Gastrointestinal symptoms are present in patients with cystic fibrosis (CF) across all ages, indicating that patients generally suffer from a high gastrointestinal disease burden, according to a study published in the Journal of Cystic Fibrosis. 

CF is characterized by thickened secretions and impaired ciliary function in the lungs, the luminal gut, and the pancreas. Although the pulmonary manifestations of CF are well-characterized, gastrointestinal symptoms of this disease have received less attention. 

Among the gastrointestinal problems reportedly experienced by patients with CF are gastroesophageal reflux disease, pancreatic insufficiency, and delayed gut motility. Long-term gastrointestinal disease can result in malnutrition and weight loss, resulting in poorer clinical outcomes in this patient population. 

The authors of the study sought to characterize gastrointestinal disease in patients with CF and recruited patients with cystic fibrosis who were 2 years of age and older. This was a prospective observational study conducted across 26 US healthcare centers. 

Read more about CF etiology 

Participants were requested to fill in 3 electronic validated patient-related outcome measures that assessed gastrointestinal symptoms, constipation, and quality of life. A stool-specific questionnaire was also administered. Participants were asked to fill in these surveys at week 0, as well as weeks 1, 2, and 4. The researchers then estimated proportions and 95% confidence intervals by age groups and sex. 

The results indicate that the most common gastrointestinal symptoms experienced by patients of all ages are bloating, early satiety, and abdominal pain. Constipation was also a commonly reported symptom among patients with CF. The study revealed that fecal incontinence is a problem experienced by patients across all ages. 

“Moderate to severe symptoms of straining, fullness, bloating, and distension are seen in >20% of patients with cystic fibrosis,” the authors wrote. “Use of these electronic patient-reported outcome measures can allow for simple and consistent patient-centered outcomes for future targeted clinical trial endpoints.” 


Moshiree B, Freeman AJ, Vu PT, et al. Multicenter prospective study showing a high gastrointestinal symptom burden in cystic fibrosisJ Cyst Fibros. 2022;S1569-1993(22)01388-1. doi:10.1016/j.jcf.2022.10.006