Diseases and Disorders

Pancreas and Pancreatitis

Pancreas is an organ in the abdomen that produces digestive juices. Pancreatitis is the inflammation of the pancreas. It is usually caused by gallstones or alcohol abuse. Learn more about this condition here!

The head of the pancreas is on the right side of the abdomen and is connected to the duodenum (the first section of the small intestine) through a small tube called the pancreatic duct. The narrow end of the pancreas, called the tail, extends to the left side of the body.

What is pancreatitis?

Pancreatitis is an inflammation of the pancreas. It causes severe pain and discomfort in the abdomen. Find out more about this disease here!

What is the pancreas?

The pancreas is a long flattened gland located deep in the belly (abdomen). Because the pancreas isn’t seen or felt in our day to day lives, most people don’t know as much about the pancreas as they do about other parts of their bodies. The pancreas is, however, a vital part of the digestive system and a critical controller of blood sugar levels.

What are the components of the pancreas?

The pancreas is really two glands that are intimately mixed into one organ. The bulk of the pancreas is composed of “exocrine” cells that produce enzymes to help with the digestion of food. These exocrine cells release their enzymes into a series of progressively larger tubes (called ducts) that eventually join to form the main pancreatic duct. The main pancreatic duct runs the length of the pancreas and drains the fluid produced by the exocrine cells into the duodenum, the first part of the small bowel.

The second functional component of the pancreas is the “endocrine” pancreas. The endocrine pancreas is composed of small islands of cells, called the islets of Langerhans. These endocrine cells don’t release their secretions into the pancreatic ducts, instead, they release hormones, such as insulin and glucagon, into the bloodstream, and these hormones help control blood sugar (glucose) levels.

8 Common Disorders of the Pancreas

  1. Diabetes, Type 1: The body’s immune system attacks and destroys the pancreas’ insulin-producing cells. Lifelong insulin injections are required to control blood sugar.
  2. Diabetes, type 2: The pancreas loses the ability to appropriately produce and release insulin. The body also becomes resistant to insulin, and blood sugar rises.
  3. Cystic fibrosis: A genetic disorder that affects multiple body systems, usually including the lungs and the pancreas. Digestive problems and diabetes often result.
  4. Pancreatic cancer: The pancreas has many types of cells, each of which can give rise to a different type of tumor. The most common type arises from the cells that line the pancreatic duct. Because there are usually few or no early symptoms, pancreatic cancer is often advanced by the time it’s discovered.
  5. Pancreatitis: The pancreas becomes inflamed and damaged by its own digestive chemicals. Swelling and death of tissue of the pancreas can result. Although alcohol or gallstones can contribute, sometimes a cause for pancreatitis is never found.
  6. Pancreatic pseudocyst: After a bout of pancreatitis, a fluid-filled cavity called a pseudocyst can form. Pseudo-cysts may resolve spontaneously, or they may need surgical drainage.
  7. Islet cell tumour: The hormone-producing cells of the pancreas multiply abnormally, creating a benign or a cancerous tumour. These tumours produce excess amounts of hormones and then release them into the blood. Gastrinomas, glucagonomas, and insulinomas are examples of islet cell tumours.
  8. Enlarged pancreas: An enlarged pancreas may mean nothing. You may simply have a pancreas that is larger than normal. Or, it can be because of an anatomic abnormality. But other causes of an enlarged pancreas may exist and require treatment.

Pancreas Function Tests

Pancreas function tests are used to assess the health of the exocrine pancreas, typically by assessing the levels of certain enzymes or digestive products in blood, faeces, or urine.

Why do I need a Pancreas Function Test?

Pancreas function tests are most commonly used to diagnose chronic pancreatitis. These include tests which document exocrine or endocrine gland insufficiency and tests which instead measure gradations of decreased secretory capacity. Book comprehensive health profile, which includes amylase and lipase tests of pancreas functions.

What are the Pancreas Function Tests?

Pancreatic function testing is an essential diagnostic tool for patients who have symptoms suggestive of pancreatitis. Learn more about these tests here!

Blood Tests

Pancreatic function test is a blood test that measures the amount of enzymes produced by the pancreas. It is used to detect pancreatic disease.

Blood tests can evaluate the function of the gallbladder, liver, and pancreas. Levels of the pancreatic enzymes amylase and lipase can be measured. Blood tests can also check for signs of related conditions, including infection, anaemia (low blood count), and dehydration. A tumour marker called CA 19-9 may be checked if pancreatic cancer is suspected.

