All about the pancreas

All about the pancreas
November 7, 2012 8:13 AM

The leaf-shaped gland known as the pancreas is about 6 inches long and is situated at the back of the stomach, deep in the abdominal cavity. It is part of the body’s complex digestive system, which is made up of the digestive tract and its associated organs – three pairs of salivary glands, the gallbladder, the liver and the pancreas.

Pancreas anatomy

The pancreas is divided into five sections – a head, neck, body, tail and uncinate. The head nestles in the duodenum, the first part of the small intestine, while a pancreatic duct runs along the length of the organ. The tapering pancreas’ tail is located near the spleen. The body of the pancreas is connected to the gallbladder via a common duct, which also connects to the liver.

Two crucial blood vessels are located near the uncinate process, the part of the pancreas that extends from the head and bends under the body. These vessels, the superior mesenteric artery and vein, are part of the reason the pancreas is so challenging to operate on.

Functions of the pancreas

Together with the gallbladder and the liver, the pancreas helps break down food chemically. When food enters the duodenum, the gallbladder releases bile into it through the bile duct. Meanwhile, the pancreas secretes strong digestive juices or enzymes into the duodenum in a process known as an exocrine function. This refers to an organ that secretes juices locally.

These juices are vital as they neutralise strong acids from the stomach, and so protect the intestine from damage. However, a disadvantage of the pancreas’ efficiency is that if something blocks the its duct, the pancreas continues to produce these chemicals, which spill over and begin to digest the organ itself. The damaging consequences can lead to a serious condition known as pancreatitis.

Apart from the exocrine function, the pancreas has another crucial task as part of the digestive system; it secretes insulin into the body in order to maintain carbohydrate metabolism. This is known as an endocrine function because the secretion is done via the bloodstream.

The endocrine cells in the pancreas are known as the islets of Langerhans, and each pancreas contains about a million of them. The islets are home to four types of cells, two of which are particularly significant: glucagon-making alpha cells and insulin-making beta cells. Glucagon raises glucose levels in the blood while insulin stimulates cells to use the glucose.

Type 1 and 2 diabetes

Both types of cells are secreted into the blood vessels that are located in the pancreas; they painstakingly control blood glucose levels, but when a vast majority of these cells are damaged, Type 1 diabetes is triggered.

Type 2 diabetes, which is also known as adult onset, is caused when the pancreas produces too little insulin, or the body cannot use the available insulin (insulin resistance). Being overweight is a major risk factor for Type 2 diabetes, although it also has a genetic component.

Pancreatitis and tumors of the pancreas

Alcohol and the pancreas do not mix well. Between 5 and 10 years of heavy drinking (roughly defined as consuming more than 5 units of liquor every day) can inflame the pancreas and trigger acute or chronic pancreatitis, which can in turn lead to pancreatic cancer.

Cancerous tumours in the pancreas tend to be particularly aggressive; the most common type is adenocarcinoma, which makes up about 85% of all cases. It has a poor prognosis with less than 5% of patients surviving more than five years after diagnosis.

Adenocarcinoma originates in the cells that line the pancreatic duct, but by the time most pancreatic cancers are discovered, it is usually too late to operate as the disease has spread to other organs such as the liver.

Pancreatic cancer risk factors include smoking, obesity, family history, and advanced age, and it is more common in men than women.

How to keep your pancreas in good shape

The pancreas’ important role in the body means that ensuring its health is paramount. This is done by maintaining a balanced diet, reducing alcohol consumption and avoiding cigarettes. Eating less processed meat such as bacon, ham, hot dogs and sausages, is advisable, while too much red meat and pork can be problematic.

Fresh vegetables such as garlic, cauliflower and cabbage are rich in nutrients and can improve pancreas function, as can fibre such as whole wheat bread, which slows the release of sugar into the blood.

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Written by: Michal Vilímovský (EN)
Education: Medical student, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
Published: November 7, 2012 8:13 AM
Next scheduled update: November 7, 2014 8:13 AM
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