Management of digestive and nutritional disorders in adults with cystic fibrosis

Digestive disturbances are frequent in adults with cystic fibrosis. They ca rt lead to malnutrition which in turn is deleterious to the prognosis. We s ummarise the information on epidemiology, pathogenicity, signs, diagnostic criteria and treatments of exocrine pancreatic insufficiency, gastro-oesoph ageal reflux and denutrition (which are all frequent) but also of constipat ion, rectal prolapse, distal intestinal obstruction syndrome, and liver dis eases. The main recommendations are the following: I - know how to treat pa ncreatic insufficiency with enzyme replacement and vitamins; 2 - know how t o treat aggressively any gastro-oenophageal reflux; 3 - diagnose and treat denutrition as early as possible; 4 - know the distal intestinal obstructio n syndrome to avoid abusive and dangerous surgery; 5 - know that the most s evere hepatic diseases can be treated by liver transplantation.