Safe Fasting Menu Guide for Ulcer and GERD Sufferers

A complete guide to the Ramadhan sahur and iftar menu that is safe for ulcer and GERD sufferers. Know the dietary restrictions and recipes to prevent stomach acid from rising.

Key Insights: Physiological adaptation usually occurs on the 10th day of fasting, where stomach acid production can decrease by up to 65%.

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Basic Understanding of Ulcers, GERD, and Ramadan Fasting

It is important to understand the mechanisms of the disease and how the body adapts during fasting.

Stomach (Gastritis) vs GERD

• Stomach (Matritis): Inflammation of the mucosal lining of the stomach which causes heartburn, nausea and bloating. These complaints often increase by up to 21% on the first day of fasting.
• GERD (Gastroesophageal Reflux Disease): Reflux (rising) of stomach acid into the esophagus due to weakening of the sphincter muscle. Interestingly, research from FKUI-RSCM shows that fasting can actually reduce GERD symptoms in 83% of subjects.

General Symptoms:

• Pain or burning sensation in the pit of the stomach (indigestion).
• Nausea, bloating and excessive belching.
• Regurgitation (rising) of acid or food into the throat.

Physiological Adaptations: Day 10 is Key

Prof. Dr. Dr. Ari Fahrial Syam, Sp.PD-KGEH, MMB emphasized that stomach discomfort usually only occurs in the first 7-10 days of fasting. After that time, the body begins to adapt so that you can fast more comfortably without having to rely on medication constantly.

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Specific Dietary Restrictions and Preferences

Recognizing symptom triggers is key to optimal dietary management.

Abstinence Category	Food Examples	Reasons for Avoidance	Safe Alternative
Spicy	Chili, chili sauce, pepper, curry spices	Capsaicin irritates the mucosa and weakens the gastric sphincter.	Ginger, turmeric, garlic, lime leaves
Sour	Oranges, lemons, tomatoes, vinegar	Lowers gastric pH and irritates the esophagus.	Banana, papaya, melon, sweet apple
High in Fat	Fried, thick coconut milk, chicken skin	Slows gastric emptying (can take 4-6 hours).	Steamed, boiled, grilled, thin coconut milk
Excessive	Portions too big, too sweet/salty	Increases intra-abdominal pressure (pressure in the stomach).	Eat moderate and balanced portions

Individual Approach: Food Diary is Key

Dr. Andi Khomeini Takdir Haruni, Sp.PD emphasize: “Regarding food, almost anything is allowed except for those where the patient is not suitable from the start, for example there is a history.”

Component Food Diary Effective:

• Meal times, type of food (including brand if any).
• Approximate portions and processing methods.
• Stress levels and body position after eating.
• Symptom records: type, time of appearance, duration, and intensity scale (1-10).

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List of Recommended Foods

1. Complex Carbohydrates. Helps regulate stomach acid (based on General Soedirman University Study).

• Brown rice and black rice.
• Oatmeal and whole wheat.
• Steamed potatoes and sweet potatoes.
• Wheat bread without butter.

2. Low Fat Protein. Dr. Surapsari Perhiasan, Sp.GK recommend low-fat protein to reduce gastric digestive burden.

• Skinless chicken (steamed/boiled).
• White meat fish (snapper, carp).
• Steamed tofu and tempeh.
• Boiled eggs or a splash of water.

3. Safe Fruit

• Banana: It is an ideal choice because it has very low acid levels and its texture is able to coat the stomach walls.
• Pawpaw: Contains papain enzyme which is good for digestion.
• Melon and Watermelon: High water content for hydration.
• Sweet Apple: It is best to peel it before consuming it.

Recommended Cooking Method:

• Steamed: Maximum nutrient retention without added oil.
• boiled: Excellent in soups and increasing fluid intake.
• Roast: Minimal fat, make sure it doesn’t burn.
• Water Stir-Fry: Use very little oil, more water.

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Safe Sahur Menu Guide

Sahur functions as buffer (buffer) stomach acid throughout the day. Skipping sahur means leaving the stomach empty for 18-20 hours, which triggers excess acid production.

• Optimal Time: 30-60 minutes before imsak. Avoid having sahur too early or too late so that digestion doesn’t rush.
• Ideal Composition: Complex carbohydrates (50-60%), Low fat protein (15-20%), Fiber/Vegetables (20-25%), Healthy fats (5-10%).

Example of a Sahur Menu:

• Menu 1 (Practical): Oatmeal with low fat milk + ginger, sliced ​​banana, boiled egg, warm ginger tea.
• Menu 2 (Complete): Brown rice, steamed skinless chicken, sauteed garlic spinach, ripe papaya, water.
• Menu 3 (Comfortable on the stomach): Rice porridge with shredded chicken, steamed tempeh, boiled carrots, tea chamomile.

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Safe Iftar Menu Guide

Avoid “revenge” when breaking the fast. Eating large portions will increase the pressure in the stomach 3-4 times, forcing stomach acid to rise into the esophagus.

Gradual Breaking Principle:

1. Opener (0-5 minutes): 1-3 dates + 2 glasses of warm water (or low-fat milk or vegetable milk (such as almond/soy milk) for those whose stomachs are sensitive to lactose (cow’s milk)).
2. Light Soup (10-15 minutes): Chicken soup without coconut milk or fruit is safe to consume while waiting for Maghrib.
3. Main (15-30 minutes): Complex carbohydrates, low-fat protein, and non-acidic vegetables.

