Pancreas: Function, Location &

Diseases
The pancreas is an abdominal organ that is located behind the stomach and is
surrounded by other organs, including the spleen, liver and small intestine. The
pancreas is about 6 inches (15.24 centimeters) long, oblong and flat.

The pancreas plays an important role in digestion and in regulating blood sugar.
Three diseases associated with the pancreas are pancreatitis, pancreatic cancer
and diabetes.

Function of the pancreas

The pancreas serves two primary functions, according to Jordan Knowlton, an
advanced registered nurse practitioner at the University of Florida Health Shands
Hospital. It makes "enzymes to digest proteins, fats, and carbs in the intestines"
and produces the hormones insulin and glucagon, he said.

Dr. Richard Bowen of Colorado State University's Department of Biomedical

Sciences wrote in Hypertexts for Pathophysiology: Endocrine System, "A well-
known effect of insulin is to decrease the concentration of glucose in blood." This
lowers blood sugar levels and allows the body's cells to use glucose for energy.

Insulin also allows glucose to enter muscle and other tissue, works with the liver to
store glucose and synthesize fatty acids, and "stimulates the uptake of amino
acids," according to Bowen. Insulin is released after eating protein and especially
after eating carbohydrates, which increase glucose levels in the blood. If the
pancreas does not produce sufficient insulin, type 1 diabetes will develop.

Unlike insulin, glucagon raises blood sugar levels. According to the Johns Hopkins
University Sol Goldman Pancreatic Cancer Research Center, the combination of
insulin and glucagon maintains the proper level of sugar in the blood.

The pancreas' second, exocrine function is to produce and release digestive fluids.
After food enters the stomach, digestive enzymes called pancreatic juice travel
through several small ducts to the main pancreatic duct and then to the bile duct,
according to the Medical University of South Carolina’s Digestive Disease Center.
The bile duct takes the juice to the gallbladder, where it mixes with bile to aid in
digestion.

Location of the pancreas

"The pancreas is located in the upper abdomen behind the stomach," Knowlton
said. The right end of the pancreas is wide and called the head. From the head, the
organ tapers to the left. The middle sections are called the neck and body, while
the narrow end on the left side of the body is called the tail.

The Hume-Lee Transplant Center at Virginia Commonwealth University described

the pancreas as "j-shaped." The portion of the pancreas called the uncinate
process bends backward from the head and underneath the body, according to the
Pancreatic Cancer Action Network.

Pancreas pain
Intense pancreatic pain is usually associated with acute pancreatitis. It can be hard
to identify pancreas pain and evaluate pancreas diseases because the organ sits
deep in the abdomen, according to The National Pancreas Association. Other
signs that the pain may be pancreatic include jaundice, itchy skin and unexplained
weight loss. If you are experiencing pancreas pain, consult your doctor.

Pancreatitis

The National Institutes of Health defines pancreatitis as inflammation of the

pancreas, happening when "digestive enzymes start digesting the pancreas itself."
It can be acute or chronic, but both forms should be taken seriously and may lead
to additional health problems.

Chronic pancreatitis

There are up to 23 cases of chronic pancreatitis per 100,000 people per year
worldwide. In just the United States, it results in more than 122,000 outpatient visits
and more than 56,000 hospitalizations per year, according to the Cleveland Clinic.

"Chronic pancreatitis is a persistent inflammation (greater than three weeks) of the

pancreas that causes permanent damage," Knowlton said. The condition is often
caused by "heavy, ongoing" alcohol consumption, but she added that there are
other causes, including "those that cause acute pancreatitis attacks." Other causes
may be cystic fibrosis, high levels of calcium or fat in the blood and autoimmune
disorders.

Symptoms include upper abdominal pain, nausea, vomiting, weight loss, and oily
stools. According to Peter Lee and Tyler Stevens, in an article for the Cleveland
Clinic, "clinically apparent" oily stools (steatorrhea) do not appear until "90 percent
of pancreatic function has been lost."

