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Cystic fibrosis

• Signs and Symptoms
• What Causes It?
• Who's Most At Risk?
• What to Expect at Your Provider's Office
• Treatment Options
• Prognosis/Possible Complications
• Following Up
• Supporting Research

Cystic fibrosis (CF) is a chronic, progressive, and frequently fatal genetic disease of the glands that produce or secrete sweat and mucus. CF primarily affects the respiratory, digestive, and reproductive tracts in children and young adults. On average, individuals with CF have a lifespan of around 30 years.

According to the Cystic Fibrosis Foundation, about 30,000 Americans have CF. The disease occurs mostly in whites whose ancestors came from northern Europe, although it cuts across all races and ethnic groups. About 2,500 babies are born with the disease each year in the United States. Moreover, about one in every 20 Americans, or 12 million people, are unaffected carriers of an abnormal CF gene.

Signs and Symptoms

CF is often accompanied by the following signs and symptoms:

• Thick, viscous mucus secretions in the lungs
• Changes in color and amount of sputum (material coughed up from the lungs)
• Chronic cough, possibly with blood streaking
• Wheezing
• Bronchitis
• Chronic sinusitis
• Asthma
• Nasal polyps (fleshy growths inside the nose)
• Weight loss, failure to thrive in infants, abdominal swelling
• Excessive salt in sweat, dehydration
• Failure of newborn to pass stool
• Abdominal pain, flatulence
• Fatigue

Conditions such as late onset of puberty, intestinal obstruction, inflammation of the pancreas, cirrhosis (a liver condition), and infertility may also be signs of CF.

What Causes It?

CF is caused by a defective gene that tells the body to produce abnormally thick and sticky fluid, called mucus. This mucus builds up in the breathing passages of the lungs and the pancreas, the organ that helps to break down and absorb food. This collection of sticky mucus results in life-threatening lung infections and serious digestion problems. The disease may also affect the sweat glands and a man's reproductive system.

Who's Most At Risk?

CF is caused by inherited genes. To have CF, a child must inherit two abnormal genes -- one from each parent.

What to Expect at Your Provider's Office

A baby born with the CF gene usually has symptoms during its first year, although signs of the disease may not appear until adolescence or even later.

Your child's health care provider can help make a diagnosis and guide you in determining which treatment or combination of therapies will best alleviate symptoms of the disease. He or she will perform a physical exam and run laboratory tests, including a sweat test, which checks for higher-than-normal amounts of sodium and chloride in the sweat. Other tests include a sputum test, genetic screening, and a stool analysis. Imaging techniques may help reveal lung conditions and abdominal obstruction.

Treatment Options

Prevention

Preventing CF is not currently possible.

Treatment Plan

The hope for the future is that gene therapy could repair or replace the defective CF gene. Or, a person with CF might be given the active form of the protein product that is scarce or missing. At the moment, the best that health care providers can do is to ease the symptoms of CF or slow the progress of the disease in order to improve the patient's quality of life.

CF patients suffer from frequent lung infections caused by obstructed breathing. So, the mainstays of a treatment plan are physical therapy, exercise, and medications for reducing the mucus blocking the lung's airways.

Drug Therapies

Medications are often aerosolized (misted) and can be inhaled. These include the following:

• Bronchodilators (which widen the breathing tubes)
• Mucolytics (which thin the mucus)
• Decongestants (which reduce swelling of the membranes of the breathing tubes)
• An enzyme that thins the mucus by digesting the cellular material trapped in it
• Antibiotics to fight lung infections also are used

The digestive problems caused by CF are managed with these medications.

• Pancreatic enzymes which help digestion
• Enemas and mucolytic agents to treat intestinal obstructions

Surgical and Other Procedures

CF patients with respiratory failure may need a heart-lung transplant. Those patients experiencing gastrointestinal obstruction may also require surgery.

Complementary and Alternative Therapies

A comprehensive treatment plan for CF may include a range of complementary and alternative therapies.

Nutrition and Supplements

Following these nutritional tips may help reduce symptoms:

• Eliminate potential food allergens and foods that increase mucous production, including dairy (milk, cheese, sour cream, and ice cream), wheat (gluten), soy, corn, potatoes, cabbage, bananas, sugar, preservatives, food additives and excessive salt and meats. Your health care provider may want to test for food sensitivities.
• Eat more foods that decrease mucous production, including garlic, onions, watercress, horseradish, mustard, parsley, celery, rose hips tea, pickles, lemon, and anti-inflammatory oils (nuts, seeds, cold-water fish).
• Eat more foods containing digestive enzymes, such as papaya and pineapple.
• Avoid refined foods such as white breads, pastas, and sugar.
• Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy) or beans for protein.
• Use healthy cooking oils, such as olive oil or vegetable oil.
• Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
• Avoid coffee and other stimulants, alcohol, and tobacco.
• Drink 6 - 8 glasses of filtered water daily.
• Exercise moderately, for 30 minutes daily, 5 days a week.

