What is the pancreas?
The pancreas is a narrow, flat gland about six inches long located deep in your abdominal cavity, behind the stomach and below the liver. It has head, middle, and tail sections. Its head section connects to the first part of the small intestine (duodenum).
- Inside the pancreas, small ducts (tubes) feed digestive enzymes and bicarbonate produced by the pancreas into the pancreatic duct. This large duct carries the digestive enzymes and bicarbonate down the length of the pancreas, from the tail to the head section, and into the duodenum.
- The common bile duct also runs through the head section of the pancreas, carrying bile from the liver and gallbladder into the small intestine.
- The bile duct and pancreatic duct usually join just before entering the duodenum and share a common opening into the small intestine.
The pancreas consists of two kinds of tissues that perform different functions:
- The exocrine pancreas makes, stores and releases powerful enzymes to digest fats, proteins, and carbohydrates in the small intestine. The enzymes normally are produced and carried in an inactive form to the small intestine, where the enzymes are activated as needed. Exocrine tissues also make and release bicarbonate that neutralizes stomach acids and allows for the activation of pancreatic enzymes.
- The endocrine pancreas produces hormones, including insulin and glucagon, and releases them into the blood. These hormones regulate sugar (glucose) transport into the body’s cells, where it is used for energy and to help maintain normal blood sugar levels.
Common Diseases of the Pancreas
Pancreatitis is an inflammation of the pancreas. It occurs when digestive enzymes become activated while still inside your pancreas, causing irritation and injury to pancreatic tissue and leading to inflammation.
Pancreatitis can be acute or chronic:
- In acute pancreatitis, inflammation develops quickly and then goes away after a few days to weeks. Your pancreas returns to normal once it has healed. The main causes are gallstones and long-term alcohol abuse. Repeated bouts of acute pancreatitis can lead to chronic pancreatitis.
- Chronic pancreatitis is long-lasting inflammation in the pancreas. It can lead to the formation of scar tissue in the gland that keeps it from working properly. Long-term alcohol abuse is the main cause of chronic pancreatitis. If you smoke cigarettes, you are also at increased risk for the condition.
Read the article on Pancreatitis for additional information.
Pancreatic cancer is the uncontrolled growth of abnormal cells in the pancreas. The cancerous cells form malignant tumors, which damage tissue, and keep the pancreas from working the way it should.
Pancreatic cancer is the fourth leading cause of cancer death in men and women in the United States. According to the American Cancer Society, nearly 57,000 Americans are diagnosed with pancreatic cancer each year, and about 46,000 die from it. It is slightly more common in men than in women.
Most pancreatic cancers (about 95%) begin in exocrine cells that make up the glands and ducts in the pancreas. Pancreatic cancer is very difficult to detect in the early stages because symptoms are either absent or nonspecific.
For more details, see the Pancreatic Cancer article.
Pancreatic insufficiency is a condition in which the pancreas is not able to produce and/or transport enough digestive enzymes to break down food in the intestine. This condition is also known as exocrine pancreatic insufficiency or EPI.
EPI typically occurs as a result of ongoing (progressive) pancreatic damage, which can be caused by a variety of conditions. It is most often associated with cystic fibrosis in children and with chronic pancreatitis in adults. Less often, it results from pancreatic cancer.
Read the article on Pancreatic Insufficiency for more information.
Sources Used in Current Review
(August 7, 2018) Mayo Clinic Staff. Pancreatitis. Available online at https://www.mayoclinic.org/diseases-conditions/pancreatitis/symptoms-causes/syc-20360227. Accessed March 18, 2019.
(November 2017) National Institute of Diabetes and Digestive and Kidney Diseases. Available online at https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis/all-content. Accessed March 18, 2019.
(March 14, 2019) Tang JCF, Markus JT. Acute pancreatitis. Available online at https://emedicine.medscape.com/article/181364-overview. Accessed March 18, 2019.
(August 2017) Bansal R. Acute pancreatitis. Available online at https://www.merckmanuals.com/home/digestive-disorders/pancreatitis/acute-pancreatitis#. Accessed March 18, 2019.
(January 29, 2019) National Cancer Institute. Pancreatic Cancer Treatment (PDQ®) – Health Professional Version. Available online at https://www.cancer.gov/types/pancreatic/hp/pancreatic-treatment-pdq#_1. Accessed March 29, 2019.
(February 11, 2019) American Cancer Society. Pancreatic cancer. Available online at https://www.cancer.org/cancer/pancreatic-cancer.html. Accessed March 29, 2019.
National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program. Cancer stat facts: pancreatic cancer. Available online at https://seer.cancer.gov/statfacts/html/pancreas.html. Accessed March 31, 2019.
