0803-Issues in Upper GIT Disorders

Background material by Prof OHK for Year 3 Semester 2 PPSD session on 25th March 2008

Nausea and vomiting

Nausea is a feeling of stomach discomfort, revulsion for food, and expectation of vomiting. It arises when stomach or duodenal nerve endings are stimulated and they send impulses to brain vomit control centers. Causes of nausea include: indigestion, motion sickness (air or water), pregnancy, rapid swallowing, emotional stress, shock, pain, raised intracranial pressure, liver disease, and renal disease.


Salat is delayed while anticipating vomiting. The mouth has to be washed after an episode of vomiting. A little vomiting does not nullify wudhu. Some jurists are of the opinion that vomiting little or a lot does not nullify wudhu. If vomiting occurs during salat, the worshipper leaves salat, washes the mouth and then returns and completes the salat if he did not talk in the meanwhile. He may also choose to repeat wudhu and repeat the salat.


Vomiting nullifies fasting; it is recommended to continue fasting even after an episode of vomiting but make up the day after. Vomiting like blood letting and wet dream do not nullify wudhu. However deliberate vomiting nullifies wudhu. No fasting in cases of continuous vomiting for fear of dehydration and electrolyte imbalance.


Vomiting does not spoil hajj because all acts of hajj except tawaaf do not require wudhu. Tawaaf can be undertaken at periods of no vomiting. If vomiting occurs, tawaaf is interrupted to go and vomit and then return to complete the tawaaf.



Hiccup in salat may make recitation of the Qur’an impossible. If the hiccup persists it is preferable to terminate the salat and wait until it subsides. Salat can be delayed until the hiccup stops. If the hiccup is persistent he prays and recites as best as he can during the hiccup. A person with hiccup cannot be imaam. In fasting he breaks fast to take medication and pays back the days.



Halitosis, bad oral smell due to caries, gingivitis, and oral ulcer; is a reason for keeping away from public assemblies until the condition is cured.


Upper GIT bleeding

Upper GIT bleeding that does not cause visible blood at the anal opening does not nullify wudhu. If it leads to hematemesis, puasa is void and has to be made up later. In extreme cases of peptic ulcer disease the patient is exempted from fasting.


Oral disease

Neoplasms interfere with eating and drinking as well as recitation of the Qur’an in salat. Diseases that prevent mastication are an exemption from saum because of the need for continuous liquid diet. Oral bleeding does not nullify wudhu. If oral disease makes it difficult to speak in salat it suffices to move the tongue instead of recitation. In civil transactions, muamalat, a person who cannot speak can still conclude contracts by using sign language.


Esophageal disease

The esophagus is intimately involved in nutrition that any esophageal lesions interfere with proper nutrition. This may have implications for fasting patients. Esophageal varices may lead to hematemesis. Reflux may restrict bowing (ruku’u) and prostration (sujuud).


Stomach disease

Gastric and duodenal ulcers do not interrupt salat except in cases of hemorrhage or perforation. Saum may not be possible in advanced stages of peptic ulcer disease because of the need for regular meals and regular medication. Gastric ulcer and duodenal ulcer m-ay be complicated by: perforation, hemorrhage, and obstruction due to chronic fibrosis. Perforation and hemorrhage are a surgical emergency. Chronic obstruction is a cause of pain, indigestion, and other gastro-intestinal problems that could interfere with fasting. Hajj is not possible if there is hemorrhage and perforation.


ŠProfessor Omar Hasan Kasule, Sr. March, 2008