Tuesday

Pancreas

Pancreas is one of the extrinsic glands of the digestive system. It has mixed endocrine and exocrine functions, and is present outside the wall of the digestive tract. In order to fully understand, "What is pancreas?" you must know its location, functions and diseases. The exocrine part secrets pancreatic juice into the duodenum; the juice contains a number of digestive enzymes and pro enzymes that help digest the food. The endocrine part produces hormones such as insulin that play significant role in the absorption, metabolism and storage of nutrients such as glucose. Dysfunction in the endocrine part of the pancreas leads to diabetes mellitus.
 A normal pancreas is about 12 to 15 cm long and weighs about 110 gm. Pancreas location is behind the stomach and it lies more or less transversely in the posterior wall of the abdomen; it has duodenum on its right and spleen on its left. It has a head that lies within the curvature of the duodenum, a neck that connects the head to the body and a body that blunts into its tail to touch the spleen. Cancer of the pancreas usually involves the head and accounts for most of the cases of extrahepatic biliary obstruction.

About 1500 ml of pancreatic juice is secreted everyday which contains many digestive enzymes, water and various ions such as bicarbonate, sodium, potassium.

pH of the pancreatic juice is alkaline in nature which helps neutralize the gastric content entering the duodenum from the stomach.

Pancreatic enzymes and pro-enzymes (zymogens) are essential for the digestion of protein, carbohydrate and fat constituents of food that we eat every day.

Endocrine part of pancreas secrets two important hormones - insulin and glucagon - both of which are secreted reciprocally from pancreas and also act reciprocally in most circumstances. In a nutshell, insulin increases storage of glucose, fatty acids and amino acids. On the other hand glucagon is a catabolic hormone so it mobilizes glucose, fatty acids and amino acids from stores into the bloodstream.

Secretion of the pancreatic juice is primarily regulated by two hormones -

Secretin

Cholecystokinin (CCK)

Both of these hormones are produced by specialized cells of the duodenum. They are secreted in response to gastric acid entering the duodenum from the stomach and in response to products of protein and fat digestion (e.g. small peptides, amino acids and fatty acids). Both hormones act synergistically in response to a meal and cause a large volume of alkaline pancreatic juice rich in digestive enzymes to be released.