I once heard a prominent surgeon begin a presentation with the quip that all he had learned in surgical training could be summed up with the advice to (surgically) “stay away from the pancreas.”
While obviously intended as a humorous overstatement, many people don’t know much about this important organ and its multiple essential roles in the body.
The pancreas in a solid glandular organ in the center of the abdomen. It has roles in food digestion, maintenance of adequate nutrition and blood-sugar control.
The pancreas produces digestive enzymes necessary for the breakdown of food we eat into its component nutrients. The pancreatic enzymes are especially important for the digestion of fatty foods and certain vitamins essential to maintaining nutrition, including vitamins A, D, E and K. These vitamins play many essential roles in the body, ranging from bone health to normal clotting function.
Enzymes released from the pancreas after a meal usually enter the small intestine through a plumbing system shared with bile from the liver and gallbladder. Blockages in the plumbing such as gallstones or tumors can cause the system to back up, often producing damage to the pancreas.
Chronic blockages in the smaller tubes in the pancreas can occur because of thickened secretions caused by the childhood disease cystic fibrosis. Because this is a chronic condition, it can lead to poor growth resulting from digestion problems and associated malnutrition.
Damage to the pancreas may result from inflammation, also known as pancreatitis. This usually produces pain in the central upper abdomen. While there are a variety of potential causes of pancreatitis, two of the most common risk factors in adults are excess alcohol consumption or high triglyceride levels in the bloodstream.
Triglycerides, also known as blood fats, are consumed in fatty foods such as meat or dairy products. They are also produced in the liver. Very elevated triglycerides are commonly attributable to a genetic predisposition to overproduction of blood fats, often combined with excess dietary intake of fatty foods.
A triglyceride level is part of routine cholesterol testing for adolescents and adults. Screening for cholesterol and triglyceride problems with a simple blood test is especially important if there is a family history of these problems.
In addition to the production of digestive enzymes, the pancreas plays a critical role in the control of blood-sugar levels. It is the sole source of natural insulin production in the body.
Damage to the insulin producing cells of the pancreas can result from chronic inflammation (pancreatitis), the immune system (Type 1, or juvenile type, diabetes mellitus) or stress from prolonged Type 2 (formerly known as adult onset) diabetes mellitus. Regardless of the cause, poor or absent insulin production by the pancreas requires insulin supplementation in the form of insulin shots.
The pancreas plays a vital role in overall health and well-being. Examples of controllable risk factors for diseases of the pancreas include avoiding excess alcohol intake, screening for and controlling elevated triglyceride levels and blood-sugar control in Type 2 diabetes mellitus.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.
