To extract these nutrients, the body needs the help of the pancreas. This organ, shaped like a small fish, is attached to the small intestine behind your stomach. It is crucial for proper digestion.
The pancreas makes fluid -- from 1 to 2 quarts -- that mixes with the food. One part of that fluid is a product that neutralizes the acid from the stomach. It is called bicarbonate. The fluid also contains chemicals called pancreatic enzymes, which mix with the food to break
them into small bits the body can absorb.
Pancreatic enzymes are very important for getting nutrients, calories and vitamins into our bodies; they are the heart of proper digestion and absorption.
In addition to playing these important roles in the digestive process, the pancreas also makes important hormones, including insulin. Insulin works in your bloodstream, not in your intestines. It helps move glucose (sugar) from the blood into the cells so they can turn food into
For many people with CF, the pancreas doesn't produce enough insulin or the body doesn't let insulin do its job, leading to
CF-related diabetes (CFRD). CFRD is not caused by diet, and there is nothing you can do to prevent it.
One way to simplify this is to think of the pancreas as two separate organs: one is a digestive organ that makes pancreatic enzymes for the intestines, the other is a hormone organ that makes insulin for the body.
The healthy pancreas:
- Makes the body's natural antacid, called bicarbonate, to mix with food coming from the stomach into the intestines
- Makes special chemicals called pancreatic enzymes to digest food as it moves from the stomach into the intestines
- Squirts fluid into the intestines to help flush food along its path through the digestive tract
- Makes important hormones, including insulin
About 90 percent of people with CF have sticky mucus that blocks ducts in the pancreas and prevents enzymes from reaching the small intestine to digest food. Undigested food in the intestines can cause pain, cramping, gas and either loose, greasy, floating stools or constipation
Everyone with CF (including people who don't need enzyme supplements) has a pancreas that does not make enough bicarbonate to neutralize stomach acid. This can also contribute to pain, cramping, gas and constipation. Bloating and excessive gas also can be caused by small bowel
overgrowth, gastric paresis and gastroesophageal reflux disease.
Digestive enzymes from the pancreas are blocked and do not make it into the small intestine.
The webcast below highlights the following information:
Bacterial Overgrowth can be caused by repeated antibiotic therapy, which can kill good bacteria and cause bad bacteria to overgrow in the intestine and create gas, diarrhea, nausea and bloating. Usually, the treatment is an antibiotic that helps tamp down bad
bacteria to allow normal bacteria to regain control in the intestine.
Paresis is a condition in which the stomach empties slower than normal after eating. It can cause you to get bloated and nauseous. High blood glucose can cause gastric paresis all by itself, so make sure you maintain a healthy blood glucose. Try to eat frequent, small meals throughout the day to help your
stomach empty more efficiently.
Reflux Disease (GERD) is caused when acid from your stomach travels backwards into the esophagus. This can be very serious if acid goes down into the lungs. You need to see a doctor if you notice heartburn or other symptoms of GERD, or if you experience repeated vomiting, fever or weight loss.
GI Overview: Stomach and Pancreas Problems in CF | Webcast
Read the Foundation's care guidelines on pancreatic enzyme replacement.