What You Need to Know About Pancreatic Diseases and Lab Testing

The pancreas is described as a flat, narrow gland that is around six inches in length located inside the abdominal cavity, under the liver, and behind your stomach. This gland features a head, a middle, and a tail section. The head section connects to the duodenum (first part of the small intestine).  

The pancreas has tubes (small ducts) that feed bicarbonate and digestive enzymes that the pancreas produces directly into a pancreatic duct. This is a large duct that transports the bicarbonate and digestive enzymes down the pancreas, starting from the tail section towards the head section, where the enzymes travel into the small intestine (duodenum).  

In the head section of the pancreas, there is also a bile duct running through that carries bile produced by the gallbladder and liver into the area of the small intestine.  

The pancreatic and bile duct join just before they enter the duodenum, which means they share an opening before they enter the small intestine. The pancreas is made up of two types of tissues. These both perform a different function: 

The exocrine pancreas produces, stores, along with releasing powerful enzymes that digest fats, carbohydrates, and proteins inside the small intestine. The enzymes are normally produced and transported in a form that is inactive into the small intestine, where the enzymes activate as needed.  

Exocrine tissues present in the pancreas also produce and release enzymes like bicarbonate. This is what neutralizes the acids in the stomach and allows the pancreatic enzymes to activate.  

The endocrine pancreas creates hormones that include glucagon and insulin, before releasing these into the bloodstream. These are the hormones that perform the function of regulating glucose (sugar) transport into the cells of the body, where it used in the form of energy, along with helping to regulate and maintain blood sugar levels.  

Diseases of The Pancreas 

Pancreatitis is when the pancreas becomes inflamed. This occurs when the digestive enzymes activate while they are still inside the pancreas. This causes injury and irritation to the pancreatic tissues, which result in inflammation.  

Pancreatitis is Either Chronic or Acute

Acute pancreatitis means that the inflammation will develop fast and then subside within days or weeks. The pancreas will return to a state of normality once it heals. The primary cause is long-term alcohol abuse and gallstones. When acute pancreatitis becomes more frequent, it can result in chronic pancreatitis.  

Chronic pancreatitis involves inflammation that is long-lasting. It can also lead to scar tissue development inside this gland which stops is from working correctly. Long-term alcohol abuse is one of the leading causes of the condition known as chronic pancreatitis. For those that smoke cigarettes, there is also an increased risk of contracting this condition.  

Pancreatic Cancer 

This type of cancer involves the uncontrolled growth of cells regarded as abnormal inside the pancreas. These cancerous cells start forming malignant tumors. This damages the tissues and stops the pancreas from performing in the way that it should.  

Pancreatic cancer is the 4th leading cause of cancer deaths in women and men in the U.S.  The American Cancer Society states that close to 57,000 Americans are routinely diagnosed with this cancer every year, and around 46,000 people will die from this disease.  

The majority of pancreatic cancers, around 95%, start inside the exocrine cells, which are the ducts and the glands inside the pancreas. Pancreatic cancer happens to be hard to diagnose and detect, especially in the earlier stages, as the symptoms are usually non-specific or absent.  

Pancreatic Insufficiency 

This is a condition whereby the pancreas is unable to transport or/and produce a sufficient amount of digestive enzymes in order to break down the food that enters the intestine. This is also a condition that goes by the name of EPI (or Exocrine Pancreatic Insufficiency)  

EPI usually occurs from progressive or ongoing pancreatic damage, which is caused by several types of conditions. It is commonly linked to cystic fibrosis that occurs in children along with chronic pancreatitis that occurs in adults. It is not usually caused by pancreatic cancer.  

Lab Tests 

Carcinoembryonic Antigen (or CEA) 

Cancer Antigen 19-9 

Comprehensive Metabolic Panel (or CMP) 

Immunoreactive Trypsinogen (or IRT) 

Sweat Chloride Test 

Tumor Markers 

Lipase 

Stool Elastase 

Chymotrypsin 

Amylase 

Fecal Fat