The Pancreas & Digestion: How the Pancreas Works & Symptoms of Exocrine Pancreatic Insufficiency by Gastro MD

Have you ever given much thought to your pancreas? This organ is located in your abdomen, behind your stomach and in front of your spine. The liver, gall bladder and spleen surround your pancreas, which is about 6 to 8 inches long and extends horizontally across your abdomen. As a gland organ with an endocrine function, your pancreas produces insulin and other crucial enzymes that help break down the carbohydrates, fats and proteins you consume. Your pancreas also plays a key role in glucose control.

Understanding Your Pancreas’ Role in Digestion

When you chew your food, saliva is released in your mouth and helps the food travel down the esophagus and into your stomach. Once in the stomach, food is further broken down and then progresses to the small intestine, where your pancreas comes into play: Pancreatic enzymes reduce the food into molecules that are carried throughout the body.

Approximately 95 percent of the pancreas is exocrine tissue. When it’s functioning properly, your pancreas makes about one liter of pancreatic enzymes a day! These natural juices travel through the pancreas via ducts and empty into the duodenum to help digest your food.

These pancreatic enzymes include trypsin, protease and chymotrypsin, which digest proteins into usable molecules. The enzymes also protect you from germs, such as bacteria and yeast, that may live in your intestines. If these proteins are not properly processed, they can cause an imbalance in your gut. For some people, this can lead to allergic reactions.

Another crucial pancreatic enzyme is amylase, which processes carbohydrates. Amylase breaks down starches into sugar, which your body uses as an energy source. If your pancreas doesn’t produce enough amylase, undigested carbohydrates can cause diarrhea.

Lipase is the pancreatic enzyme that works with bile to break down fats into cholesterol and fatty acids. And when your body doesn’t produce enough lipase, poor fat absorption can lead to fatty bowel movements and diarrhea.

Exocrine Pancreatic Insufficiency

Exocrine pancreatic insufficiency (EPI) is the term for being deficient in the exocrine pancreatic enzymes, resulting in the inability to digest your food correctly, also called maldigestion. Some of the symptoms of exocrine pancreatic insufficiency include:

• Pain in the middle of the stomach.
• Gas and bloating.
• Diarrhea.
• Steatorrhea – oily, foul-smelling bowel movements that are difficult to flush.
• Appetite loss (which leads to weight and muscle loss).
• Vitamin deficiency.

How Can I Check the Health of My Pancreas?

Exocrine pancreatic insufficiency is most commonly caused by chronic pancreatitis or cystic fibrosis. Diabetes, gastric bypass surgery, Crohn’s disease and a smoking habit can also increase the risks of exocrine pancreatic insufficiency and disorders. If you have any of these, you may want to discuss evaluating your pancreas with your physician.

The most common tests used to check the health of the pancreas are:

• Angiography.
• Endoscopic ultrasound.
• Blood tests.
• Computed Tomography scan (CAT scan).
• Magnetic Resonance Cholangiopancreatography (MRCP).
• Magnetic Resonance Imaging (MRI).
• Fecal elastase test.

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