Diseases of the Pancreas
What is the pancreas?
The pancreas is an organ that is located in the back of the upper abdomen. It is about 6-8 inches long and 2 inches wide. The pancreas has two basic functions; one is to produce the hormone called insulin, which regulates the main sugar glucose in the body. The other is to make enzymes to aid in the digestion of food. These enzymes are secreted into the small intestine via a tube-like structure called the pancreatic duct.
Diabetes and pancreatic insufficiency
When the production of insulin by the pancreas is impaired, diabetes mellitus can result. This can result in high blood glucose levels, which if left untreated, can result in damage to the eyes, heart, kidneys and nerves. It can even eventually lead to coma. Fortunately, many of these problems can be avoided if diabetes is diagnosed and treated properly. Treatment usually consists of dietary modifications and medications.
Pancreatic enzymes are needed for the digestive system to break down fats, protein and carbohydrates so that they can be absorbed. When there is a deficiency of these enzymes, the body cannot absorb essential nutrients, and weight loss and malnourishment can result. Diarrhea can also occur. Synthetically manufactured digestive enzymes can be taken by mouth to replace lack of pancreatic enzyme production. Pancreatic enzyme deficiency can result from chronic inflammation, infection, tumor, or trauma to the pancreas.
Inflammation of the pancreas is termed pancreatitis. The major symptom of pancreatitis is severe pain, often accompanied by nausea, vomiting, and fever. Acute pancreatitis can be caused by a number of things. The two most common causes are heavy (or binge) alcohol consumption and gallstones. Other causes include drugs, trauma, high triglyceride levels, and hereditary conditions. Chronic pancreatitis can result from repeated episodes of acute pancreatitis, alcoholism, or certain other rare diseases. Acute pancreatitis may require hospitalization for treatment. It is diagnosed by examination of the abdomen, blood tests, ultrasound and x-rays. Most patients recover, but some patients, usually heavy alcohol users, may have a life-threatening illness. Long term complications such as chronic pain, diabetes and malabsorption may occur. Endoscopic exam with ERCP (see a separate pamphlet for explanation of this procedure) is often useful both for diagnostic and therapeutic purposes. In certain instances, surgery may be indicated.
Tumors of the pancreas can develop. These may be either benign or malignant. Benign tumors can be relatively asymptomatic and require little treatment. Other benign tumors can secrete hormones, which can cause problems in various parts of the body. Malignant or cancerous tumors of the pancreas usually occur in middle-aged and older patients. At times they can cause blockage of the bile duct system and result in yellow jaundice. This is a serious illness that may be difficult treat. Endoscopically placed stents (with ERCP), and surgery may be helpful in relieving symptoms.
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