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Symptoms and Diagnosis of Cystic Fibrosis

Cystic fibrosis (CF) is a lifelong genetic condition that affects many parts of the body, especially the lungs and digestive system. It causes thick, sticky mucus to build up, making it harder to breathe and digest food. 

Learning about the signs and symptoms, how it’s diagnosed and possible complications can help you understand what to expect and how to manage the condition. With early diagnosis and proper care, people with CF can live healthier and longer lives. 

What are the signs of cystic fibrosis?

CF can look different for everyone. Some people have mild symptoms, while others have more severe issues or life-threatening complications. 

Signs of cystic fibrosis often start within the first year of life. But some children may not show symptoms until later. 

Common signs of cystic fibrosis include:

  • Salty-tasting skin: A baby’s skin tastes salty when kissed. 
  • Meconium ileus: In some newborns, CF may cause problems passing the first poop (meconium) within the first 24 to 48 hours of life.
  • Poor weight gain and growth: Despite eating well, some children with cystic fibrosis may struggle to gain weight or grow as expected. 
  • Long-term lung symptoms: Thick mucus in the lungs can cause wheezing, shortness of breath and coughing. Coughs may be dry or bring up mucus or blood. 
  • Frequent lung infections: These can include bronchitis and pneumonia. 
  • Greasy, bulky poop: These may be hard to flush and smell bad.
  • Stomach issues: People with CF may have gas, bloating and constipation.
  • Chronic sinus infections: A stuffy nose or lots of sputum (saliva and mucus) are symptoms of sinus infections.
  • Nasal polyps: Soft, teardrop-shaped growths may form on the lining of the nose or sinuses.
  • Clubbing: The tips of the fingers and toes may become rounder and wider over time. 
  • Muscle and joint pain: Some people with CF may experience joint pain and swelling. 

Depending on the organs affected, other symptoms may include jaundice (yellowing of the skin), gallstones and pancreatitis. 

If you or your child have a family history of cystic fibrosis and/or are experiencing symptoms of the condition, talk to a health care provider. Early diagnosis can make a big difference in managing CF.

When to seek immediate medical attention

If you or a loved one experiences any of the following symptoms, call 911 or visit the closest emergency department:

  • Sudden chest pain 
  • Sudden shortness of breath
  • Coughing or spitting up blood
  • Worsening lung symptoms include more coughing, wheezing, chest congestion or a change in mucus color
  • High fever (over 103°F)
  • Confusion or fainting 
  • Bluish skin color (cyanosis)

How is cystic fibrosis diagnosed?

CF is usually diagnosed through a combination of tests. If it runs in your family or a health care specialist suspects cystic fibrosis, these tests can help confirm the condition.

Newborn screening

In the U.S., a CF test is part of routine newborn screenings. A small blood sample is taken from your baby’s heel (called a heel prick test) during the first few days of your baby’s life. 

The blood test checks for levels of IRT (immunoreactive trypsinogen), a chemical made by the pancreas. IRT is typically found in small levels in the body. In someone who has CF, these levels tend to be high but can also be high if the baby was born prematurely (before 37 weeks), had a stressful delivery or for other reasons.   

If the test shows high levels of IRT, this may indicate your baby has CF. Your state health department would let you know if your baby has a positive test for CF. However, the newborn screening test is not foolproof, so if your child has a positive test or you are concerned your child may have CF, talk to your child’s health care provider. Follow-up tests can then be done to confirm the diagnosis. Early screening means treatment can start right away. 

Sweat test

The sweat chloride test, which measures the amount of chloride in sweat, is the most common way to diagnose CF. People with CF can have two to five times the normal amount of chloride in their sweat. Providers will order this test for children with positive newborn screenings, a family history of CF or symptoms of the disorder. 

A health care provider places a small device on the skin during the test to collect sweat. The test is safe and doesn’t hurt. 

Genetic testing

Genetic testing or carrier screenings look for mutations in the CFTR gene. The movement of salt and water in and out of cells is controlled by this gene. A mutation of this gene is the cause of CF. This test looks at your DNA from a blood, saliva or cheek swab sample. 

Genetic testing is often used to confirm a diagnosis after a sweat test. It’s also recommended if CF runs in your family or if symptoms suggest cystic fibrosis, but other tests are unclear.

Other tests

You may also have these tests:

  • Chest X-ray to check for signs of lung damage, infections or blockages caused by thick mucus.
  • Lung function test to check for issues with airflow or lung capacity.
  • Imaging tests to look at the lungs, sinuses or digestive organs in more detail.
  • Pancreatic function test to test for pancreatic enzymes in the blood or poop to see if the pancreas is working normally.
  • Sputum culture to test the spit and mucus that is coughed up for bacteria or fungi.

Complications of cystic fibrosis

While treatments have improved, the disease still causes serious complications that can make life harder for those living with the disease. The most common problems happen in the lungs, digestive system and other areas of the body and they can worsen over time.

Lung complications

Thick mucus builds up in the lungs, making breathing harder and causing frequent infections. Over time, this can damage the airways and lead to respiratory failure, where the lungs can’t provide enough oxygen.

Digestive complications

The thick mucus also blocks the pancreas, preventing the release of enzymes, and making it hard to digest food and absorb nutrients. This can lead to malnutrition, poor growth and problems like bowel obstructions. CF can also lead to diabetes as scarring in the pancreas causes it to lose its ability to produce insulin. 

Bone and joint issues

CF can cause weak bones, increasing the risk of osteoporosis and fractures. 

Fertility challenges

Most men who are living with CF are infertile due to blockages in the reproductive tract. The sperm never makes it to the semen, making it impossible to fertilize an egg during sex. However, many can still have biological children with the help of assisted reproductive technology (ART).

Treatment and living with cystic fibrosis

While there is no cure for cystic fibrosis, people now live longer, healthier lives. This is why early diagnosis and treatment are so important. 

Learn more about the treatments available and how to manage daily life with CF

We are here for you

If you or a loved one has a family history of CF or experience these symptoms, schedule an appointment with a Banner Health specialist. We have a Cystic Fibrosis Center within Banner who can help. Our experienced team can help diagnose and develop a personalized treatment plan.