Why are NGT feedings not contraindicated in CF patients with pancreatic insufficiency?

• A. Pancreatic enzymes are given simultaneously to assist absorption
• B. CF patients should avoid fats
• C. NGT feeds bypass the pancreas entirely
• D. Pancreatic enzymes hinder absorption

Answer: (A)

In cystic fibrosis with pancreatic insufficiency, digestion relies on pancreatic enzymes to break down fats, proteins, and carbohydrates. When nutrition is delivered by a nasogastric tube, these enzymes are still needed in the gut to allow proper digestion and absorption. Providing pancreatic enzyme replacement therapy together with the feeding supplies the missing enzymes, so the enteral formula can be absorbed effectively. That’s why nasogastric tube feedings are not contraindicated in CF patients with pancreatic insufficiency—they depend on continuing enzyme replacement to work properly.

Fats are not something to avoid in CF; fats are a major energy source and are typically emphasized. The idea that these feeds bypass the pancreas is incorrect because the enzymes are needed to digest what the feed provides. Pancreatic enzymes do not hinder absorption; they enable it.