ABSTRACT Introduction Religious fasting is widely practiced across major faith traditions, including Christianity, Judaism, Islam, and Hinduism, and may affect the perioperative care of patients undergoing elective surgery. Despite this, it is often not addressed in preoperative assessment or surgical planning. Objective To synthesize current evidence on how religious fasting practices influence a patient's physiologic status, timing of surgery, intraoperative management, and postoperative recovery, and to highlight targeted strategies for clinical care. Methods We conducted a structured narrative review of peer-reviewed clinical studies (using PubMed, Embase, Cochrane Library, among others), society guidelines, and multidisciplinary clinical literature addressing religious fasting practices and surgical care. Results Extended periods of fasting are associated with dehydration, insulin resistance, glycogen depletion, micronutrient and protein deficits, as well as altered drug metabolism. The reported implications of these fasting-related physiologic changes include increased risk of being hemodynamically unstable with anesthesia, infections, inadequate wound healing, medication nonadherence, and nutritional compromise in the postoperative period, particularly in pediatric, elderly, and bariatric populations. The recommended strategies to mitigate these risks include preoperative fasting screening, optimization of hydration and nutrition, scheduling adjustments, and interdisciplinary collaboration with dietitians and spiritual care. Conclusion Religious fasting is both a clinically relevant and ethically important component to address during surgery. Proactive and culturally competent planning can help reduce preventable complications, while respecting patient beliefs.
Otiocha et al. (Mon,) studied this question.