In cystic fibrosis, pancreatic enzymes supplemented at high doses could result in:

• A. Steatorrhea
• B. Meconium ileus
• C. Fibrosing colonopathy
• D. Cystic fibrosis related diabetes

Answer: (C)

Giving pancreatic enzyme supplements at very high doses in cystic fibrosis can injure the colon and cause fibrosing colonopathy, a condition where the colonic wall thickens and may form strictures due to inflammatory fibrotic changes. This adverse effect was observed with excessive lipase exposure from enzyme preparations, and led to caution and dosing limits in practice. In contrast, steatorrhea happens when enzymes are insufficient, not excessive. Meconium ileus is a CF-related neonatal obstruction from thick meconium, unrelated to enzyme dosing. Cystic fibrosis–related diabetes stems from pancreatic destruction by the disease itself, not from how much pancreatic enzyme is given.