keeping themselves hydrated between non-fasting hours and maintaining good glycemic control through diet and antidiabetic drugs.
We recommend proper hydration of up to three liters of fluids a day, and a low protein and salt diet outside of fasting hours. Make a conscious effort to drink more fluids at Suhoor and Iftar, even if you don’t feel like it. Have adequate amounts of water and fruit juices to energize the body, quench thirst and ingest a host of vitamins and minerals that build immunity. Avoid too much coffee when fasting, as it is a diuretic and may stimulate further water loss. Drinking lemonade, with less sugar, reduces the risk of kidney stones, as it increases the natural citrate level in the body, which in turn, stops stones from forming.
Consider eating less spicy or salty food, as it can affect the pH levels of urine. Too much salt in your diet can cause dehydration. Differing levels can lead to an infection. In addition to drinking lots of water, we also suggest drinking cranberry juice, as it is linked to curbing the infection.
Most importantly, all these health problems can be avoided with a proper diet and adequate hydration. It is also important to seek the counsel of a doctor especially if an individual is suffering from kidney disease, recurring kidney stones or UTIs before they embark on their fast to avoid any serious shot term or long term complications.