Why do people with Cystic Fibrosis have diarrhea?
Cystic fibrosis makes a person prone to severe nutritional deficiencies and chronic diarrhea. Let us learn why.
The pancreas, which is connected to a part of the gastrointestinal tract, secretes enzymes which are necessary for the digestion of fats, proteins and other substances that arrive in the digestive system.
The thick secretions due to cystic fibrosis obstruct the pancreas and prevent the enzymes from reaching the patient’s intestines. As a result, the body is unable to absorb fat and proteins and thus diarrhea takes place. Other discomforts include abdominal bloating, gas and large stools.
It is absolutely necessary to treat diarrhea or severe complications can occur.
Proper therapy for diarrhea in cystic fibrosis
For people with CF it is extremely important to have a normal growth rate. This is only possible with specific enzyme therapy and nutritional therapy.
1. Pancreatic Enzyme Replacement Therapy
Since the pancreas is unable to provide the necessary enzymes to the small intestine, patients need to take enzyme replacement pills. These tablets contain 3 essential enzymes for correct food digestion:
- Lipase for proper fat absorption,
- Protease for normal protein digestion, and
- Amylase for starch absorption.
People suffering from cystic fibrosis will need to take 1 or more pancreatic enzyme replacement pills during meals. Patients usually have problems digesting fat and protein and thus don’t need to take tablets while eating an apple for example.
Some widely used pancreatic enzyme pills are:
- Creon (Solvay Pharmaceuticals)
- Pancrease (Ortho-McNeil Pharmaceuticals and Janssen-Cilag)
- Ultrase (Axcan Pharma)
- Pancreacarb (Digestive Care)
2. Nutritional Therapy
Although enzyme replacement pills help patients in absorbing food, the therapy will not be 100% successful. Therefore, people suffering from CF need to eat lots of calories (20% to 50% more than the RDA) to absorb at least the amount of daily allowances they need from vitamins, minerals, proteins, fat, sugar...
How to use pancreatic enzymes to avoid diarrhea?
Enzyme replacement pills should be taken with every meal. Usually the amount of fat in a meal determines the quantity needed. When doubting about the amount of fat, it is better for the patient to take a bit more tablets than less.
Examine the stools
Not everybody has the same needs for enzyme replacement pills. Some people take a lot of them and others don’t. The right amount can be determined by looking at the stools of the patient. If the following occurs, the patient should take more pills (always consult a doctor before changing anything to your therapy):
- Large stools
- Greasy stools
- Stools smelling like rotten eggs
- Gas production in the intestines
- Abdominal bloating
- Poor growth despite good appetite
Enzyme intake also varies according to food intake. For example, a sandwich with ham contains less fat and calories than spaghetti. The latter will thus require more tablets to absorb the fat. Larger portions will also require more enzymes than smaller meals.
The first sign of a problem
Usually, the first sign of cystic fibrosis is a malfunction in the pancreas and the digestive system. During the first year of the infant's life, a child may experience frequent diarrhea and large and greasy stools. The cause lies in malabsorption of food through blocked pancreas enzymes. As a result, weight gain becomes unachievable. Unfortunately, improper weight gain is known to be associated with reduced life expectancy in cystic fibrosis.
It is therefore very important for parents to watch out for frequent diarrhea with their baby and inform the pediatrician when it occurs.
Disclaimer: This website provides general information about cystic fibrosis and in no means should be taken as a medical or health advice. Please consult your doctor before acting on any of its information.