In cystic fibrosis with pancreatic insufficiency, what is routinely given with meals to aid digestion?

• A. Vitamin C supplements
• B. Antibiotics
• C. No changes
• D. Pancreatic enzymes

Answer: (D)

Pancreatic enzyme replacement is used because pancreatic insufficiency in cystic fibrosis means the body can’t provide enough enzymes to digest fats during meals. Taking pancreatic enzymes with meals and snacks supplies the lipase, protease, and amylase needed to break down fats, proteins, and carbohydrates, which improves fat absorption, reduces steatorrhea, and supports growth and nutrition. These are usually enteric-coated so they survive the stomach and release in the small intestine, with dosing guided by body weight and fat content of the meal. Other options don’t address the enzyme deficiency—vitamin supplements don’t replace enzymes, antibiotics aren’t routinely given for digestion, and doing nothing would maintain malabsorption.