23.4.1 GIT DISEASES

Patients with an acute abdomen are immediately excused from the obligation of saum until full recovery. Salat can be performed as much as their physical condition allows. Saum may not be possible in advanced stages of peptic ulcer disease. The impact of GIT neoplasms on saum and salat is variable depending on the complications. Conditions of the oropharynx interefere with eating and drinking as well as recitation of the Qur’an in salat. Esophageal disorders may have implications for fasting patients. Esophageal varices may lead to hematemesis that voids fasting. Patients with malabsorption may be exempted from fasting while they are on treatment with special diets that have to be taken during the day or if their nutritional status requires regular food intake. Use of a hernia belt is allowed in hajj for those whose small intestine herniates.

Diseases of the large intestine interfere directly with fasting if they are associated with vomiting which voids fasting. Continuous diarrhoea may make the maintenance of wudhu difficult. Stoma created after operation for cancer of the colon do not normally interfere with saum, salat, or hajj. Constant flatulence may make maintenance of wudhu difficult. It is recommended that salat is performed immediately after wudhu. If flatulence is continuous it can be ignored but efforts at finding a treatment should be continued. In cases of bleeding due to hemorrhoids and anal fissures, wudhu will have to be made immediately before the salat and for that salat only. It has to be repeated for every salat. Care must be taken during instinjah not to cause undue pain in case of anal fissures. Extreme obesity makes salat difficult because of body weight, physical weakness, and restricted movements. Saum is good for the obese.

23.4.2 IMPACT OF GIT SYMPTOMS AND SIGNS ON IBADAT

Salat is delayed while anticipating vomiting because vomiting is najasat and will nullify the salat anyway. Vomiting nullifies fasting; it is recommended to continue fasting even after an episode of vomiting but make up the day after. 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. In extreme cases of peptic ulcer disease the patient is exempted from fasting. Any incidence of audible smelt flatus nullifies wudhu. A general feeling of flatulence does not nullify wudhu. Salat should not be terminated on mere suspicion of passing flatus. A situation of continuous diarrhoea makes it difficult to maintain a state of wudhu or to pray in congregation. When an episode of diarrhoea is impending, salat is terminated by tasliim at any stage and is resumed after defecation and a new wudhu. In cases of anal incontinence, wudhu is made immediately before each prayer. Upper GIT bleeding that does not cause visible blood at the anal opening does not nullify wudhu. If it leads to hematemesis, saum is void and has to be made up later. Fresh bleeding from hemorrhoids and anal lesions does not nullify wudhu but must be washed away immediately and before salat commences. Any cause of abdominal discomfort such as pain, cramps, spasms, and digestive disorders make it difficult to concentrate in salat. It is recommended to delay salat until the discomfort is treated. Pain of gallstones in an acute attack makes concentration in salat difficult. Associated vomiting may void saum. The colostomy site is kept as clean as possible all the time. Wudhu is made before each salat. Normally there is no interference with saum. 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. Disease transmission by feco-oral route requires special measures to protect public health in the food service industry. Islamic teachings about personal hygiene play a role in preventing the spread of infection.

23.4.3 IMPACT OF GIT DISEASE ON ‘AADAAT

23.4.4 IMPACT OF GIT DISEASE ON MUAMALAAT