As the most sacred day in the Jewish calendar, which most Jews are keen to observe, Yom Kippur – the Day of Atonement – can be very difficult if you have Inflammatory Bowel Disease.
We spoke to Young Jews with IBD about how they manage their conditions round the festival.
**Please note these are personal views and you should always seek medical advice from your IBD team and Halachic advice from your Rabbi, independently as it will be specific to your medical situation.
Managing IBD and Yom Kippur – Matty Fisher
Fasting is generally discouraged when managing IBD, as there is a need to maintain regular meals for a healthy lifestyle, and to take medication.
Since being diagnosed with Crohn’s Disease, managing my IBD over Yom Kippur has fluctuated depending on the year. Having spoken to my local Rabbi, I have learnt it is important to put your health first. Therefore, I think it is vital to take the advice of your medical team when it comes to fasting on Yom Kippur – the way to manage your condition on Yom Kippur can differentiate person to person. Many Rabbis have told me over the years that taking the guidance of your healthcare team in how to observe Yom Kippur is the best thing to do.
Personally, I have been ok to fast in recent years due to my Crohn’s being under control and managed. However, when I was on daily medication such as Azathioprine, I would have some water with my pills to ensure I didn’t miss out on my important treatment to keep my IBD managed.
Therefore, my experience is that you should have food/drink if necessary to maintain your medication dosage and also ask medical advice on whether you should fast at all.
Managing Ulcerative Colitis and a Stoma and Yom Kippur – Oliver Kaye
Being diagnosed with Ulcerative Colitis, a form of Inflammatory Bowel Disease (IBD) alongside Crohn’s disease, and after months of medical treatment, I ultimately underwent surgery and now live with a permanent ileostomy. While this has significantly improved my quality of life, it also brings unique challenges, with one of them being fasting during Yom Kippur.
Fasting for 25 hours is physically and emotionally challenging for anyone! For people like me living with an ileostomy, where I’ve had my colon removed, this brings additional medical considerations. The colon has an important function to reabsorb fluids and electrolytes so, now without this organ I lose significantly more fluid and vital electrolytes compared to someone with their colon, putting me at a much greater risk of dehydration and electrolyte imbalances, that can be further heightened if I abstain from food for an extended period, like a 25 hour fast.
Another important consideration is how fasting affects stoma output. A sudden and drastic change in food and fluid intake can lead to unpredictable stoma output, which may increase the likelihood of dehydration, bag leakages and complications such as blockages (this is where food gets stuck as it passes through the digestive system which can be incredibly uncomfortable, distressing and potentially dangerous in complete bowel obstructions).
Because of these risks, it’s essential for anyone with a stoma to speak with their medical and/or surgical team in advance of fasting. They can help assess whether fasting is safe in your individual case and provide guidance and support to reduce risk if you choose to fast. It’s also important to consider seeking guidance from a Rabbi with experience in Halacha (Jewish law).
For the above reasons, I no longer fast during Yom Kippur.
Do not worry, you can still mark the festival if you don’t fast – and support is available!
If fasting doesn’t work for you, there are plenty of ways to mark Yom Kippur without doing so. As it is seen as the holiest day of the year, there are many practices people partake in to observe Yom Kippur, such as not wearing leather over the course of the day as well as going to synagogue to take part in services. Others will also not use technology or electricity over the course of the day. Therefore. you can still mark it in many ways without fasting.
If you or your child is suffering from a form of IBD, please feel free to get in touch with Camp Simcha to discuss how we can help, and join support networks for Jewish parents, students and young adults – including our Jdigest@CampSimcha group.
