Levent ŞAHİN, Merve AYYILDIZ AKIN, Taner GÜVEN
Eurasian Journal of Emergency Medicine - 2026;25(1):351-359
Aim: Prolonged fasting impacts chronic diseases. This study aimed to describe the clinical, laboratory, radiological, and disposition characteristics of fasting patients with known biliary system disease who presented to the emergency department during Ramadan. Materials and Methods: In this prospective descriptive study, we included fasting patients with known biliary diseases who presented to the emergency department during Ramadan with acute right upper quadrant pain, nausea, and/or vomiting. We recorded demographics (age, gender), laboratory parameters, and hospitalization/discharge status. Patients were categorized into four groups based on radiological imaging: normal findings, common bile duct (CBD) dilatation, cholelithiasis, and biliary sludge. Results: The study included 37 patients. The most frequent pathological finding on radiological imaging was CBD dilatation (27%). Aspartate transaminase levels were significantly higher in females than in males (p<0.05). Furthermore, total and direct bilirubin levels were significantly elevated in patients with abnormal imaging findings and in those requiring hospitalization or referral (p<0.001). The hospitalization rate was also significantly higher for female patients (p=0.007). Conclusion: Consuming high-calorie meals after prolonged Ramadan fasting may trigger symptomatic exacerbations in patients with biliary tract pathology. Elevated C-reactive protein and bilirubin levels were correlated with disease severity and the need for hospitalization. Patients with a history of biliary disease should consult their physician before fasting. Because the study was descriptive and lacked a control group, no definitive causal relationship can be established.
