Introduction

The pancreas is a 12-25 cm elongated organ in the abdomen located posterior to the stomach and in close association with the duodenum. It is often described as having three regions: a head, body and tail. The pancreatic head abuts the second part of the duodenum while the tail extends towards the spleen. The pancreatic duct runs the length of the pancreas and empties into the second part of the duodenum at the ampulla of Vater. The common bile duct commonly joins the pancreatic duct at or near this point

The pancreas is an organ in the digestive system and serves two major functions:

• exocrine - producing pancreatic juice containing digestive enzymes
• endocrine - producing several important hormones, including insulin

Function of the pancreas

The pancreas produces enzymes that break down all categories of digestible foods (exocrine pancreas) and secretes hormones that affect carbohydrate metabolism (endocrine pancreas). The pancreas is near the liver, and is the main source of enzymes for digesting fats (lipids) and proteins - the intestinal walls have enzymes that will digest polysaccharides. Pancreatic secretions from ductal cells contain bicarbonate ions and are alkaline in order to neutralize the acidic chyme that the stomach churns out.

Pancreatic secretions accumulate in intralobular ducts that drain to the main pancreatic duct, which drains directly into the duodenum.

Due to the importance of its enzyme contents, injuring the pancreas is a very dangerous situation. A puncture of the pancreas tends to require careful medical intervention.

Causes of pancreatitis

The most common causes of pancreatitis are gallstones and frequent and excessive consumption of alcohol (80% of cases), and less common causes are drugs or medication. The onset of pain in the abdomen region usually occurs within a day of binge drinking or eating a large meal. Sufferers often feel better in 2 to 3 days if they abstain from food and liquids.

Types

There are three forms of pancreatitis, which are different in causes and symptoms, and require different treatment:

• Acute pancreatitis: One-time occurrence
• Chronic pancreatitis: Persists even after the cause has been removed
• Hereditary pancreatitis: - A genetic abnormality leads to activation of enzymes. Acute hepatic porphyrias including acute intermittent porphyria, hereditary coproporphyria and variegate porphyria are genetic disorders that can be linked to both acute and chronic pancreatitis. Acute pancreatitis has also occurred with erythropoietic protoporphyria.

Treatment to malabsorption complications

Due to lack of digestive enzymes usually produces by the pancreas, malabsorption of food is a major issue producing painful episodes and periods of discomfort after eating. Malabsorption  is treated by administering pancreatic supplements in capsule or powder form.

Diarrhoea occurs in just under half of patients. Normally, all the fat in food is broken down by enzymes from the pancreas and small intestine, and the fat is then absorbed in the small bowel. With a reduced level of digestive enzymes the fat is not absorbed. When the fat reaches the large intestine, it is partially broken down by the bacteria in the colon. This produces substances which irritate the colon and result in diarrhoea. The undigested fat also traps water in the faeces, resulting in pale, bulky, greasy stools which are difficult to flush away. They may make the water in the toilet look oily, smell offensive and may be associated with bad wind.

Clinical studies including the one documented by the Department of Internal Medicine, University of California, Efficacy of enzyme supplementation after surgery for chronic pancreatitis (Van Hoozen et al,Pancreas. 1997 Mar;14(2):174-80) conclude that  enzyme supplementation significantly improved the absorption of dietary fat. Research suggest that long-term postoperative pancreatic enzyme supplementation is both efficacious and necessary in pancreatitis patients.

Both Lipase and Amlyase, two of the enzymes produced by the pancreas are now obtainable at foodreactions.org. Additionally, biocarbonate, is also available.

• Lipozyme providing the lipase responsible to break down fats and lipids avoiding painful episodes and bloating caused by undigested fats
• Carbozyme containing capsules of amylase, crucial to break down starches which if left indigestible will be absorbed by the natural microflora of the digestive system producing gases, leading to wind, flatulence, cramps and finally diarrhoea
•  Bio-Carbonate as the name implies consists of biocarbonate, an alkaline pancreatic secretion to neutralise the acids released by the stomach into the small intestine. Human digestive enzymes of the small intestine are destroyed in acid, hence biocarbonate is essential for their function

To find these products and others visit the Gastrointestinal Products page.