NCLEX Pediatric Practice Exam

The key idea is fat digestion. In cystic fibrosis, the pancreas often doesn’t secrete enough enzymes, especially lipase, which is essential for breaking down fats in the small intestine. Pancreatic enzyme replacement supplies these lipase enzymes, allowing triglycerides to be hydrolyzed into fatty acids and monoglycerides so they can be absorbed. Without adequate lipase, fats pass through undigested, leading to steatorrhea and deficiencies of fat-soluble vitamins.

Carbohydrates also can be digested with help from other sources of amylase, and minerals don’t require this pancreatic enzyme activity in the same way. Vitamins, particularly the fat-soluble ones, rely on fat digestion for absorption, but the enzymes themselves don’t digest vitamins—so the primary impact of replacement is on fats.