The Digestestive System – Pancreatic Enzyme Replacement Therapy (PERT)

The Digestive System
CF affects the pancreas (which produces the enzyme needed to digest food) and makes it difficult for people with CF to absorb food. This can cause malnutrition, which can lead to poor growth, physical weakness and delayed puberty. There is medication that can compensate for the failure of the pancreas.

Many people with CF will also take up to 40 enzyme replacement tablets each day to aid digestion. They must also follow high energy diets with added vitamins and salt.

Cystic Fibrosis affects the pancreas, so enzyme replacement capsules should be taken with meals and snacks to replace pancreatic enzymes and enable people with CF to gain more energy from the food they eat.

Pancreatic Enzyme Insufficiency

Pancreatic enzyme insufficiency is one of the common symptoms of CF. The CF gene defect results in a thickening of the pancreatic secretions. The accumulation of thick secretions causes obstruction and eventually leads to damage of the pancreas. Pancreatic enzyme insufficiency prevents digestion and absorption of nutrients. Large, bulky, smelly stools containing undigested nutrients are a direct result of a lack of pancreatic enzymes.

Pancreatic enzyme insufficiency is treated with pancreatic enzyme replacement capsules, which should be taken with every meal or snack.

Pancreatic Enzyme Replacement Therapy (PERT)

Specially coated enzyme beads have been a treatment breakthrough for people with CF. Effective and acceptable enzyme replacement therapy has been a significant factor in maintaining health for those with CF.

For infants and younger children, who cannot swallow capsules whole, the capsules can be opened and the enteric coated microspheres mixed with fruit gel. This is then fed to the infant before and during their feed. Older children can have the microspheres mixed with yoghurt or pureed fruit.

Dosage Of Enzymes

The physician and dietitian will monitor pancreatic enzyme therapy dosing. The dietitian will provide information on the correct dosage of enzymes for different foods.


* Information from Cystic Fibrosis Australia Website.