The Pancreas and Cystic Fibrosis.

The pancreas has 2 major functions.

One is an exogenous secretion of enzymes into the intestine.

This comes from the inner part of the pancreas, which secretes enzymes via a tube-like canal down the center of the pancreas, towards the part of the intestine that is right after the stomach.

(Exogenous means it gets secreted towards the exterior of the body, in this case the path is pancreas, intestine, which eventually gets excretedthrough the stools.)

The other is endogenous secretion of insulin into the bloodstream.

This part of the pancreas that makes insulin, is all around the outside of the pancreas.

(Endogenous means that it gets secreted directly into the bloodstream, and does not really directly exit the body.)

Pancreatic insufficiency in CF leads to lack of enzymes, which in turn leads to improper digestion of foods and liquids.

The stools become very large, lighter in color, greasy, and floating on top of the water in the toilet.

Mushy and quite foul-smelling.

Lots of abdominal cramping also, is also often seen.

Not all people with CF are pancreatic insufficient.

It is not entirely predictable yet which ones will be pancreatic sufficient.

It may have something to do with the genotype of CF you have.

Studies are ongoing about this.

What happens subsequently, is that the person cannot maintain a sufficient amount of weight to have reserves for when they are really sick from lung/sinus infections.

Vitamin intakes are usually insufficient, too.

It's a viscious cycle.

Supplemental tube feedings are often required.

In some individuals, they may develop diabetes also.

Not always, but in some people.

Usually it is in later years, as in the 20's, but some are earlier, and some are later.

This has to do somewhat with the pancreas becoming damaged by the CF process.

Some will be diet or pill-controlled, but many/most will require insulin.

This complicates dietary intake, as pwcf usually need higher caloric intake and take in lots of fats and sugars to maintain weight, due to malabsorption.

Careful dietary counseling is needed.