Pancreatic Function

According to the CF Foundation, the pancreas is a gland in the body connected to the small intestine. The small intestine is where most of the digestion and absorption of food occurs. One of the functions of the pancreas is to make enzymes that digest food. Digestive enzymes from the pancreas enter the small intestine through a small duct, or passageway. In cystic Fibrosis, the ducts int he pancreas become clogged with thick, sticky mucous. The mucous blocks the enzymes from reaching food in the small intestine. This can lead to poor digestion and absorption of food, as well as problems with weight gain. Fortunately, pancreatic enzyme replacements or "enzymes" are available to help people with CF digest and absorb their food.

Signs of Maldigestion and Malabsorption:

• Poor weight gain despite a good (sometimes ravenous) appetite;
• Frequent, loose and/or large bowel movements;
• Foul-smelling bowel movements;
• Mucus or oil in the bowel movement;
• Excessive gas and/or stomach pain;
• Distention or bloating.

Just under 90% of patients with CF are pancreatic insufficient (PI) and require life-long supplementation with pancreatic enzyme replacement therapy (PERT). Fecal elastase is an enzyme- linked immunosorbent assay (ELISA) that can be performed on a single stool sample to define pancreatic functional status. Your physician will order a Pancreatic Fecal Elastase to be performed at most local laboratories. The result of this test will tell us if your/your child's pancreas is functioning well enough or if there is a need for enzymes.

Persons with CF who have not yet started taking enzymes may have any or all of the symptoms listed above. Improvement is generally noted once enzymes are started. Sometimes, people with CF who already take enzymes experience these symptoms. This may suggest that the dose or type of enzymes may need to be adjusted. Do not increase or decrease the dose of enzymes without talking to your CF dietitian or care provider. Always give the prescribed dose of enzymes.