A reader shared a family story that raises a common but often confusing religious question. Her older sister once missed Ramadan fasting because of severe gastritis. At the time, doctors warned that fasting could endanger her health and advised against forcing it. Over the years, she gradually retrained herself to fast and has since recovered.
The issue emerged six years later. The Ramadan fasts she missed over multiple years were never made up. This led to an important question: Can those fast still be performed gradually now, or is it sufficient to pay fidyah instead.
The Qur’an provides clear guidance on this matter. Allah states in Surah Al-Baqarah, verse 184:
فَمَنْ كَانَ مِنْكُمْ مَّرِيْضًا اَوْ عَلٰى سَفَرٍ فَعِدَّةٌ مِّنْ اَيَّامٍ اُخَرَ ۗوَعَلَى الَّذِيْنَ يُطِيْقُوْنَهٗ فِدْيَةٌ طَعَامُ مِسْكِيْنٍۗ فَمَنْ تَطَوَّعَ خَيْرًا فَهُوَ خَيْرٌ لَّهٗ ۗوَاَنْ تَصُوْمُوْا خَيْرٌ لَّكُمْ اِنْ كُنْتُمْ تَعْلَمُوْنَ
“Whoever of you is ill or on a journey, then let them fast an equal number of days after Ramaḍân. For those who can only fast with extreme difficulty, compensation can be made by feeding a needy person for every day not fasted. But whoever volunteers to give more, it is better for them. And to fast is better for you, if only you knew.”
This verse establishes two fundamental principles.
First, those who are ill or travelling are permitted not to fast, with the obligation to make up the missed days later (qadha).
Second, for individuals who experience severe difficulty or are unable to fast, Islam provides an alternative: fidyah, which consists of feeding one poor person for each missed day.
Chronic Illness and Religious Leniency
In Islamic jurisprudence, severe and recurring gastritis can fall under maradh muzmin (chronic illness). This refers to a condition that makes fasting consistently difficult or potentially harmful. In such cases, Islamic law offers flexibility.
A person with this condition may choose to make up the missed fasts at a later time when they are able. Alternatively, they may pay fidyah, especially if fasting remains physically taxing or poses health risks.
In this case, the person clearly falls into the category of those granted rukhsah (religious concession). She is permitted to perform qadha if her condition allows. She is also permitted to pay fidyah if fasting remains burdensome.
However, the same Qur’anic verse includes a subtle moral reminder:
وَاَنْ تَصُوْمُوْا خَيْرٌ لَّكُمْ اِنْ كُنْتُمْ تَعْلَمُوْنَ
“And fasting is better for you, if only you knew.”
It suggests that if a person regains the ability to fast, doing so is the more virtuous option.
The challenge, however, lies in the scale of the missed obligation. Missing one full month of fasting over six years amounts to roughly six months of unpaid fasts.
In such circumstances, a realistic and proportional approach is strongly encouraged. The individual may begin making up the missed fasts gradually, according to her capacity, throughout the current year. Any remaining days that feel too heavy or risky can be compensated with fidyah.
This balanced method prevents the burden from becoming overwhelming while ensuring that religious obligations are still fulfilled. At the same time, it allows the next Ramadan to be observed fully, without the weight of unresolved obligation from the past.
Preventing Future Accumulation
Ideally, when fasting is missed due to illness, the obligation of qadha or fidyah should be fulfilled as soon as health conditions permit, or at least before the next Ramadan arrives. This helps prevent the accumulation of unpaid duties and allows worship to be carried out with peace of mind.
Nevertheless, when delays have already stretched over many years—as in this case—Islam still provides a path of ease. Making up fasts gradually or replacing some of them with fidyah remains permissible, depending on one’s present health and capacity.
Looking ahead, if gastritis were to recur and medical advice again discourages fasting, it would be wiser to immediately opt for fidyah for those days. Chronic or recurring illness qualifies as maradh muzmin, making fidyah the lighter and more appropriate option under Islamic law. This prevents health risks and avoids the buildup of future obligations.
In this way, the observance of fasting remains intact without self-harm, in line with the foundational Islamic principle: “There should be neither harm nor reciprocating harm.”
Reference:
Council for Tarjih and Tajdid of Muhammadiyah Central Board, “Hutang Puasa Bertahun-tahun, Bagaimana Cara Membayarnya?”, https://fatwatarjih.or.id/membayar-hutang-puasa-bertahun-tahun/, accessed 06 February 2026.
Translator: Bintang Adrian
