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Cystic fibrosisThis factsheet is for people who have cystic fibrosis or people who would like information about the condition. Cystic fibrosis (CF) is an inherited condition. It affects organs in the body, particularly the lungs and digestive system, which become clogged with sticky mucus, making it difficult to breathe and digest food. Cystic fibrosis affects over 7,500 people in the UK and is most common in Caucasian people. People with cystic fibrosis have a shorter life expectancy, with the average being around 31 years. Cystic fibrosis symptomsCystic fibrosis is a "multi-system" disease, meaning that it affects many body organs. However, most of the symptoms are to do with the lungs and the digestive system. LungsIn a healthy person, there is a constant flow of mucus over the surfaces of the air passages in the lungs. This removes debris and bacteria. If you have cystic fibrosis, this mucus is excessively thick and sticky and cannot perform this role properly. The sticky mucus also provides an ideal environment for bacterial growth. This can put a person with cystic fibrosis at risk of getting bacterial chest infections and pneumonia. If these infections are not treated early and properly, they can be very difficult to treat. Digestive systemCystic fibrosis also affects the digestive system. In a healthy person, the pancreas produces chemicals (enzymes) which pass into the gut as food leaves the stomach. These enzymes break down the fat. If you have cystic fibrosis, the pancreas does not produce enzymes. Without these enzymes, the fat in food is not properly digested and it is difficult to gain weight. The faeces contain an excess of fat and are oily and very smelly. Other conditions associated with cystic fibrosis include:
CausesCystic fibrosis is an inherited, or genetic, condition. Cystic fibrosis occurs because of a faulty gene called the cystic fibrosis transmembrane conductance regulator - or CFTR gene. Cystic fibrosis is an autosomal recessive disorder. This means that in order to develop the condition you need to inherit two cystic fibrosis genes, one from your mother and one from your father. If you inherit only one cystic fibrosis gene, you are called a carrier and do not have symptoms.
When both parents are carriers, with each pregnancy there is a:
There are several different types of genetic mutation which are associated with different degrees of severity of the disease. DiagnosisAbout one in five people with cystic fibrosis are diagnosed at birth, when their gut becomes blocked by extra thick meconium (the black tar-like bowel contents that all babies pass soon after birth). This bowel blockage may need surgery. Just over half of people with CF are diagnosed as babies. This is because they are not growing or putting on weight as they should due to the digestive system not breaking down the fat content in food. ScreeningIf you have a family history of cystic fibrosis, you can be tested to see if you carry the cystic fibrosis gene before you have a family. Testing during pregnancyIf you and your partner are both carriers or if you already have a child with cystic fibrosis, tests can be done early in pregnancy to see if the fetus is affected. Tests include:
There are risks of side-effects and complications including a small risk of miscarriage with both tests. Ask your doctor for more information. If the test you chose produces a positive result for cystic fibrosis, then there are a number of things to consider.
These decisions are difficult and it's a good idea for you to discuss the issues with health professionals before deciding to have chorionic villus sampling or amniocentesis. Neonatal screeningNewborn babies are routinely screened for cystic fibrosis using "blood spot screening". About five days after your baby is born your midwife will prick your baby's heel using a special device to collect some drops of blood. The blood sample is also tested for two other conditions, low thyroid function and phenylketonuria. Sweat testsIf blood spot screening indicates that your baby may have cystic fibrosis you may be offered a sweat test. People with cystic fibrosis have a large amount of salt in their sweat, and measuring the amount of salt in the sweat can help determine whether or not your baby has cystic fibrosis. A small amount of sweat will be collected from the skin on your baby's arm or leg. You will be given the test results usually later the same day. If the sweat test indicates that your baby has cystic fibrosis, your doctor will discuss available treatments. You and your baby will be referred to a team of health professionals which often includes a specialist doctor, a specialist nurse, a dietitian and a physiotherapist. TreatmentThere is currently no cure for cystic fibrosis. There is a lot of research under way to try to find a cure for cystic fibrosis lung disease through gene therapy. Current treatments aim to control the symptoms and have two main aims:
PhysiotherapyIf you have cystic fibrosis you will need daily chest physiotherapy, which involves vigorous massage to help loosen the sticky mucus. Parents of a child with cystic fibrosis are taught by hospital staff how to do this. Older children and adults with cystic fibrosis can be taught to do this for themselves. Enzyme therapyWith each meal or snack, most people with cystic fibrosis need to take replacement enzymes such as pancreatin (eg Pancrex). These supply the missing pancreatic enzymes and allow proper digestion. People with cystic fibrosis normally need vitamin and mineral supplements too. Other cystic fibrosis-related therapyThere is a range of other possible treatments, according to each person's condition. These may include:
People with cystic fibrosis may also need help to overcome fertility problems as well as counselling to help cope with the psychological aspects of the illness. VaccinationsThe usual childhood vaccinations, such as measles, mumps and rubella (MMR) and diptheria, tetanus and whooping cough (DTP) are important for children with cystic fibrosis. If you have cystic fibrosis you should also be vaccinated against flu and pneumococcus to help prevent chest infections. For more information about vaccines, please see the separate BUPA factsheets, Childhood immunisation and Colds and flu. Further information
Sources
Published by BUPA's health information team, healthinfo@bupa.com, December 2006.
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