Paediatria Croatica, Vol. 59 No. 2, 2015.
Review article
https://doi.org/10.13112/PC.2015.11
Malnutrition in cystic fi brosis – beyond pancreatic insuffi ciency
Duška Tješić-Drinković
; Klinički bolnički centar Zagreb
Dorian Tješić-Drinković
Abstract
Malnutrition in cystic fi brosis is a result of imbalance between increased energy requirement, increased losses and poorer nutrient
utilization on the one hand, and inadequate food intake on the other hand. The most important cause of maldigestion and malabsorption
is pancreatic insuffi ciency. However, even optimal enzyme replacement cannot correct malnutrition as it does not target
many other causes adding to the nutritional imbalance and the pathophysiological triad of infection, infl ammation and obstruction.
Contributing factors are abnormal intestinal juices, dysbiosis, bile salt abnormalities and altered lipolysis, altered motility, liver
disease, etc. Energy requirements are increased in comparison to healthy subjects due to chronic infection and infl ammation, and
additionally rise as pulmonary function deteriorates. Energy intake may be inadequate due to gastrointestinal complications, poor
nutrient utilization, or psychosocial issues. An anticipatory and active attitude of gastroenterologists and nutritionists regarding
nutritional problems is mandatory even before malnutrition emerges.
Keywords
cystic fi brosis – complications; malnutrition – etiology; nutritional status
Hrčak ID:
142548
URI
Publication date:
26.6.2015.
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