Secretin Stimulation Test

Secretin is a hormone made by the small intestine and it stimulates the pancreas to release a fluid that neutralizes stomach acid and aids in digestion. The secretin stimulation test measures the ability of the pancreas to respond to secretin.

This test may be performed to determine the activity of the pancreas in people with diseases that affect the pancreas (for example, cystic fibrosis or pancreatic cancer). During the test, a health care professional places a tube down the throat, into the stomach, then into the upper part of the small intestine. Secretin is administered by vein and the contents of the duodenal secretions are aspirated (removed with suction) and analyzed over a period of about two hours.

Faecal Elastase Test

The faecal elastase test is another type of pancreas function test. The test measures the levels of elastase, an enzyme found in fluids produced by the pancreas. Elastase digests (breaks down) proteins. In this test, a patient’s stool sample is analyzed for elastase.

Computed Tomography (CT) Scan with Contrast Dye

This imaging test can help assess the health of the pancreas. A CT scan can identify complications of the pancreatic disease such as fluid around the pancreas, an enclosed infection (abscess), or a collection of tissue, fluid, and pancreatic enzymes (pancreatic pseudocyst).

Abdominal Ultrasound

An abdominal ultrasound can detect gallstones that might block the outflow of fluid from the pancreas. It also can show an abscess or a pancreatic pseudocyst.

Endoscopic Retrograde Cholangiopancreatography (ERCP)

In an ERCP, a health care professional places a tube down the throat, into the stomach, then into the small intestine. The dye is used to helping the doctor see the structure of the common bile duct, other bile ducts, and the pancreatic duct on an X-ray. If gallstones are blocking the bile duct, they may also be removed during an ERCP.

Endoscopic Ultrasound

In this test, a probe attached to a lighted scope is placed down the throat and into the stomach. Sound waves show images of organs in the abdomen. Endoscopic ultrasound may reveal gallstones and can be helpful in diagnosing severe pancreatitis when an invasive test such as ERCP might make the condition worse. A biopsy or sampling of the pancreas may also be possible with this type of ultrasound.

Magnetic Resonance Cholangiopancreatography (MRCP)

This kind of Magnetic Resonance Imaging (MRI) can look at the bile ducts and the pancreatic duct.

What are the Pancreas Function Test Normal Values?

Enzymes are proteins produced by the body to do a particular job. The pancreas produces amylase to break down carbohydrates in food into simple sugars. The pancreas makes lipase to digest fats into fatty acids. Sugars and fatty acids can then be absorbed by the small intestine. Some amylase and lipase can be found in saliva and in the stomach. However, most of the enzymes made in the pancreas are released into the small intestine.

  • The values of pancreas function test include normal amylase levels of 23-85 U/L (some lab results go up to 140 U/L) and lipase levels of 0-160 U/L.
  • Pancreatitis suspected amylase levels are > 200 U/L and lipase levels are > 200 U/L.

When the pancreas is damaged, these digestive enzymes can be found in the blood at higher levels than normal. Amylase or lipase results in over three times normal levels are likely to mean pancreatitis or damage to your pancreas. However, in rare cases, there can be significant damage to the pancreas without abnormal amylase or lipase levels. In these cases, abdominal pain is the most common symptom. Early in damage to the pancreas, amylase or lipase levels may also be normal.

What Causes Abnormal Lipase Levels During Pancreas Function Test?

  • Lipase levels may be abnormally high if someone is experiencing:
  • Acute pancreatitis, a sudden inflammation of the pancreas
  • chronic pancreatitis, long-term inflammation of the pancreas
  • Pancreatic cancer
  • Severe Gastroenteritis or Stomach Flu
  • Cholecystitis, inflammation of the gallbladder
  • Celiac disease, an allergy to gluten
  • Duodenal Ulcer
  • Macrolipasemia
  • HIV infection

Abnormal levels of lipase may also exist in people with Familial Lipoprotein Lipase Deficiency. Drugs that may affect the levels of lipase in your bloodstream are the same ones known to affect the levels of amylase.

What Does it Mean if My Lipase and Amylase are High?

When levels of lipase and amylase are higher than normal, it may show pancreatic injury or another disease. Lipase levels alone can’t determine the severity of an acute pancreatitis attack. When these test results are abnormal, you may need other tests such as an ultrasound, a CT scan, an MRI scan, and endoscopy.

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