Dr. Muayad Kassim Khalid, Senior Consultant at Hamad Medical Corporation (HMC) is asking members of the public who will fast during Ramadan to be aware of the warning signs of dehydration, heat exhaustion, and other forms of heat-related illness. He says while mild to moderate dehydration can normally be reversed by drinking more fluids, severe cases of dehydration and heat-related illness are medical emergencies and require immediate treatment.
“While thirst and exhaustion can be expected as a result of fasting during Ramadan, particularly when the Holy Month falls during hot months, these conditions can become worse and lead to dehydration, heat exhaustion, and even heat stroke,” said Dr. Khalid.
Dr. Khalid says the first signs of heat-related illness typically include skin redness and warmth, dizziness, nausea, vomiting, tiredness, muscles cramps, difficulty breathing, and a racing heart rate. He says if left untreated, heat cramps or heat exhaustion can lead to heat stroke, which is the most serious heat-related illness and can be fatal.
“During Ramadan, people abstain from drinking and eating for a long period of time and dehydration can occur. However, the risk of dehydration is heightened when you add factors that can increase water loss, such as exposure to hot weather and excessive sweating,” said Dr. Khalid.
“Prolonged exposure to a hot environment and increased physical activity can then cause heat cramps and heat exhaustion and if those conditions continue, this can lead to heat stroke. People with heat exhaustion will often not realize the severity of their condition and may just complain of discomfort and uneasiness. They may experience excessive sweating, a throbbing headache, and dizziness – all of which are a result of the body’s temperature rising rapidly and the sweating mechanism failing. Essentially, the body loses its ability to cool down. Heat stroke can cause death or permanent disability if emergency medical treatment is not received,” said Dr. Khalid.
Individuals most at risk of dehydration and heat-related illnesses during Ramadan include those with chronic illnesses including diabetes and kidney diseases, those over the age of 65, patients with heart disease, and those taking multiple medications such as diuretics, which increase the production of urine.
“Individuals with chronic illnesses should consult their doctor before they start fasting because they can experience more severe complications if they suffer dehydration,” warns Dr. Khalid.
Individuals who work outdoors during daylight hours, or who work in very warm or less-ventilated environments, such as factories, kitchens, or bakeries, are also more susceptible to dehydration. However, Dr. Khalid says restrictions and regulations around Ramadan working hours are designed to help prevent those who fall into this category from the risks of heat-related illnesses.
Dr. Khalid says in the case of heat stroke, it is important to get immediate medical attention. He says if the affected person is conscious, they should be made to drink fluids, such as water or any cold drink. If the person is unconscious, use cool water (not cold) by applying a wet flannel or face-cloth to the skin. The affected person should be exposed to a fan or an air stream to help lower their body temperature.
Individuals with a low fitness level and those who have experienced a heat illness in the past are also at increased risk of dehydration. Dr. Khalid says the first line of defense in treating dehydration is staying hydrated. He recommends consuming ample amounts of fluids during non-fasting hours and says people should strive to drink three liters of water between Iftar and Suhoor.
“Individuals who fast should try to stay indoors and avoid direct exposure to the sunlight and humidity. Those working outdoors are advised to rest when the weather is hottest or to work in a shaded area when possible. Individuals who enjoy sports are encouraged to exercise during the evening or indoors,” said Dr. Khalid.