The landscape of gastrointestinal disease in cystic fibrosis has changed significantly with the use of highly effective modulatory therapy (HEMT) in the majority of CF patients in both adult and pediatric CF care. In that light, this session focuses on the developments and challenges we see as GI providers. In addition, we discuss how to adapt best practices to improve the care and most importantly quality of life for our patients and families who continue to struggle with the GI manifestations of their CF. We focus on several aspects of GI care as it relates to adult and pediatric patients on HEMT; pancreatic function and enzyme use, how to assess the need for supplemental tube feeding, liver test abnormalities and updates in constipation and bloating. Originally recorded November 3, 2023.