How Does Your Pancreas Work?

The pancreas is an organ located in your abdomen behind the lower part of the stomach. This vital organ has two main functions: the exocrine and endocrine functions. The exocrine function produces enzymes to help you digest food, while the endocrine function secretes hormones that regulate blood glucose (sugar) levels.

Several conditions can affect the function and overall health of your pancreas. These include type 1 diabetes, type 2 diabetes, pancreatitis (pancreas inflammation), and pancreatic cancer. That said, understanding the anatomy and function of your pancreas can help you understand how to keep your pancreatic health in optimal shape.

Anatomy of the Pancreas

Your pancreas is an organ that sits near your stomach, liver, intestines, gallbladder, and colon. Here's what you should know about its anatomy.

Structure

Your pancreas is an elongated gland that occupies the space between the stomach and spine. This organ is roughly six inches long (or, 15 centimeters) and divides into four separate sections: the head, neck, body, and tail. The widest part is the head, which lies in a C-shaped gap next to the duodenum, or the upper part of the intestine. As the pancreas passes from the head to the tail, it tapers and grows narrower.

The pancreas consists of two types of gland tissue, which have different functions. The exocrine gland makes up about 80% of the pancreas and helps your body with digestion. The endocrine gland is made up of three different types of cells which help your body secrete hormones that play a role in regulating blood sugar levels. The pancreas also has a pancreatic duct that runs from the head to the tail of the pancreas and connects to your bile duct.

Location

Your pancreas is located at the level of the L1 vertebrae of the spine and below the back of your stomach. The pancreas sits in the middle of your small intestine, gallbladder, and spleen. The aorta—or, your body’s largest blood vessel that runs to the heart—is located just behind the pancreas.  

Anatomical Variations

Sometimes, there are variations in the anatomy of the pancreas. The most common of these include:

• Pancreas divisum: Estimated to affect 10% to 15% of the general population, this is when there is an abnormal or absent fusion of the pancreatic buds. This affects how substances and proteins that your pancreas makes drain from your body and can increase the risk of recurrent pancreatitis (or, inflammation of the pancreas).
• Pancreatic tissue in the stomach: In about 3% to 5% of the population, pancreatic tissue develops in the stomach or small intestine. This rarely causes symptoms but you may experience some bowel obstruction, making it difficult for you to pass stool or gas.
• Ansa pancreatica: This rare anomaly can happen when the main pancreatic duct and another one become connected, which affects the flow of substances and protein from the organ.
• Annular pancreas: This variation can happen at birth and occurs when pancreatic tissue forms a ring around the duodenum—the first part of the small intestine that is located right next to the stomach. This increases the risk of pancreatitis, intestinal ulcers, blockages, and jaundice (or, the yellowing of your eyes and skin). 

What Does the Pancreas Do?

The pancreas serves two important and separate functions in the body. This organ helps with digestion (an exocrine function) and regulates blood sugar levels (an endocrine function) in your body. Your body is able to carry out these functions by releasing hormones and enzymes.

Digestion

As a part of the digestive system, the pancreas secretes digestive enzymes into the duodenum of the small intestine. These enzymes play different roles in digestion. These are the primary classes of enzymes that your pancreas secretes:

• Protease enzymes: These enzymes, which include trypsin, chymotrypsin, carboxypeptidase, and elastase, work to break down proteins from the food you eat and allow your cells to absorb them. They also protect you from bacteria, yeast, or other microbes in the intestines. 
• Lipolytic enzymes: When combined with bile (a fluid that your liver produces), this class of enzymes helps the body to break down fats. Lipase, phospholipase, and esterase enzymes belong to this category.
• Glycolytic enzymes: These enzymes include amylase and lactase, which help your body convert starches into sugars so that your body can use the sugar for energy.
• Nucleolytic enzymes: The nucleolytic enzymes—ribonuclease and deoxyribonuclease—work to break down the DNA and RNA that are found in your food.

Blood Sugar Regulation

As part of the endocrine system, the pancreas also works to regulate blood sugar levels in your bloodstream. To properly manage your blood sugar, the cells in your pancreas secrete the following hormones directly into the blood:

• Insulin: This hormone works to lower blood sugar. Insulin allows sugar to enter into your liver, muscle, and fat cells, which those cells use to create energy.
• Glucagon: If your blood sugar levels are too low, glucagon signals the liver to release stored sugars and help raise your blood sugar.
• Gastrin: This hormone triggers the stomach to produce gastric acid, which breaks down food. It's worth noting that this hormone is mostly made in your stomach, but the pancreas also supports its production.
• Amylin: Working closely with the function of insulin, this hormone controls appetite and plays a role in emptying your stomach to keep blood sugar levels in a normal range.

