Background: People with CF (pwCF) frequently have gastrointestinal symptoms (GI), including abdominal pain and irregular bowel movements. These are often embarrassing, difficult to report, and frequently missed. Thus, a GI Symptom Tracker was created and validated in the US and translated and validated in Dutch. This questionnaire consists of four subscales: Eating Challenges, Stools, Adherence Challenges and Abdominal Symptoms. Aim of this study was to investigate the relationship between GI symptoms, anxiety/depression and health-related quality of life (HRQoL) in Dutch pwCF. Methods: In this prospective, cross-sectional single-center pilot study, pwCF completed the Dutch GI Symptom Tracker, GAD-7 (anxiety), PHQ-9 (depression), and CFQ-R (HRQoL) from Sept 2021-June 2022. Regression analyses were used to analyze the univariable associations between GI symptoms, anxiety/depression and HRQoL. Results: 51 pwCF were enrolled consecutively ( n= 41 adults, 66% female, mean age (y) [range]= 32.7 [19-71] & n=10 adolescents, 70% female, mean age (y) [range]= 14.2 [12-17]). Elevated levels of anxiety (scores ≥10 on GAD-7) were found in 17% of adults and 0% of adolescents. Elevated depression scores ( ≥10 on PHQ-9) were found in 9% of adults and 20% of adolescents. GI scales ‘Eating Challenges’ and ‘Stools’ were significantly, positively associated with elevated symptoms of anxiety and depression. Most GI scales were associated with lower HRQoL. Conclusion: This is the first study investigating the link between GI symptoms assessed by the Dutch GI Symptom Tracker and anxiety/depression and HRQoL in Dutch pwCF. More GI symptoms were associated with higher anxiety and depression scores and worse health-related quality of life. Additional research is needed to better understand how mental and physical health are linked in CF.