Gastrointestinal System

GI involvement may present initially as small bowel obstruction shortly after birth due to abnormally thick meconium that cannot be passed (meconium ileus). Older CF patients may develop distal intestinal obstruction syndrome (DIOS), formerly called meconium ileus equivalent, which occurs due to fecal impaction in the terminal ileum and cecum.

Maldigestion due to pancreatic enzyme insufficiency is present in about 85% to 90% of CF patients.5 Thick pancreatic secretions and cellular debris obstruct the pancreatic ducts and lead to fibrosis. Volume and concentration of pancreatic enzymes and bicarbonate are reduced, leading to maldigestion of fat and protein and subsequent malabsorption of fat-soluble vitamins (A, D, E, and K). Maldigestion is characterized by abdominal distention, steatorrhea, flatulence, and malnourish-ment despite voracious intake. Maldigestion is progressive and may develop later in a previously pancreatic sufficient patient. Other complications may include gastroesophageal reflux, dysmotility, salivary dysfunction, intussusception, volvulus, atresia, rectal prolapse, and complications related to corrective surgery for meconium ileus.6

Hepatobiliary disease occurs due to bile duct obstruction from abnormal bile composition and flow. Hepatomegaly, splenomegaly, and cholecystitis may be present. Hepatic steatosis may also be present due to effects of malnutrition. The progression from cholestasis (impaired bile flow) to portal fibrosis and to focal and multilobar cirrhosis, esophageal varices, and portal hypertension takes several years. Many patients are compensated and asymptomatic but may be susceptible to acute decompensation in the event of extrinsic hepatic insult from viruses, medications, or other factors.7

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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