Earlier this month, Muslims around the world started 30 days of fasting as part of Ramadan. The ninth month of the Muslim lunar calendar, Ramadan is a holy time for Muslims that includes introspection, communal prayer, and abstaining from food and drink from sun up until sun down—that means fasting for as many as 11 to 17 hours at a time.
For many who observe Ramadan, those lifestyle changes—along with decreased sleep due to night prayers and other activities—can result in digestive issues, like constipation. Research shows that during Ramadan, those who fast may see significant increases in constipation, as well as bloating, heaviness or fullness.
While those who struggle with this challenge may feel like they just have to tough it out or ignore the discomfort, there are ways to help alleviate constipation. Here, nutritionists offer tips to help relieve constipation during Ramadan.
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Constipation occurs when a person has fewer than three bowel movements a week. Stool may also be hard and difficult to pass—and even after a bowel movement, you may not feel completely empty.
Various factors can lead to constipation, including many lifestyle factors or nutrition issues, like food intake, hydration, amount of movement, and even stress levels.
Ramadan specifically is a time when many people experience constipation. According to a 2017 study in the Journal of Religion and Health, constipation frequency and severity increased significantly among people who fasted.
Samina Qureshi, RDN, a dietitian who works primarily with individuals that suffer from irritable bowel syndrome and a large Muslim population, has seen this first-hand. "Throughout the year, my clients that observe Ramadan are interested in how to fuel their bodies appropriately and even more so, how to avoid constipation that occurs while fasting," Qureshi told Health.com. "We spend time during our sessions chatting about how to set ourselves up for success prior to, during, and after Ramadan."
Below, Qureshi offers tips she shares with her clients who observe Ramadan, to help reduce the frequency and severity of constipation, while still observing the holy month through fasting.
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During Ramadan, reduced food intake can be a large driver for constipation. When fasting, people decrease their meals to just two a day—Sahar, the morning meal; and Iftar, the evening meal. According to a 2016 report in the Iranian Red Crescent Medical Journal, about 30% of the day's total calorie intake occurs at Sahar; approximately 60% is seen at Iftar.
Because you're limited to two meals a day when fasting, it's important to make sure they're fiber-rich. In the report, researchers found that eating fewer than 15 grams of fiber each day was associated with an increased risk of constipation.
Eating a fiber-heavy morning meal may help reduce your chances of constipation. "Oatmeal can be a quick and easy option and is filled with fiber to help bulk up your stool," Qureshi said. "Another easy option for Suhoor [Sahar, the morning meal] is a smoothie with hydrating fruit, nut or seed butter, yogurt, chia seeds, and ground flaxseed for an extra boost of fiber."
Getting your fiber from natural sources and whole foods is key here. Fiber is a carbohydrate our bodies can't digest, which is why it plays a big role in digestion—it specifically adds bulk to stool, which allows for softer bowel movements. When you opt for a fiber supplement, you don't get the added benefit of the extra bulk to help move and soften stool.
Water and fiber go hand-in-hand: Increasing fiber without adding adequate fluids can lead to more constipation, Qureshi said.
According to the 2016 report, drinking less than 750 milliliters (about 25 ounces) of fluids each day can contribute to constipation. While water needs vary from person to person, the Institute of Medicine of the National Academies recommends 95 to 125 ounces of total liquid intake daily, about 80% of which comes from water and other fluids.
It may be hard to fully meet your needs while fasting. To help address this issue, it's important to regularly sip on water during the night hours rather than trying to chug water at the morning or evening meals.
To keep track of your fluid intake, you may want to take a look in the toilet: Urine color is a simple way to assess hydration levels and has been found to be a reasonably accurate indication of whether more hydration is necessary. Normal urine color is light to pale yellow; anything darker suggests you may need more fluids in your diet.
Paying attention to fiber and hydration are an important starting place, but there are additional actions that can also help you address constipation and move your bowels a little more smoothly.
If you've tried all of the tips outlined, or you're unsure about any of them, consider reaching out to your health care provider for further guidance. Additional actions a provider may recommend could include stool softeners or laxatives.
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