Diarrhea or constipation

Question

I have a question concerning CF. I have a diagnosis of asthma (since the age of 5 years) but I also had many problems with my intestines (sometimes I had constipation, the other time I had diarrhea). I understand you cannot answer whether I suffer from a mild form of cystic fibrosis. But I would like to ask if people with CF have diarrhea or constipation or both? Thank you in advance.

Answer

You ask whether people with CF have diarrhea or constipation or both.

Well indeed, both can occur.
Most typical is fat diarrhea, certainly in patients who are not on treatment yet, or who are insufficiently treated. Most patients with CF do have poor digestion because the enzymes of the pancreas, that should ‘digest’ the fat, do not arrive in the intestine. We suggest you read more in the sections on pancreatic enzymes. When patients are treated correctly, this fat diarrhea will go away or diminish strongly.

But indeed there is not only diarrhea, constipation can occur, even at different moments in the patient’s life. Sometimes obstruction of the intestine already occurs before birth. And the baby is then born with what is called ‘meconium ileus’. If his intestine cannot be ‘rinsed’ by enemas, an urgent surgical intervention can be needed. Also later in life these episodes of obstruction an occur. They are then ‘called meconium-ileus equivalent’ or distal intestinal obstruction syndrome ‘DIOS’. Here again the treatment is to rinse the intestine and clear the obstruction. Rarely a surgical intervention will be needed.

Usually these patterns of constipation and fat diarrhea are easily distinguished from bowel complaints that occur in people with sensitive bowels. Also these people can have intermittently constipation and then loose stools. Of course in case of doubt the disease CF can be excluded by a sweat test. We suggest you discuss this with your doctor.

Best regards,

Prof. dr. K. De Boeck

30.08.2011