Association of peptic ulcer perforation with ramadan related lifestyle modifications.


  • Attiya Nasir Siddique Hayatabad Medical Complex, Peshawar.
  • Muhammad Usama Khyber Teaching Hospital, Peshawar.
  • Sophia Asif Khan Khyber Teaching Hospital, Peshawar.
  • Muhammad Umer Faheem Khyber Teaching Hospital, Peshawar.
  • Hizbullah Riaz Ansari Lady Reading Hospital, Peshawar.
  • Muhammad Naveed Khyber Teaching Hospital, Peshawar.



Gastric Perforation, Peptic Ulcer Perforation, Risk Factor


Objective: To look into the relationship of Ramadan with peptic ulcer perforation. This will include assessing the effect of fasting as well as other Ramadan related factors like changes in eating and smoking habits. Study Design: Retrospective Analysis. Setting: Three Tertiary care hospitals of Peshawar i-e Hayatabad Medical Complex, Khyber Teaching Hospital and Lady Reading Hospital. Period: 6th May 2019 to 26th May 2020. Material & Methods: Patients presenting with the aforementioned complication of peptic ulcer during the research period were divided into two groups. Patients presenting during the two Ramadan months were designated as cases (Group 1). While those presenting during the rest of the period i-e 11 months, were the controls (Group 2). So comparison of these groups was done on basis of various predisposing factors of the disease. Inferences were drawn by applying Student’s t, Chi-square and Fischer’s exact chi-square tests. Results: A total of 129 patients were considered. Among these, 36 were cases (Group 1) and 93 were controls (Group 2) as per our study design. Number of perforations per month were statistically higher in Group 1 in comparison to Group 2 (i-e 18 patients per month vs 8.4 patients per month, p<0.05). Patients with dyspepsia and preference for fried food were significantly higher in Group 1 (p<0.001 and p=0.022 respectively). Whereas smoker were significantly lower in Group 1 (p=0.048). Conclusion: Analysis concluded that the incidence of perforation is higher during the Ramadan. Since Ramadan is not only about fasting, and it affects eating and smoking habits, this rise in rate of perforations can be considered to be an interplay of such changes and the complication of peptic ulcer.

Author Biographies

Attiya Nasir Siddique, Hayatabad Medical Complex, Peshawar.

MBBS, FCPS (Surgery), Resident General Surgery, 

Muhammad Usama, Khyber Teaching Hospital, Peshawar.

MBBS, MRCS, FCPS (Surgery), Resident General Surgery, 

Sophia Asif Khan, Khyber Teaching Hospital, Peshawar.

MBBS, FCPS (Surgery), Resident General Surgery, 

Muhammad Umer Faheem, Khyber Teaching Hospital, Peshawar.

MBBS, FCPS (Surgery), Resident Surgery, 

Hizbullah Riaz Ansari, Lady Reading Hospital, Peshawar.

MBBS, FCPS (Surgery), Resident Surgery, 

Muhammad Naveed, Khyber Teaching Hospital, Peshawar.

MBBS, FCPS (Surgery, Resident Surgery,