You may address nutritional deficiencies with the following supplements:

• Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tablespoonful of oil twice daily, to help decrease inflammation and improve immunity. Cold-water fish, such as salmon or halibut, are good food sources.
• A multivitamin daily, containing the antioxidant vitamins A, C, D, E, the B-vitamins and trace minerals, such as magnesium, calcium, zinc, and selenium.
• Digestive enzymes, 1 - 2 tablets three times daily with meals.
• Coenzyme Q10, 100-200 mg at bedtime, for antioxidant and immune activity.
• N-acetyl cysteine (NAC), 200 mg daily, for antioxidant effects. Alternative health care practitioners may use higher dosages. Check with your health care provider.
• Probiotic supplement (containing Lactobacillus acidophilus) , 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. You should refrigerate your acidophilus products.
• Grapefruit seed extract ( Citrus paradisi ), 100 mg capsule or 5 - 10 drops (in favorite beverage) three times daily, for antibacterial or antifungal activity, gastrointestinal health, and immunity.
• Methylsulfonylmethane (MSM), 3,000 mg twice a day, to help decrease inflammation.
• Whey protein, 10 - 20 grams daily mixed in favorite beverage, for support of immunity and weight gain, when needed.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

• Ginkgo ( Ginkgo biloba ) standardized extract, 40 - 80 mg three times daily, for inflammation and as an antioxidant.
• Green tea ( Camellia sinensis ) standardized extract, 250 - 500 mg daily, for antioxidant and immune effects. You may also prepare teas from the leaf of this herb.
• Cat's claw ( Uncaria tomentosa ) standardized extract, 20 mg three times a day, for inflammation, immune and antibacterial or antifungal activity.
• Milk thistle ( Silybum marianum ) seed standardized extract, 80 - 160 mg two to three times daily, for detoxification support.
• Bromelain ( Ananus comosus ) standardized extract, 40 mg three times daily, for pain and inflammation.
• Ground Ivy ( Hedera helix ) standardized extract, 50 mg three times daily, to decrease mucous production and to loosen phlegm.

Homeopathy

Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following treatments to alleviate respiratory symptoms (such as those experienced from cystic fibrosis) based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

The following treatments should be used under the guidance of a licensed, certified homeopath in addition to standard medical care provided by a medical doctor:

• Antimonium tartaricum -- for wet, rattling cough (although the cough is usually too weak to bring up mucus material from the lungs) that is accompanied by extreme fatigue and difficulty breathing. Symptoms usually worsen when the person is lying down.
• Carbo vegetabilis -- for shortness of breath with anxiety, chills, and bluish skin discoloration.

Acupuncture

Acupuncture may alleviate symptoms of cystic fibrosis. Acupuncture may help enhance immune function, normalize digestion, and strengthen respiratory function.

Massage

Therapeutic massage can help drain mucus from the lungs.

Prognosis/Possible Complications

Respiratory problems are the most common complication from CF.

Following Up

CF patients receive pulmonary function tests every 3 - 6 months. They also receive chest x-rays every 2 - 4 years, or more often if needed.

Supporting Research

Adde FV, Rodrizues JC, Cardoso AL. Nutritional follow-up of cystic fibrosis patients: the role of nutrition education. J Pediatr (Rio J). 2004;80(6):475-82.

Beckles Willson N, Elliot TM, Everard ML. Omega-3 fatty acids (from fish oils) for cystic fibrosis. Cochrane Database Syst Rev . 2002;(3):CD002201.

Bartram T. Encyclopedia of Herbal Medicine . Dorset, England: Grace Publishers; 1995:138.

Behrman R. Nelson Textbook of Pediatrics . 15th ed. Philadelphia, Pa: W.B. Saunders; 1996.

Blumenthal M, ed. The Complete German Commission E Monographs , Boston, Mass: Integrative Medicine Communications; 1998:466.

Bone R . Pulmonary & Critical Care Medicine . 1998 ed. St. Louis, Mo: Mosby-Year Book; 1998.

Bruzzese E, Raia V, Gaudiello G, et al. Intestinal inflammation is a frequent feature of cystic fibrosis and is reduced by probiotic administration. Aliment Pharmacol Ther . 2004;20(7):813-9.

Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea -- a review. J Am Coll Nutr . 2006;25(2):79-99.

Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr. 1999;69(6):1086-1107.

Caramia G, Cocchi M, Garliardini R, et al. Fatty acids composition of plasma phospholipids and triglycerides in children with cystic fibrosis. The effect of dietary supplementation with an olive and soybean oils mixture. Pediatr Med Chir . 2003;25(1):42-9.

Chin J. Intestinal microflora: negotiating health outcomes with the warring community within us. Asia Pac J Clin Nutr . 2004;13(Suppl):S24-5.

Cummings S, Ullman D. Everybody's Guide to Homeopathic Medicines. 3 ^rd ed. New York, NY: Penguin Putnam; 1997: 116.

Cvetnic Z, Vladimir-Knezevic S. Antimicrobial activity of grapefruit seed and pulp ethanolic extract. Acta Pharm . 2004;54(3):243-50.

Dambro MR. Griffith's 5-Minute Clinical Consult . 1999 ed. Baltimore, Md: Lippincott Williams & Wilkins, Inc.; 1999.

Doron S, Gorbach SL. Probiotics: their role in the treatment and prevention of disease. Expert Rev Anti Infect Ther . 2006;4(2):261-75.

Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine . 14th ed. New York, NY: McGraw-Hill; 1998.

Gonclaves C, Dinis T, Batista MT. Antioxidant properties of proanthocyanidins of Uncaria tomentosa bark decoction: a mechanism for anti-inflammatory activity. Phytochemistr y. 2005;66(1):89-98.

Grey V, Mohammed SR, Smountas AA, et al. Improved glutathione status in young adult patients with cystic fibrosis supplemented with whey protein. J Cyst Fibros . 2003;2(4):195-8.

Guo R, Pittler MH, Ernst E. Herbal medicines for the treatment of COPD: a systematic review. Eur Respir J . 2006;28(2):330-8.

Hale LP, Greer PK, Trinh CT, James CL. Proteinase activity and stability of natural bromelain preparations. Int Immunopharmacol . 2005;5(4):783-93.

Heggers JP, Cottingham J, Gussman J, et al. The effectiveness of processed grapefruit-seed extract as an antibacterial agent: II. Mechanism of action and in vitro toxicity. J Altern Complement Med . 2002;8(3):333-40.

Huang SH, Schall JI, Zemel BS, Stallings VA. Vitamin E status in children with cystic fibrosis and pancreatic insufficiency . J Pediatr . 2006;148(4):556-559.

JAMA Patient Page. How much vitamin C do you need? JAMA. 1999;281(15):1460.

Johnston CS. Recommendations for vitamin C intake. JAMA. 1999;282(22):2118-2119.

Kormosh N, Laktionov K, Antoshechkina M. Effect of a combination of extract from several plants on cell-mediated and humoral immunity of patients with advanced ovarian cancer. Phytother Res . 2006;20(5):424-5.

Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and recommendations for vitamin C intake. JAMA. 1999;281(15):1415-1453.

McCabe H. Riboflavin deficiency in cystic fibrosis: three case reports. J Hum Nutr Diet . 2001;14(5):365-70.

Mizejewski GJ, Pass KA. Fatty acids, alpha-fetoprotein, and cystic fibrosis. Pediatrics . 2001;108(6):1370-3.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms . Albany, Calif: Hahnemann Clinic Publishing; 1993:25, 26, 103, 221.

Rakel RE, ed. Conn's Current Therapy . 50th ed. Philadelphia, Pa: W.B. Saunders; 1998.

Rubin BK. The pharmacologic approach to airway clearance: Mucoactive agents. Paediatr Respir Rev . 2006;7 Suppl 1:S215-9.

Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr . 2002;21(6):495-505.

Ullman D. Homeopathic Medicine for Children and Infants. New York, NY: Penguin Putnam; 1992: 70.

Ullman D. The Consumer's Guide to Homeopathy. New York, NY: Penguin Putnam; 1995: 220-228.

Yamada T, ed. Textbook of Gastroenterology . 2nd ed. Philadelphia, Pa: Lippincott-Raven Publishers; 1995.

Yoon JH, Baek SJ. Molecular targets of dietary polyphenols with anti-inflammatory properties. Yonsei Med J . 2005;46(5):585-96.

• Review Date: 8/7/2006
• Reviewed By: Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network; Leonard Wisneski, MD, FACP, George Washington University, Rockville, MD.

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