طفل عمره ٦ سنوات عنده تليف كيسي، وزنه تحت المعدل، وبرازه دهني كريه الرائحة. الطبيب وصف كبسولات إنزيمات البنكرياس، وأمه تسأل كيف يأخذها لأنه يأكل ٣ وجبات ووجبتين خفيفتين يومياً. أي تعليمات صحيحة عن إنزيمات البنكرياس؟

A 6-year-old with cystic fibrosis is underweight with greasy, foul-smelling stools. Pancreatic enzyme capsules are prescribed, and his mother asks how to give them since he eats 3 meals and 2 snacks a day. Which instruction is correct?

1. Mix them into hot milk and leave for an hour
2. Take them only when there is diarrhoea
3. Take them once a day at bedtime
4. Take them with every meal and snack

Answer: D) Take them with every meal and snack. In CF pancreatic enzymes do not reach the gut, so they are given with every meal to digest fat and protein. Bulky fatty stools may mean too low a dose. They are not crushed or mixed into hot food.