When food is eaten it goes into the stomach where it is broken down into tiny pieces. These pieces pass into the small intestine where, in a healthy body, digestion takes place with the help of bile from the liver and enzymes from the pancreas. The nutrients from the food are then taken in by the body (absorbed) and used for energy and growth. Food that is not broken down (not digested) passes out of the body in the stools.

In most people with CF, the tubes in the pancreas are blocked with the same type of sticky mucous found in the lungs. Pancreatic enzymes cannot get into the small intestines, so food is not properly digested. This leads to poor nutrition and/or poor growth. Most people with CF need to take pancreatic enzymes capsules to help with digestion of food.


Pancreatic enzymes contain lipases, proteases, and amylases which digest fat, protein, and larger sugars such as starch. The number on your enzyme bottle represents the amount of lipase in the product. Enteric coated enzymes are used by most adults with CF. The coating protects the enzymes from acid in the stomach so that the enzymes reach the small intestines. The coating may take some time to dissolve, so the enzymes are released further down the intestine than they would if uncoated.

The amount of enzymes needed by a person with CF varies with age, body size, and amount and type of food eaten. Your CF dietitian will decide the type and dose of enzymes to use. This may change over time. In general, your body needs more enzymes to digest foods that are high in fat and protein than foods high in carbohydrate. Enzymes are not needed for foods that contain only sugar because someone with CF is able to digest these foods with the enzymes found in saliva. Examples of these are fruit, juice, soft drinks, hard candy, popsicles and Jello-O.

Taking Enzymes

Enzymes capsules may be swallowed whole. They should be given either at the beginning of the meal, or given throughout the meal (especially if you are a slower eater). It is recommended to take additional enzymes if food is eaten more than 1 hour after the last enzymes were taken. How many enzymes you need depends on how much fat you eat. Each enzymes contains a standard amount of lipase which helps you digest fat. The amount you take with each meal is adjusted until you no longer have signs of malabsorption. For more information on how many enzymes to take click here.