Pancreas: Function, Location & Diseases

The pancreas is located deep inside the abdomen.

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. 

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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

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]

Additional reporting by Alina Bradford, Live Science contributor.

Additional resources

 National Pancreas Foundation: About the Pancreas

 The Pancreas Center at Columbia University: The Pancreas and Its Functions

 Cleveland Clinic: Chronic Pancreatitis