At UVA Health, you'll find a Cystic Fibrosis Clinic that serves as a national model in caring for adults. It's one of our several subspecialty clinics for a wide range of pulmonary conditions.
Cystic Fibrosis Care at UVA Health
UVA Health is home to one of the nation's few accredited adult cystic fibrosis (CF) programs. We work closely with our accredited CF program for children. This gives our patients seamless care throughout their lives.
As leaders in the field, we give our patients access to the latest treatments. In fact, we were part of the clinical trials for a breakthrough treatment for CF.
We also have a highly ranked lung transplant program. Transplant can be an important part of CF care.
CF is a complex disease. It requires more than respiratory care to improve lung function. We work closely with patients to help them better manage all aspects of their chronic condition. This includes sharing our expertise in nutrition, physical activity and mental health.
We see patients in the Adult Cystic Fibrosis Clinic. But we can also see them at home with telehealth. Highly successful, our CF telehealth program is used as a model by others nationwide.
What is Cystic Fibrosis?
CF is an inherited disease. It causes a defect in certain cells of the lung and digestive system. The defect makes the cells produce a thick, sticky mucus. This mucus can cause:
- Blockages in the lungs and airways
- Problems digesting and absorbing nutrients
CF is a serious life-long condition, but the severity of the illness can vary greatly. The average life expectancy for someone with CF is about 35 years. Although, some with mild forms of CF can live to age 60 or beyond.
Causes of Cystic Fibrosis
CF is a genetic disorder. A child with CF inherits defective genes from each parent. Parents who have the gene but do not have CF are called carriers.
Risk Factors
Factors that increase your chance of CF include:
- Parents who are known carriers of the CF gene
- Siblings with CF
- Parents with CF — mostly the mother since men with CF are often sterile
Cystic Fibrosis Care at UVA
Dana Albon, MD, discusses the symptoms of the disease, as well as some of the innovative treatment options offered at the Cystic Fibrosis Clinic at UVA. View cystic fibrosis care transcript.
Cystic Fibrosis Symptoms
The abnormally thick mucus of CF blocks certain organs. This causes many of the symptoms of CF.
Symptoms in infants may include:
- Difficulty passing the first stool
- Intestinal obstruction, sometimes requiring surgery
- Salty sweat
Mucus that causes blockages in the lungs may lead to:
- Coughing and wheezing
- Shortness of breath
- Difficulty with exercise
- Abnormally shaped clubbed fingertips
- Malformed chest
Mucus can also block the pancreas. This can block enzymes used to help you digest food. This can lead to:
- Trouble gaining weight
- Poor growth
- Failure to thrive
- Malnutrition
- Dehydration
- Bulky, bad-smelling, floating stools, due to poor digestion of fats
- Diarrhea
Other symptoms may include:
- Mildly decreased fertility in females
- Prolapsed rectum
- Prevention of sperm production in males
- Nasal polyps
- Chronic nasal congestion from chronic sinus infections
- Jaundice or other symptoms of liver disease
- Excessive thirst or urination that may indicate diabetes mellitus type 2
- Stomach pain or swelling from intestinal blockage
Overall, girls are affected more severely than boys.
Diagnosis
The doctor will ask about symptoms and medical history. A physical exam will be done. CF is suspected in a child with classic symptoms, especially if a sibling has CF.
CF is often diagnosed by symptoms, family history of CF, or a positive screening test in newborns. The diagnosis may be confirmed with genetic testing. Other lab tests that may be used to confirm CF is sweat chloride testing.
Your doctor may need to check your lungs. This may be done to look for symptoms or to determine treatment. Tests may include:
- Chest and/or sinus x-rays
- Lung function tests
- Sputum cultures
Tests may also be needed to check the pancreas. These tests may be done to assess symptoms or determine treatment.
Treatments for Cystic Fibrosis
There is no cure for CF. But treatment can:
- Improve the amount of nutrition your body receives
- Prevent and treat lung and sinus infections
- Keep the airways and lungs as clear as possible
Nutritional Support
Better nutrition will help improve overall health. It will also improve growth and development in children. Children who have returned to normal weight within two years of the diagnosis have fewer coughing episodes and better lung function. Some nutritional steps that may help include:
- A high-calorie diet planned by a registered dietitian
- Nutritional supplements, including fat-soluble vitamins (D, E, A and K)
- Pancreatic enzyme tablets with meals to improve digestion and absorption of nutrients
- Drinking lots of fluids and salt replacement, especially in hot weather or during illnesses
Managing Lung Infections
Thick mucus in the airways increases the risk of respiratory infections. The infection can also be more severe because of the mucus. Treatment of a current infection often requires antibiotics. Prevention of new infections may be done with:
- Vaccination
- Antibiotics (usually inhaled)
Lung & Airway Support
Medications help keep the airways clear. Most will be delivered through an inhaler or nebulizer. Medications may include:
- Bronchodilators — to relax muscles and open the airway
- Steroid inhalers — to decrease swelling and irritation (only when necessary)
- Mucolytic agents — to reduce mucus and help it move out of the lung such as Pulmozyme
Other steps that may help clear mucus from the lungs include:
- Hypertonic saline is a special type of salt water. A nebulizer machine creates a mist of this saline, which is inhaled. The mist may help thin out the mucus in the lungs.
- Chest percussion is rhythmic clapping over the chest. They may help clear mucus from airways.
Oxygen therapy may be required as the disease progresses. Ventilation may also be needed. Talk to your doctor about whether these are options for you.
Other Treatment Options
Surgery may be required to treat blockages in the intestine. Lung and liver transplants may also be considered.
Support is important for those with CF and their families. Ask your doctor about local support groups or counseling options.
Prevention
If you have the defective genes, there is no way to prevent CF.
Adults can be tested to see if they carry the genes before having children. Prenatal testing can determine if a baby will have CF.