To the Editor: In their Letter to the Editor, Dr Crosby and colleagues1 discussed medical issues during Ramadan. Fasting during the month of Ramadan is not a ritual, it is a requirement for all Muslims. During the fast, Muslims refrain from eating and drinking between sunrise and sunset, but also forbidden are smoking, chewing tobacco or other substances, snuffing, sexual intercourse, intramuscular or intravenous administration of fluids, and the use of inhalers. However, young children, infirm or seriously ill persons, pregnant and nursing mothers, menstruating women, and long-distance travelers are exempted from fasting. The commandment was not intended to impose hardship or harm on the faithful. It is for him or her to apply common sense and not fast if medication, such as diuretics, is necessary between sunrise and sunset.
Sheikh K. Medical Issues and Ramadan. JAMA. 2006;295(5):498. doi:10.1001/jama.295.5.498-b
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