How does the Pancreas Work

The pancreas is a pivotal organ within the digestive system. It sits inside the abdomen, behind the stomach and the large bowel, adjacent to the spleen. In humans, it has a head, neck, body and tail. It is connected to the first section of the small intestine, the duodenum, by the pancreatic duct, and to the bloodstream via a rich network of vessels. The function of the pancreas is best considered by thinking about the two types of cell it contains: endocrine and exocrine.

The endocrine pancreas is made up of clusters of cells called islets of Langerhans, which in total contain approximately 1 million cells and are responsible for producing hormones. These cells include alpha cells, which secrete glucagon, and beta cells which generate insulin. These two hormones have opposite effects on blood sugar levels throughout the body: glucagon increases glucose levels, while insulin decreases them.

The cells here are all in contact with capillaries, so hormones which are produced can be fed directly into the bloodstream. Insulin secretion is under the control of a negative-feedback loop; high blood sugar leads to insulin secretion, which then lowers blood sugar with subsequent suppression of insulin. Disorders of these cells (and thus alterations of hormone levels) can lead to many conditions, including diabetes. The islets of Langerhans are also responsible for producing other hormones, like somatostatin, which governs nutrient absorption among other things.

The exocrine pancreas, meanwhile, is responsible for secreting digestive enzymes. Cells are arranged in clusters called acini, which flow into the central pancreatic duct. This leads into the duodenum – part of the small bowel – to come into contact with and aid in the digestion of food. The enzymes secreted include proteases (to digest protein), lipases (for fat) and amylase (for sugar/starch). Secretion of these enzymes is controlled by a series of hormones (gastrin, cholecystokinin and secretin), which are released from the stomach and duodenum in response to the stretch from the presence of food.

Does the pancreas vary in humans and animals?

Every vertebrate animal has a pancreas of some form, meaning they are all susceptible to diabetes too. The arrangement, however, varies from creature to creature. In humans, the pancreas is most often a single structure that sits at the back of the abdomen. In other animals, the arrangement varies from two or three masses of tissue scattered around the abdomen, to tissue interspersed within the connective tissue between the bowels, to small collections of tissue within the bowel mucosal wall itself. One of the other key differences is the number of ducts that connect the pancreas to the bowel. In most humans there’s only one duct, but occasionally there may be two or three – and sometimes even more. In other animals, the number is much more variable. However, the function is largely similar, where the pancreas secretes digestive enzymes and hormones to control blood sugar levels.

What is the function of the pancreas?

What brings on diabetes?

Diabetes is a condition where a person has higher blood sugar than normal. It is either caused by a failure of the pancreas to produce insulin (ie type 1, or insulin-dependent diabetes mellitus), or resistance of the body’s cells to insulin present in the circulation (ie type 2, or non-insulin-dependent diabetes mellitus). There are also other disorders of the pancreas. Inflammation of the organ (ie acute pancreatitis) causes severe pain in the upper abdomen, forcing most people to attend the emergency department as it can be life threatening. In contrast, cancer of the pancreas causes gradually worsening pain which can often be mistaken for other ailments.