Gastrointestinal manifestations of cystic fibrosis.

From a historical view cystic fibrosis (CF) has been considered a disease 
of the pancreas which results in maldigestion and loss of fat, 
and nitrogen in the stool. A number of early synonyms included 
congenital steatorrhea, pancreatic infantilism, and pancreatic fibrosis. The concern of the 
pediatrician in the late 1930's and early 1940's was to distinguish 
nonfatal celiac disease from fatal cystic fibrosis. In 1954, Shwachman presented 
clinical and laboratory features that distinguish these two entities. Today one 
is not justified in making a diagnosis of celiac disease without 
a confirmatory small intestinal biopsy coupled with a normal sweat test. 
A number of gastrointestinal complications in cystic fibrosis are examined: meconium 
ileus, intestinal obstruction, pancreatic insufficiency, lactase deficiency, intestinal impaction, intussusception, rectal 
prolapse, growth retardation, excessive appetite, cirrhosis and portal hypertension, gallbladder problems, 
and diabetes. The article closes by recording the indications for the 
sweat test. 