Table 4.

 Management of other common complications of cystic fibrosis

Organ	Manifestation of cystic fibrosis	Treatment	Comments
Upper airway	Polyps18	Topical steroids; antibiotics; surgery if medical management fails	Surgery may have medium term benefit, but recurrence common
	Sinusitis	Topical steroids; antibiotics; surgery if medical management fails	Most cases are asymptomatic (changes seen on x ray films or computed tomograms almost universal): no treatment required
Endocrine pancreas19	Insulin deficiency; frank diabetes	Insulin; continue high fat diet; oral hypoglycaemic agents rarely useful	Deleterious impact on respiratory health and nutrition even before diabetes diagnosed
Bones	Osteopenia; pathological fracture	Prevention: weight bearing exercise, high dairy intake, vitamin D and K therapy* (bisphosphonates if severe*)
	Cystic fibrosis arthropathy	Anti-inflammatory agents
Sweat gland	Electrolyte depletion leading to failure to thrive, acute collapse	Sodium and potassium chloride supplementation
Male reproductive tract	Bilateral absence of vas deferens	Sperm aspiration, and assisted fertilisation techniques
Female reproductive tract	Vaginal candidiasis; stress incontinence	Topical antifungal agents	Seek gynaecological advice

*Treatments for which consensus is lacking.