You wait all day for that first bite. The aroma of freshly prepared kuih, rich gravies, and sweet drinks fills the table. After hours of fasting, it is tempting to indulge. Yet by midnight, many find themselves bloated, uncomfortable, or struggling with heartburn.
For many, Ramadan is a time of spiritual renewal and an opportunity to embrace a more mindful, balanced approach to physical well-being. However, some may experience digestive discomfort. Acid reflux, bloating, constipation, and fatigue can arise during the fasting month due to dietary choices between Iftar and Sahur. Dr Sheikh Anwar Abdullah, Consultant Gastroenterologist and Hepatologist at Sunway Medical Centre, Sunway City, encourages those observing the fast to treat Ramadan as an opportunity to reset gut health rather than strain it.
“The digestive system experiences a period of rest when people choose to fast. The body produces less acid and experiences decreased inflammatory triggers, which can improve gut health. But we often undo these benefits by overeating at Iftar or neglecting hydration and fibre,” he explains.
Research supports what many experience firsthand. Studies have shown a rise in gastrointestinal complaints such as bloating, acid reflux, and constipation during Ramadan. The main causes are familiar: heavy meals, oily and spicy foods, dehydration, and long gaps between eating. “The biggest culprits are usually overeating at Iftar, consuming deep-fried or spicy foods, not drinking enough water, and skipping fibre. Reduced physical activity due to altered sleep patterns and lower energy levels also slows digestion and worsens constipation,” says Dr Sheikh Anwar.
Skipping Sahur or choosing fast food may seem convenient, but it often backfires. Dr Sheikh Anwar advises a balanced, slow-digesting Sahur that sustains energy and protects the gut. “The ideal Sahur includes complex carbohydrates such as oats or brown rice, protein from eggs, fish, or tofu, and water-rich fruits like watermelon or cucumber. Yogurt can also benefit gut health due to its probiotics, provided you do not have lactose intolerance. The main foods to avoid during Sahur are spicy and greasy dishes that irritate the stomach lining and increase the risk of reflux later in the day,” he says.
At Iftar, it is important to ease the stomach back into digestion. Sugary drinks, excessive fried foods, and salty dishes may feel satisfying in the moment but often lead to bloating and indigestion. “Start with water and a few dates, then perhaps pause for Maghrib prayers before eating a proper meal. Eat slowly, and aim for a balanced plate with complex carbs, lean protein, and some healthy fats,” Dr Sheikh Anwar advises. Late-night eating during Moreh, the post-Tarawih supper, is another common issue. While it is a cherished Ramadan tradition in Malaysia, it should be done moderately. “Keep it light during Moreh and try to leave two to three hours between your last meal and bedtime to reduce acid reflux and digestive issues,” he adds.
Hydration is crucial. Constipation is one of the most frequent complaints during Ramadan, often caused by inadequate fluid intake. Proper hydration supports digestion and prevents headaches and fatigue. “Aim for at least 2 to 2.5 litres of water between Iftar and Sahur. Sip regularly instead of drinking large amounts at once. Include water-rich fruits and avoid excessive caffeine, which can worsen dehydration,” says Dr Sheikh Anwar.
While fasting is safe for most healthy adults, it may aggravate preexisting gastrointestinal conditions. Those managing conditions such as ulcerative colitis, duodenal ulcers, upper GI bleeding, or moderate-to-severe liver cirrhosis could have a higher risk of flares and complications and require careful monitoring from healthcare professionals. “If you are on gastric medication, take it about 30 minutes before Sahur for maximum effect. If you develop persistent abdominal pain, vomiting, diarrhoea, or see blood in your stool, do not feel pressured to continue your fast and seek medical attention,” he advises.
Fibre may be the missing piece to a healthier Ramadan. According to the National Health and Morbidity Survey 2024, only 17% of Malaysian adults and 13% of adolescents meet the recommended daily intake of fruits, while just 12% of adults and 5% of adolescents get enough vegetables. This shortfall can worsen constipation and bloating during Ramadan. “Fibre is essential for bowel regularity. It can also lower cholesterol, stabilize blood sugar, and keep you full longer. Increase it gradually through fruits, vegetables, legumes, and whole grains to avoid gas and discomfort,” says Dr Sheikh Anwar.
Ramadan does not have to be a temporary reset. Dr Sheikh Anwar encourages Malaysians to maintain healthier routines even after the fasting month ends. “Continue eating mindfully, staying hydrated, and spacing out meals. Older adults especially should ensure enough protein and fibre to maintain muscle strength and digestive health,” he says.
This Ramadan, Dr Sheikh Anwar urges everyone to go beyond cravings at Iftar and focus on what truly nourishes the body. A healthier gut supports a healthier fasting experience and a more meaningful month of reflection. “Fasting and health go hand-in-hand. Eat in moderation, hydrate well, and listen to your body. If something feels off, do not push through the pain and get it checked immediately,” he concludes.