Associated Conditions

There are several conditions that affect the health of the pancreas. These include:

• Perforation: If the pancreas becomes perforated (or, develops holes), the digestive enzymes leak into your abdominal cavity. Not only can this damage your pancreas, but can also affect the health of surrounding organs.
• Pancreatic cancer: Cancers of the pancreas, especially pancreatic adenocarcinoma, are challenging because they’re usually in an advanced stage by the time your healthcare provider can detect the condition. This type of cancer is most common among people older than 70.
• Type 1 diabetes: This autoimmune disorder occurs when the immune system accidentally attacks cells in the pancreas that produce insulin. Though adults can develop it, type 1 diabetes is most common in childhood and early adolescence. Symptoms include thirst, frequent urination, hunger, fatigue, and vision problems.
• Type 2 diabetes: Type 2 diabetes is the most common type of diabetes, which often occurs due to high blood sugar levels and insulin resistance. Similar to type 1 diabetes, type 2 diabetes can also cause increased thirst, frequent urination, hunger, fatigue, and blurred vision.
• Pancreatitis: Also known as inflammation of the pancreas, this condition can be chronic (long-term) or acute (short-term). Those with pancreatitis may experience upper abdominal pain, which can spread to other parts of the body. Experiencing gallstones, drinking excess amounts of alcohol, and being deficient in the protein alpha-1 antitrypsin can all lead to pancreatitis.

Diagnostic Testing

To assess the health and functioning of your pancreas, there are several tests and screening measures your healthcare provider may use. These include:

• Secretin pancreatic function test: Your healthcare provider will insert a thin tube through your nose to deliver the hormone secretin to your pancreas. Then, they will take a sample of your blood to see how your pancreas responds to the hormone.
• Fecal elastase test: This involves screening a sample of fecal matter (or, your poop) to check for levels of elastase, a digestive enzyme, and test how well the pancreas is working in digestion.
• Endoscopic retrograde cholangiopancreatography (ECRP): This test uses an endoscope (a long tube with a camera attached to it) and contrast dye to take an X-ray to view clearly view the anatomy of the pancreas and bile ducts.
• Computed tomography (CT) scan: This type of imaging test uses contrast dye and an X-ray machine to detect swelling or scarring around the pancreas.
• Blood tests: Your provider may order a variety of blood tests to check your blood sugar levels, measure digestive enzymes, and detect pancreatitis.

Tips for Keeping Your Pancreas Healthy

Keeping the pancreas healthy is a critical part of maintaining your overall health. There are a number of things you can do to protect this organ, including:

• Participating in physical activity: Aim for a minimum of 150 minutes a week—or, 30 minutes a day, five days a week—of light to moderate exercise. It's also important to find movement that you enjoy. This may include strength training, walking, yoga, playing sports, or swimming, among other physical activities.
• Avoiding tobacco: Smoking or chewing tobacco greatly increases the risk of certain cancers—including pancreatic cancer. Quitting this habit or asking a loved one or healthcare provider for support on how to stop can help preserve the health of your pancreas.
• Minimizing alcohol use: Drinking alcohol is a risk factor for pancreatic cancer. Reducing your alcohol intake can support your pancreas in the long term.
• Staying hydrated: Most adults should drink eight to 10 glasses of water per day. Getting the fluids that your body needs can support digestion.
• Limiting eating foods high in fat: Eating foods high in fat can increase your risk of developing diabetes. Instead, try incorporating foods that are plant-based, whole grain, or high in lean protein, such as fish, lean meat, beans, eggs, nuts, and seeds.

A Quick Review 

The pancreas is an organ located abdomen, just behind the stomach and next to the intestines and gallbladder. This organ plays a vital role in helping your body digest food and regulate your blood sugar levels. Type 1 diabetes, type 2 diabetes, and pancreatic cancer can all affect the functioning of your pancreas. To preserve the health of your pancreas, try adding more protein to your diet, make time for physical activity, limit alcohol and tobacco use, and stay hydrated.