Steatorrhea and azotorrhea and their relation to growth and nutrition in adolescents and young adults with cystic fibrosis.

Fecal fat and nitrogen excretion were determined in 20 patients, 12 to 
17 years of age, with cystic fibrosis (CF); all had pancreatic 
deficiency. Current clinical and nutritional status and growth achievement in relation 
to fecal nutrient loss, age at diagnosis, and adequacy of treatment 
were evaluated. Steatorrhea and azotorrhea were present to a variable extent 
(at times massive) in all patients studied, but bore little relation 
to existing intestinal symptoms, state of nutrition, growth achieved, or age 
at diagnosis. Many of the patients with better growth, nutrition, and 
prognostic scores had been diagnosed relatively late in life and presumably 
had not received adequate or optimal treatment. Addition of pancreatic supplements 
resulted in significant, but not dramatic decreases in fecal losses of 
fat and nitrogen. It was concluded that despite pancreatic deficiency most 
older patients with CF need little dietary restriction, although treatment should 
be individualized. Growth failure and state of nutrition seem to be 
correlated more closely with the pulmonary state than with pancreatic deficiency. 
For ultimate prognosis, natural variation in the severity of lung involvement 
is at least as important as early diagnosis and adequate or 
optimal treatment. 