Medical University of South Carolina Digestive Disease Center. Pancreatic insufficiency. Available online at http://ddc.musc.edu/public/diseases/pancreas-biliary-system/pancreatic-insufficiency.html. Accessed March 23, 2019.
(May 21 2014). Johnson DA. Exocrine pancreatic insufficiency: seen but not recognized? Available online at https://www.medscape.com/viewarticle/825138_1. Accessed March 27, 2019.
(January 10, 2019) Al-Kaade S, Khardori R. Exocrine pancreatic insufficiency. Available online at https://emedicine.medscape.com/article/2121028-overview. Accessed March 25, 2019.
Struyvenberg M, Martin CR, Freedman SD. Practical guide to exocrine pancreatic insufficiency—breaking the myths. BMC Medicine. (2017) 15:29. Available online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5301368/pdf/12916_2017_Article_783.pdf. Accessed March 25, 2019.
(October 25, 2016) American Gastroenterological Association press release. Largest analysis examining barriers to EPI diagnosis finds patients with digestive health issues overlook their symptoms. Available online at https://www.gastro.org/press-release/largest-analysis-examining-barriers-to-epi-diagnosis-finds-patients-with-digestive-health-issues-overlook-their-symptoms. Accessed March 27, 2019.
Sources Used in Previous Reviews
(2006) American Cancer Society. Cancer Facts and Figures 2006 [On-line information]. Available online through http://www.cancer.org.
November 2006) Mayoclinic.com. Health information-Digestive system, Pancreatitis (online information). Available online at http://www.mayoclinic.com/health/pancreatitis/DS00371.
(November 2006) National Digestive Diseases Information Clearinghouse (NDDIC), National Institute of Diabetes and Digestive and Kidney Diseases, NIH—Pancreatitis (Online information). Available online at http://digestive.niddk.nih.gov/ddiseases/pubs/pancreatitis/.
(© 2009). What is the Pancreas? Pancreas.org [On-line information]. Available online at http://pancreas.org/pancreas/normal-pancreas/. Accessed January 2011.
(Modified 2010 June 9). What is the Pancreas. John Hopkins Medicine, The Sol Goldman Pancreatic Cancer Research Center [On-line information]. Available online at http://pathology.jhu.edu/pancreas/BasicOverview1.php?area=ba. Accessed January 2011.
Erickson, R et al (Updated 2010 December 7). Pancreatic Cancer. eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/280605-overview. Accessed January 2011.
Obideen, K. and Wehbi, M. (Updated 2010 November 19). Pancreatitis, Chronic. eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/181554-overview. Accessed January 2011.
Whitcomb, DC. Genetic Aspects of Pancreatitis. Annual Review of Medicine 61, Pp 413-24, 2010. Available online at http://www.annualreviews.org/doi/abs/10.1146/annurev.med.041608.121416?journalCode=med. Accessed April 2011.
Lal A, Lal DR. Hereditary Pancreatitis. Pediatr Surg Int 26 (12) Pp 1193-1199, 2010. Available online at http://www.ncbi.nlm.nih.gov/pubmed/20697897. Accessed April 2011.
Lerch MM, et al. Advances in the Etiology of Chronic Pancreatitis. Dig Dis 28 p324-329, 2010. Available online at http://www.ncbi.nlm.nih.gov/pubmed/20814206. Accessed April 2011.
(Updated Nov. 12, 2012). What is the Pancreas? Johns Hopkins Medicine. Available online at http://pathology.jhu.edu/pc/BasicOverview1.php?area=ba. Accessed March 2014.
(Updated Feb. 5, 2014). What Are the Key Statistics About Pancreatic Cancer? American Cancer Society. Available online at http://www.cancer.org/cancer/pancreaticcancer/detailedguide/pancreatic-cancer-key-statistics. Accessed March 2014.
Dragovich, Tomislav, et. al. (Updated Feb. 3, 2014). Pancreatic Cancer. Medscape. Available online at http://emedicine.medscape.com/article/280605-overview. Accessed March 2014.
(Updated Feb. 5, 2014). What’s New in Pancreatic Cancer Research and Treatment? American Cancer Society. Available online at http://www.cancer.org/cancer/pancreaticcancer/detailedguide/pancreatic-cancer-new-research. Accessed March 2014.
Al-Kaade, Samer, et. al. (Updated Jan. 29, 2013). Exocrine Pancreatic Insufficiency. Medscape. Available online at http://emedicine.medscape.com/article/2121028-overview#aw2aab6b2b4. Accessed March 2014.
Mayo Clinic. Pancreatitis. Available online at http://www.mayoclinic.org/diseases-conditions/pancreatitis/basics/causes/con-20028421. Accessed May 2014.
Gregory C. Sephel. Lab Tests Online adjunct board member.