Fibrosing colonopathy is associated with which therapy in cystic fibrosis?

• A. MCT oil formulas
• B. Hydrolyzed protein feeding
• C. Lipid emulsions
• D. High-dose pancreatic enzyme supplementation

Answer: (D)

Fibrosing colonopathy is linked to very high doses of pancreatic enzyme replacement therapy in cystic fibrosis. When large amounts of pancreatic enzymes, especially lipase, pass through the colon, they can irritate the colonic mucosa and trigger an inflammatory fibrotic response, leading to strictures. This risk became evident with high-dose enzyme regimens in the past and prompted clinicians to lower dosing and monitor therapy more closely. The association is not with MCT oil formulas, hydrolyzed protein feeds, or lipid emulsions themselves, which address nutrition differently and do not drive this enzyme-related colonic fibrosis.