The pancreas, located behind the stomach in the center of the abdomen, extends into the left side of the abdomen. It is connected to the first part of the intestine, the duodenum. The pancreas secretes enzymes that aid food digestion and help to regulate blood sugar.
In CF, the altered transport of electrolytes across pancreatic tissues leads to abnormal production of digestive enzymes. Decreased production of sodium bicarbonate makes pancreatic secretions dehydrated and thickened, blocking the pancreatic ducts. Despite these blockages, the pancreas continues to make more enzymes required for food digestion. These abundant enzymes damage the pancreatic tissue, eventually leading to fibrosis of the pancreas until it is no longer able to produce enough enzymes to properly digest food.
Pancreatic insufficiency occurs when the pancreas loses about 90% of its ability to secrete digestive enzymes. Patients become unable to digest food properly, which leads to the malabsorption of nutrients, or even malnutrition. Vitamins, such as A, B12, D, E, and K, and fats, are the most important nutrients that are not absorbed when a patient has pancreatic insufficiency.
The impaired absorption of fats causes diarrhea, weight loss, and malnutrition, but supplemental pancreatic enzymes can help with digestion of fats and reduce diarrhea. Approximately 80% of CF patients develop pancreatic insufficiency.
The following vitamin deficiencies result from pancreatic insufficiency:
Vitamin A: Visual and Skin Changes
Vitamin B12: Anemia
Vitamin D: BoneAbnormalities
Vitamin E: NeurologicalProblems
Vitamin K: BloodClottingProblems