The pancreas is an oblong flat gland, about 6 inches long, located below the liver, deep in the abdomen, between the stomach and the spine. It is about as long as your hand in an irregular tube shape. The pancreas has 2 types of cells:
Endocrine. The endocrine cells make hormones like insulin and glucagon, along with other hormones that the pancreas makes. These 2 hormones work together to regulate the level of sugar in the blood.
Exocrine. The exocrine cells produce and secrete enzymes into the duodenum, the first part of the small intestine, where they break down protein, carbohydrates, and fat into simpler components that can be easily absorbed. There are 3 major classes of enzymes. The enzyme trypsin breaks proteins down into peptides and amino acids. Lipase breaks fats down into short-chain fatty acids that can be easily absorbed. Amylase breaks starches (complex carbohydrates) down into simple sugars.
In 1922, scientists discovered that a shortage of the hormone insulin is responsible for the disease called juvenile diabetes (now called type 1 diabetes). The source of insulin is none other than your pancreas.
The pancreas and diabetes
Most of the time, the pancreas goes about its work quietly from its strategic location behind the stomach. But a relatively small number of people develop type 1 diabetes. The beta cells of the pancreas are destroyed in people with type 1 diabetes and the pancreas can't produce insulin. This condition usually occurs when the patient is a child or young adult — thus the earlier name, juvenile diabetes. Another form of diabetes, type 2, tends to occur in older people. It stems mainly from the body's inability to use insulin effectively. Early in the disease, the body may respond by producing excessively high levels of insulin, but eventually the beta islet cells of the pancreas tire out and fail to produce enough insulin.
Other diseases of the pancreas
Cystic fibrosis. In cystic fibrosis, an inherited genetic disorder, mucous plugs can block pancreatic enzymes from reaching the intestines. This leads to digestive problems, delayed growth, and fat-soluble vitamin deficiencies.
Pancreatitis. Another disease of the pancreas is pancreatitis, an inflammation of the pancreas that can be painful. It can be acute (sudden) or chronic. The most common causes of acute pancreatitis are blockage of the pancreatic duct by a gallstone and excessive alcohol use. The most common cause of chronic pancreatitis in the United States is alcoholism.
Pancreatic cancer. Cancer of the pancreas is a leading cause of cancer death in the United States. Risks for pancreatic cancer include smoking, age, being male, having chronic pancreatitis, and exposure to some industrial chemicals. Most pancreatic cancers develop in the exocrine tissues of the pancreas. It is a very difficult cancer to detect in the early stages.
Pancreatic insufficiency. Pancreatic insufficiency is the inability of the pancreas to produce and/or secrete enough digestive enzymes to break down food in the small intestine. It typically occurs as a result of chronic pancreatic damage caused by cystic fibrosis or chronic pancreatitis.
- MMI board-certified, academically affiliated clinician
- Turley, Ray, BSN, MSN