Why would nasogastric tube feedings not be contraindicated in cystic fibrosis patients with pancreatic insufficiency?

• A. Because formulas are easier to digest
• B. Because NGT reduces mucus
• C. Because enzymes given
• D. Because those patients have less need for nutrition

Answer: (C)

In pancreatic insufficiency from cystic fibrosis, the lack of pancreatic enzymes (lipase, protease, amylase) leads to malabsorption, especially of fats. Nasogastric tube feedings can safely deliver adequate calories, but to digest and absorb those nutrients effectively you must provide pancreatic enzyme replacement with the feeds. Enzyme therapy enables proper breakdown of fats and other nutrients, making enteral nutrition via a tube feasible and beneficial. The other ideas aren’t the mechanism: formulas aren’t inherently easier to digest on their own, NGT tubes don’t reduce mucus, and these patients typically have increased, not decreased, nutritional needs due to malabsorption and higher energy expenditure.