Pancreas: Functions and possible problems
The pancreas has an endocrine function because it releases juices directly into the bloodstream, and it has an exocrine function because it releases juices into ducts.
Enzymes, or digestive juices, are secreted by the pancreas into the small intestine. There, it continues breaking down food that has left the stomach.
Here are some key points about the pancreas. More detail is in the main article.
- The pancreas is a gland organ with a key role in digestion and glucose control.
- Problems related to the pancreas include diabetes and cancer.
- A healthful diet can contribute to maintaining a healthy pancreas.
The pancreas is located in the abdomen and plays an important role in digestion.
The pancreas is an organ 6 to 8 inches long. It extends horizontally across the abdomen.
The largest part lays on the right side of the abdomen where the stomach attaches to the first part of the small intestine, the duodenum.
At this point, the partially digested food passes from the stomach into the small intestine, and it mixes with the secretions from the pancreas.
The narrow part of the pancreas extends to the left side of the abdomen next to the spleen.
A duct runs the length of the pancreas, and it is joined by several small branches from the glandular tissue. The end of this duct is connected to a similar duct that comes from the liver, which delivers bile to the duodenum.
Around 95 percent of the pancreas is exocrine tissue. It produces pancreatic enzymes to aid digestion. A healthy pancreas makes about 2.2 pints (1 liter) of these enzymes every day.
The remaining 5 percent comprises hundreds of thousands of endocrine cells known as islets of Langerhans. These grape-like cell clusters produce important hormones that regulate pancreatic secretions and control blood sugar.
A healthy pancreas produces chemicals to digest the food we eat.
The exocrine tissues secrete a clear, watery, alkaline juice that contains several enzymes. These break down food into small molecules that can be absorbed by the intestines.
The enzymes include:
- trypsin and chymotrypsin to digest proteins
- amylase to break down carbohydrates
- lipase, to break down fats into fatty acids and cholesterol
The endocrine portion, or islets of Langerhans, secrete insulin and other hormones.
Pancreatic beta cells release insulin when blood sugar levels rise.
- moves glucose from the blood into muscles and other tissues, for use as energy
- helps the liver absorb glucose, storing it as glycogen in case the body needs energy during stress or exercise
When blood sugar falls, pancreatic alpha cells release the hormone glucagon.
Glucagon causes glycogen to be broken down into glucose in the liver.
The glucose then enters the bloodstream, restoring blood sugar levels to normal.
Problems with the pancreas can affect the whole body.
If the pancreas does not produce enough digestive enzymes, for example, food will not be properly absorbed. This can lead to weight loss and diarrhea.
The islets of Langerhans are responsible for regulating blood glucose. Too little insulin production will increase the risk of diabetes, and blood glucose levels will rise.
A flareup in pancreatitis can cause abdominal pain.
Pancreatic juices will accumulate in the pancreas, causing damage to the pancreas. The pancreas may start to digest itself.
Pancreatitis can happen as a result of mumps, gallstones, trauma and the use of alcohol, steroids, and drugs.
Acute pancreatitis is rare, but it needs immediate medical attention.
- intense abdominal pain, tenderness, and swelling
- nausea and vomiting
- muscle aches
Immediate treatment is normally with fluids and painkillers. Patients often do not want to eat at the beginning, but if the pancreatitis is mild, they will start to eat again relatively quickly.
If a secondary infection has occurred, surgery may be necessary.
Chronic pancreatitis can develop if acute pancreatitis happens repeatedly, resulting in permanent damage.
The most common cause is alcohol abuse, and it mostly affects middle-aged men.
- persistent pain in the upper abdomen and back
- weight loss
- mild jaundice
Hereditary pancreatitis can happen if there is an inherited problem in the pancreas or the intestine. A person under 30 years of age may experience repeated acute pancreatitis, leading to a chronic condition.
It is a progressive condition that can lead to permanent damage. The person may experience pain, diarrhea, malnutrition or diabetes. Treatment aims to control pain to replace lost enzymes.
Genetic testing is available for patients who may be at risk.
Cancer can develop in the pancreas. The exact cause is often unknown, but it is often linked to smoking or heavy drinking.
Other risk factors include:
- chronic pancreatitis
- liver problems
- stomach infections
- pain in the upper abdomen as the tumor pushes against the nerves
- jaundice, a yellowing of the skin and eyes and darkening of the urine as the cancer interferes with the bile duct and the liver
- loss of appetite, nausea, and vomiting
- significant weight loss and weakness
- pale or gray stool, and excess fat in the stool
Symptoms may not appear until the cancer is in the advanced stages. By then, it may be too late for successful treatment. The prognosis for pancreatic cancer tends to be poor.
Treatment usually involves surgery, chemotherapy, radiation, or a combination these.
Palliative treatment will focus on reducing the pain.
Pancreatic cancer is the fourth most common cause of cancer in men in the United States (U.S.) and the fifth in women. Over 37,000 new cases are diagnosed each year.
Type 1 diabetes is an autoimmune disease. It occurs when the immune system attacks and destroys the beta cells in the pancreas so that they can no longer produce insulin. The exact cause remains unknown, but it may be due to genetic and environmental factors, including viruses.
Type 2 diabetes begins when the body's muscle, fat, and liver cells become unable to process glucose. The pancreas reacts by producing extra insulin, but in time, it cannot produce enough insulin. The body can no longer control blood glucose levels.
Other problems that can occur include:
- Exocrine pancreatic insufficiency (EPI): The pancreas does not produce enough enzymes
- Pancreatic cysts: These can be removed by surgery if there is a risk of cancer
- Pancreatic fluid collections: Resulting from a range of conditions, this can lead to pain and fever
- Zollinger-Ellison syndrome: A tumor known as a gastinoma develops in the pancreas or duodenum
Maintaining a healthy pancreas
Following a balanced diet and avoiding smoking and excessive drinking will help keep the pancreas healthy.
Keeping hydrated is important for maintaining a healthy pancreas.
The National Pancreatic Foundation recommend:
- consuming no more than 20 grams of fat a day
- avoiding alcohol
- drinking plenty of water to keep hydrated
A fasting diet may trigger the pancreas to regenerate itself, which could help people with diabetes, according to results of an animal study published in February 2017.
A fast would involve consuming far fewer calories than usual for a number of days.
The National Pancreatic Foundation suggests a similar strategy for people who are experiencing a flareup of pancreatic pain. They suggest taking a clear liquid diet for 1 to 2 days, including grape juice, broth, gelatin, apple, and cranberry.
A fast cannot provide all the necessary nutrients for wellbeing. After fasting, people should ensure they eat nutritious food to make up for nutrients lost.
Fasting should first be discussed with a doctor.