Example of an Open Menu:

• Healthy Traditional Menu: Dates & warm water (appetizer), Carrot ginger chicken soup (soup), Rice with grilled chicken & kale (main), Boiled banana (dessert).
• Traditional Menu Modifications:
  • Vegetable Dumplings: Replace thick coconut milk with thin coconut milk for chayote.
  • Marrow Porridge: Use thin coconut milk.
  • Fried chicken: Change to yellow spice grilled chicken.

Nutritionist Tips: Dr. Eny from IPB University recommends pepes tilapia (tilapia) with brown rice as a balanced iftar menu.

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Specific Recipes for Ulcer and GERD Sufferers

Practical menu with safe cooking methods.

Sahur Recipe

1. Honey Ginger Oatmeal

• Material: ½ cup whole oatmeal, 1 cup water/low-fat milk/vegetable milk (such as almond/soy milk) for those whose stomachs are sensitive to lactose (cow’s milk), 1 tsp grated ginger, 1 tsp honey (optional).
• How to make: Boil the oatmeal with ginger for 5-7 minutes until gentle. Add honey and serve with banana slices.
• Benefit: The beta-glucan in oatmeal forms a protective gel in the stomach, while ginger helps soothe digestion.

2. Pepes Tofu Without Coconut Milk

• Material: 300g white tofu (crushed), 1 handful of basil, 3 cloves of garlic, 1 tsp grated ginger, banana leaves.
• How to make: Mix all the ingredients, wrap in banana leaves, then steam for 20 minutes until cooked.
• Benefit: Highly digestible vegetable protein with non-irritating aromatic seasonings.

Recipe for breaking the fast

1. Yellow Pumpkin Chicken Soup

• Material: 200g diced chicken breast, 300g diced yellow pumpkin, 1 sliced ​​carrot, 3 cm bruised ginger, 3 cloves garlic.
• How to make: Boil the chicken and remove the foam. Add ginger, onions and vegetables. Cook 20-25 minutes until soft. Season with salt and a pinch of white pepper.
• Benefit: The texture of pumpkin is very gentle on the stomach, while the broth provides optimal rehydration.

2. Lemongrass Ginger Steamed Fish

• Material: 2 fish (snapper/tilapia), 5 cm thinly sliced ​​ginger, 2 bruised lemongrass stalks, 3 cloves of garlic, 1 tsp soy sauce.
• How to make: Coat the fish with spices, let stand 15 minutes. Steam for 15-20 minutes until cooked.
• Benefit: Rich in Omega-3 which has anti-inflammatory properties. Ginger and lemongrass warm the stomach without triggering acidity.

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Snacks and Drinks Guide

Ideal Hydration Distribution (8-10 glasses/day):

• 2 glasses when breaking the fast.
• 2-4 glasses at night (in installments).
• 2 glasses at dawn.

Evening Drinks:

• ⭐ Safe & Priority: Warm water, ginger/chamomile tea, young coconut water (natural source of electrolytes).
• ⚠️ Should Avoid: Coffee, strong black tea, soft drinks, drinks that are too cold/ice, and alcohol.

Evening Snack (Consume small portions if necessary):

• ⭐ Safe: Boiled/grilled bananas, boiled potatoes.
• ⚠️ Currently: Wheat bread without butter, yogurt plain low fat (if tolerated by the body).
• ❌ Should Avoid: Fried foods, chips, chocolate, processed foods with preservatives, excess fried nuts.

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Lifestyle and Medication Management

Holistic strategies for comfort during fasting.

Daily Habits:

• Chew food slowly (20-30 times).
• Don’t lie down straight away after eating; give a break of 2-3 hours.
• Elevate your head 15-20 cm when sleeping at night.
• Avoid clothes that are too tight in the stomach area.
• Avoid heavy physical activity immediately after eating.

Medication Schedule During Fasting (Consult with Doctor):

Drug Class	Example	Fasting Schedule	Information
PPI	Omeprazole, Esomeprazole	30 minutes before dawn	Requires acid activation during meals.
H2 blocker	Cimetidine, Famotidine	Sahur and/or breaking the fast	Can be adjusted according to the emergence of symptoms.
Antacid	MgOH, AlOH	According to acute symptoms	To relieve temporary complaints.

“If you have been suffering from stomach ulcers for which a doctor has to give medicine, you should see a doctor first or at least contact him before fasting.” – Dr. Andy

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When to Stop Fasting and See a Doctor?

Immediately cancel fasting and seek medical help if you experience Medical Emergency Sign following:

• Vomiting blood: Fresh blood is bright red or brown like coffee grounds (an indication of stomach bleeding).
• CHAPTER Black (Melena): The stool is dark black and smells rancid.
• Severe Chest Pain: Chest pain that spreads to the back/left arm, often accompanied by shortness of breath (can be a heart symptom that is confused with GERD).
• Persistent Symptoms: Heartburn that is very severe and does not subside even after taking antacids.

Rukhsah (Light) in Islam: For those who are sick and whose fasting has the potential to endanger their health, Islam provides permission. This is not a failure, but a form of wisdom in implementing sharia.

• Qadha: Changing fasting to another day (for diseases that can be cured).
• Fidyah: Feeding the poor (for chronic conditions that do not allow fasting at all). The ideal decision always involves a doctor (for medical aspects) and an understanding of religious law.

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List of References and Trusted Sources

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Conclusion: Ramadan fasting for ulcer and GERD sufferers is not an obstacle, but an opportunity to discipline your diet. The key is dietary discipline, knowledge of symptom triggers, and appropriate medical support.