Pancreatic enzyme supplements and vitamins in cystic fibrosis

The management of pancreatic insufficiency and the maintenance of satisfactory fat-soluble vitamin status are major issues in the nutritional management of cystic fibrosis (CF). This article discusses the pancreatic enzyme replacement preparations currently used in the United Kingdom. It also provides an overview of the importance of fat-soluble vitamins in CF, the supplements currently used, and assesses where future research might be directed. We conclude that dietitians play an important role in helping CF patients to achieve optimal growth and nutritional status, and should therefore be involved in management from diagnosis. Monitoring of pancreatic enzyme replacement therapy (PERT) and vitamin therapy is an integral part of the dietetic assessment, and should be carried out on a regular basis to ensure optimal nutritional management for each individual. Future research needs to concentrate on the efficacy and safety of high lipase enzyme preparations. Research is required to assess the absorption, metabolism and losses of fat-soluble vitamins amongst today's CF population, and to determine requirements according to age group.