The pancreas is a gland located in the back of the abdomen, behind the stomach, between the upper part of the intestine and the spleen. It is part of both the digestive system and the endocrine system.
The pancreas has an exocrine function, in which it produces substances that help with digestion. It also has an endocrine function, in which it produces and releases hormones involved in blood glucose control.
When the pancreas does not work properly, conditions such as pancreatitis, diabetes, and cancer can develop. This can lead to symptoms such as abdominal pain, nausea, vomiting, weight loss, and excessive thirst, and it is important to see an endocrinologist for evaluation and appropriate treatment.
What does the pancreas do?
The main functions of the pancreas are:
1. Blood glucose control
The cells in the islets of Langerhans in the pancreas have an endocrine function, because they produce insulin and glucagon, which are hormones responsible for controlling blood sugar levels and the body’s metabolism.
Insulin helps lower blood sugar levels, while glucagon is responsible for increasing the concentration of circulating glucose.
In addition, these cells also produce the hormone somatostatin, which helps regulate insulin and glucagon production and also participates in blood glucose control.
2. Food digestion
The exocrine pancreas, made up of clusters of cells called acini, produces pancreatic juice that contains enzymes such as amylase, which digests carbohydrates and sugars, trypsin, which digests proteins, and lipase, which digests fats.
These enzymes are released into the duodenum, which is the first part of the intestine, through a small tube in the pancreas called the pancreatic duct, allowing food to be broken down into smaller pieces so it can pass into the intestine.
This process supports digestion and nutrient metabolism.
Symptoms of pancreas problems
Symptoms that may indicate a developing problem in the pancreas include:
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Abdominal pain that may start suddenly and become progressively stronger and constant, usually felt in the center of the abdomen and spreading upward and downward;
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Worsening abdominal pain when lying on the back;
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Diarrhea with fat in the stool;
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Nausea and vomiting after eating, usually associated with pain.
These symptoms help an endocrinologist consider conditions such as diabetes, pancreatitis, a pancreatic cyst, or pancreatic cancer.
Anatomy of the pancreas
The pancreas is made up of four main regions:
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Head, the widest part of the pancreas, located on the right side of the abdomen within the curve of the duodenum;
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Neck, the portion that connects the head and the body of the pancreas;
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Body, the middle part of the pancreas located between the neck and the tail;
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Tail, the narrowest end of the pancreas, extending toward the left side of the body.
The pancreas is between 15 and 25 cm long. Important blood vessels are located around the pancreas, such as the superior mesenteric artery, superior mesenteric vein, portal vein, and the celiac trunk, which supply blood to the pancreas and other abdominal organs.
The islets of Langerhans produce the hormones insulin and glucagon, while the pancreatic acinar cells produce enzymes that participate in food digestion.
Which specialist to see
When a pancreatic disorder is suspected, referral to an endocrinologist is recommended. The specialist will evaluate the symptoms and request appropriate tests to confirm or exclude the diagnosis.
To assess changes in the organ, a clinician may order imaging tests such as ultrasound, MRI, CT scan, or cholangiography. Blood tests may also be requested, such as a complete blood count (CBC) and pancreatic enzyme levels, including amylase and lipase.
Based on the results, a doctor can recommend treatment according to the specific condition affecting the pancreas.
Main diseases
Some of the main diseases affecting the pancreas are:
1. Pancreatitis
Pancreatitis is inflammation of the pancreas that occurs when pancreatic enzymes become activated while still inside it. It can be caused by gallstones, alcohol use, and smoking.
This inflammation can cause symptoms such as abdominal pain, nausea, vomiting, and fever, and it can be acute or chronic.
2. Diabetes mellitus
Diabetes mellitus is a metabolic disease characterized by increased blood sugar levels. The most common symptoms are drinking a lot of water during the day, increased appetite, and frequent urge to urinate.
3. Pancreatic cancer
Pancreatic cancer is a serious type of cancer that develops in the pancreas. Symptoms of pancreatic cancer include weakness, abdominal pain, yellowing of the skin and eyes, and weight loss, and it is often identified at more advanced stages.
Preventing disease
Some measures can help prevent or reduce the risk of pancreatic diseases, such as:
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Eating a healthy, varied diet;
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Maintaining a healthy weight;
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Not drinking alcohol or drinking in moderation;
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Not smoking;
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Exercising regularly.
If you already have a pancreatic condition such as pancreatitis or diabetes, it’s important to follow your medical team’s advice and maintain a balanced diet.