[Therapy of pancreatic insufficiency]

The replacing therapy in the treatment of pancreatic insufficiency is considered the first and most important step. At present, the choice is between highly concentrate or enteric-coated enzymatic compounds. Their administration before or during each meal has to be the one able to reduce fecal fat and nitrogen, allowing a satisfactory growth. A long term therapy even at low dosage with antacids or cimetidine must be considered with caution and evaluated in each case. In CF children the nutritional care has now been emphasized for the possible relationship between malnutrition and lung disease; the caloric intake must be higher than normal. The limitation of fat intake is not so important any more when the enzymes replacement is adequate. The vitamins requirement is usually satisfied doubling the normal daily requirement. An increase of vitamins and/or minerals must be considered when clinical or laboratory signs of deficiency are found.