"Chronic pancreatitis requires dietary modifications, including a low-fat diet and

cessation of alcohol [intake] and smoking," Knowlton said. Chronic pancreatitis
does not heal and tends to worsen with time, and "treatment options are mostly for
pain relief." She added that treatments "may include a pancreas stent or, for
severe cases, surgery (either a lateral pancreaticojejunostomy, or a Whipple
procedure)." Pancreatiocojejunostomies are designed to decrease pancreatic
leakage while the Whipple procedure removes the head of the pancreas where,
according to the Mayo Clinic, most tumors occur.

There may be a link between chronic pancreatitis and pancreatic cancer.

According to the University of California Los Angeles Center for Pancreatic
Diseases, "Recent studies reveal a 2-5 times increase in the incidence of
pancreatic cancer in patients with chronic pancreatitis from a variety of causes."

Acute pancreatitis

"Acute pancreatitis is inflammation of the pancreas (lasting less than three weeks),
that is most often caused by gallstones," said Knowlton. It usually comes on
suddenly and disappears within a few days of treatment. In addition to gallstones,
Knowlton said that causes "may include medications, high triglycerides, high
calcium in the blood and high alcohol consumption."

Pancreas pain is the chief symptom of acute pancreatitis, according to Medscape.

The pain is usually severe and sudden. It increases in severity until it becomes a
constant ache. This pancreas pain is felt in the upper abdomen. The Mayo Clinic
noted that the pain can radiate through to the back, and Knowlton pointed out that
it might be worse after eating. Other symptoms of acute pancreatitis include
nausea, vomiting, fever and diarrhea.

According to Knowlton, "This patient often looks acutely ill, and requires
hospitalization (typically for three to five days), intravenous (IV) hydration, nothing
by mouth (for bowel rest), pain medication, treatment of underlying conditions, and
possibly a radiologic procedure called an endoscopic retrograde
cholangiopancreatography (ERCP), which can more specifically target the
problem." If the acute pancreatitis was caused by gallstones, doctors may
recommend removing the gallbladder.

Pancreatic cancer

It is hard to diagnose pancreatic cancer early. The Mayo Clinic noted that
symptoms typically don't occur until the cancer has advanced. Knowlton said,
"Unfortunately, symptoms can be vague, but can include abdominal pain, jaundice,
severe itching, weight-loss, nausea, vomiting, and digestive problems."

Making matters even more complicated is the pancreas' deep-in-the-abdomen

location. The NIH pointed out that as a result, tumors cannot usually be felt by
touch. Because of the difficulty of early diagnosis and the rapidity with which
pancreatic cancer spreads, the prognosis is often poor.

Risk factors for pancreatic cancer include smoking, long-term diabetes and chronic
pancreatitis, according to the National Cancer Institute.

According to the American Cancer Society, pancreatic cancer usually begins in the
cells that produce pancreatic (digestive) juices or in the cells that line the ducts. In
rare occasions, pancreatic cancer will begin in the cells that produce hormones.

According to the University of Texas MD Anderson Cancer Center, to diagnose

pancreatic cancer, doctors typically conduct physical exams, blood tests, imaging
tests, endoscopic ultrasounds and tests and biopsies. Treatment options include
surgery, radiation, chemotherapy and therapies targeted to attack cancer cells
without harming normal cells.

Artificial pancreas
When a person's pancreas isn't functioning properly or has to be removed, doctors
may replace or supplement it with an artificial pancreas. These devices that
automatically monitor blood glucose and provide the appropriate insulin doses are
often called closed-loop systems, automated insulin delivery systems, or
autonomous systems for glycemic control, according to the Food and Drug
Administration.

In a 2014 study published in the journal The Lancet Diabetes & Endocrinology,
researchers found that an artificial pancreas offer people with type 1 diabetes a
reliable way to keep glucose levels in check, when compared to other treatments.
"Our study confirms that both artificial pancreas systems improve glucose control
and reduce the risk of hypoglycemia compared to conventional pump therapy,"
study author Ahmad Haidar, of Institut de Recherches Cliniques de Montreal, said
in a statement. [Artificial Pancreas May Improve Type 1 Diabetes Treatment]