Pancreas

What and where is it?

The pancreas is a long soft organ in the upper abdomen behind the stomach, extending from the curve of the duodenum (the first part of the small intestine) to the spleen.

It belongs to two systems at once: the digestive system because it makes digestive juices, and the endocrine system because it secretes hormones into the blood.

What it does

How it works

The pancreas regulates blood sugar through a feedback loop that works throughout the day:

1. 1
   After eatingGlucose rises in the blood.
2. 2
   Beta cellsThey sense the rise and secrete insulin.
3. 3
   TissuesMuscle and fat absorb glucose, and the liver stores part of it.
4. 4
   Between mealsWhen sugar falls, alpha cells secrete glucagon so the liver releases stored glucose.

When tissue response to insulin weakens or its secretion falls, this loop is disrupted and blood sugar rises — which is the essence of type 2 diabetes. In type 1, the beta cells themselves are destroyed.

Links to other organs

Liver and gallbladder

• The liver responds to the signals of insulin and glucagon, and the bile duct meets the pancreatic duct near the duodenum; so gallstones can block the pancreatic duct and cause inflammation.

Small intestine

• Pancreatic enzymes flow into it so digestion and absorption are completed.

Muscle and fatty tissue

• They receive the insulin signal to take up glucose.

Conditions that affect it

Disorders of the hormonal part

• Type 2 diabetes
• Type 1 diabetes

Disorders of the digestive part

• Acute and chronic pancreatitis
• Cystic fibrosis, which blocks the ducts with sticky secretions

Tumours

• Pancreatic cancer

Tests used to study it

For its hormonal function:

• Hemoglobin A1cLab test
• Fasting plasma glucoseLab test
• Oral glucose tolerance testLab test

For its digestive function and its inflammation:

• Lipase testLab test

For imaging:

• Ultrasound (sonography)Procedure
• CT scan (computed tomography)Procedure
• MRI scan (magnetic resonance imaging)Procedure

Keeping it healthy

• Maintaining a healthy weight and regular physical activity reduce the risk of type 2 diabetes.
• Avoid alcohol and smoking, which are risk factors for pancreatitis, and smoking is a risk factor for pancreatic cancer.
• Treating gallstones when present under medical supervision, because they are among the most common causes of acute pancreatitis.