Religious Fasting of Muslim Patients After Metabolic and Bariatric Surgery: a Modified Delphi Consensus.
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Kermansaravi Mohammad, Omar Islam, Mahawar Kamal, Shahabi Shahab, Bashir Ahmad, Haddad Ashraf, Abbass Alaa, Abbas Syed Imran, Abbas Mujjahid, Abouzeid Tarek, Akin Faki, Aghajani Ebrahim, Aminian Ali, AlAnsari Mohanad, Asghar Syed Tanseer, Balta Ahmet Ziya, Bukhari Waleed, Elfawal Mohamad Hayssam, Gado Waleed, Gawdat Khaled, Gee Tikfu, Ghavami Bijan, Goel Ramen, AlHadad Mohammed, AlHadhrami Bader, AlHaifi Mohammad, AlHamdani Ali, Hassan Ibrahim, Illan Selim Jalil, Inam Atif, Ismaeil Aiman, Kayyal Yasser, Mohammad Khaleel, Khan Amir Ulhagh, Khoursheed Mousa, Khwaja Haris, Kular K S, Layani Laurent Abram, Maazulhassan, Mahdy Tarek, Maher Mumtaz, Mansoor Ebrahim, Mirza Salman, Niam Muhammad S, Omarov Taryel, Pazouki Abdolreza, Alqahtani Aayed R, Qassem Mohamed, Rezvani Masoud, Sabry Karim, Salim Safauldeen, Shabbir Asim, Skalli Mehdi, Taha Osama, Talebpour Mohammad, Taskin Halit Eren, Taskin Mustafa, Yunus Tahir, Jazi Amir Hossein Davarpanah, Kassir Radwan, Nimeri Abdelrahman
Аннотация
METHODS: A committee of 61 well-known metabolic and bariatric surgeons from 24 countries was created to participate in the Delphi consensus. The committee voted on 45 statements regarding recommendations and controversies around fasting after MBS. An agreement/disagreement ≥ of 70.0% was regarded as consensus.
RESULTS: The experts reached a consensus on 40 out of 45 statements after two rounds of voting. One hundred percent of the experts believed that fasting needs special nutritional support in patients who underwent MBS. The decision regarding fasting must be coordinated among the surgeon, the nutritionist and the patient. At any time after MBS, 96.7% advised stopping fasting in the presence of persistent symptoms of intolerance. Seventy percent of the experts recommended delaying fasting after MBS for 6 to 12 months after combined and malabsorptive procedures according to the patient's situation and surgeon's experience, and 90.1% felt that proton pump inhibitors should be continued in patients who start fasting less than 6 months after MBS. There was consensus that fasting may help in weight loss, improvement/remission of non-alcoholic fatty liver disease, dyslipidemia, hypertension and type 2 diabetes mellitus among 88.5%, 90.2%, 88.5%, 85.2% and 85.2% of experts, respectively.
CONCLUSION: Experts voted and reached a consensus on 40 statements covering various aspects of fasting after MBS.