Fasting With Frequent Vomiting, TPN, And Pain Injections

Question: A woman asks, is it permissible for me to fast even though I vomit a lot every day, and I take total parenteral nutrition, TPN, through the vein, and I also take pain relieving injections, so is my fasting valid or not valid?

Summary:

Since you vomit without choice and take TPN, your fast is invalid because of TPN, and you may break the fast, rather it may be obligatory if fasting harms you.

Answer:

In the name of Allah, all praise is due to Allah, and may Peace and Blessings be upon the Messenger of Allah (ﷺ)

First, the ruling on vomiting for the fasting person

From the Sunnah:

  • Sunan Abī Dāwūd: 2380, Jāmiʿ al-Tirmidhī: 720Narrated by Abū Hurayrah (may Allah be pleased with him):
    The Prophet (ﷺ) said: if one has a sudden attack of vomiting while one is fasting, no atonement is required of him, but if he vomits intentionally he must make atonement.

    Meaning • If vomiting happens without choice, the fast is valid • If vomiting is done intentionally, the fast is invalid and must be made up

From the Scholars:

  • Al-Mughnī
    Ibn Qudāmah said:“If vomiting overcomes him he does not break the fast because he cannot avoid it.”

    Conclusion: Frequent unintentional vomiting does not invalidate the fast.

Second, the ruling of Total Parenteral Nutrition (TPN) Legal principle: Anything nourishing that replaces eating and drinking breaks the fast even if it does not enter through the mouth.

From the Scholars:

  • Al-Sharḥ al-Mumtiʿ
    Shaykh Ibn ʿUthaymīn رحمه الله said: “Nourishing injections which make a person independent of food and drink break the fast because they are equivalent to eating and drinking.”
  • Shaykh Ibn Bāz رحمه الله said:
    “If the injection is nourishing then it breaks the fast because it takes the place of food and drink.”

    TPN is complete nutrition entering the body and fully replacing food. Ruling: TPN breaks the fast without معتبر disagreement.

Third, the ruling of pain relieving injections If they are non nourishing, painkillers, medications, anesthesia, they do not break the fast because they do not nourish and do not replace food and drink.

From the Scholars:

  • Ibn ʿUthaymīn said:
    “Non nourishing injections do not break the fast whether in the muscle or vein.”

    Ruling: Pain injections do not invalidate the fast.

From the Qur'an:

  • Al Baqarah: 184
    "...But whoever of you is ill or on a journey, then ˹let them fast˺ an equal number of days ˹after Ramaḍân˺..."

And Allah knows best.

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