Functions of the pancreas (in men): exocrine, endocrine, humoral, excretory, intrasecretory, exocrine and digestive на flymega.ru

The functions of the pancreas are very important for the body. If we talk about the functional purpose of this organ in general, the pancreas carries out internal and external secretion, which ensures digestion. Without the enzymes produced by the gland, the stomach would not be able to digest food, and as a result, nutrients would not be absorbed into the blood. In addition, the pancreas, by secreting hormones, helps control blood sugar levels.

If we talk about the functional purpose, the pancreas carries out internal and external secretion, which ensures digestion.

The pancreas is a multifunctional organ. If its functions are disrupted, it can cause many systems to malfunction. The structure of the pancreas is the same in all people; it may differ only in size. It is an elongated formation that is located at the bottom of the stomach (in the peritoneum) and has the shape of a grape bunch.

There is a close relationship between the pancreas and the abdominal cavity. The upper and lower regions of the gland are covered with peritoneum, the posterior is not.

Feasts always lead to heaviness in the stomach and pain in this area. This happens because the pancreas fails to perform one of its main functions; it cannot produce a sufficient amount of enzyme substances involved in the process of digesting foods. In some cases, necrosis of the cells of the gland itself and neighboring organs occurs.

What are the signs of pancreatitis in men?

Among the adult population, problems with the pancreas often arise due to systematic alcohol consumption, but the symptoms of acute pancreatitis are the same in men and women. In childhood, organ dysfunction is less common. With a mild degree of the disease, the symptoms are weakly expressed, and the acute form is painful and difficult. There is a high probability of complications, such as hemorrhagic pancreatitis or pancreatosis (total damage to the pancreas due to self-destruction).

Symptoms of pancreatic inflammation

The main clinical sign of the onset of the disease is severe abdominal pain. It must be borne in mind that pain can radiate to the heart area, which resembles a myocardial infarction. The sick person:

continuous vomiting occurs;
blood pressure drops;
general weakness appears;
the skin turns pale.

General symptoms of pancreatic disease are similar to other abdominal diseases:

inflammation of the gallbladder;
hepatic colic;
acute intestinal obstruction;
food poisoning.

What are the pains with pancreatitis?

Prolonged cutting pain in the upper abdomen is the first symptom of pancreatitis in men and women. It becomes so intense, bursting, that a person experiences a painful shock. When the entire organ is affected, the pain is girdling in nature. A sitting position with your legs pulled up to your chest can bring some relief, but lying on your back only intensifies the pain. Attacks can last up to several days, appear suddenly or after eating or drinking.

Temperature

When the disease worsens, inflammatory processes cause a slight increase in body temperature. Thermometer readings above 38°C and chills indicate the onset of a purulent complication, peritonitis. If the temperature during pancreatitis is reduced to 35.5°C, this is a symptom of collapse (painful shock) or excessive fluid loss. The body can react with heat to unbearable pain, but in the chronic course of the disease the temperature does not decrease for a long time, which indicates the hidden progression of the disease.

Chair

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Problems with intestinal function and diarrhea always accompany the disease. At the beginning of the attack, constipation and bloating are possible. Then the stool becomes mushy, foamy, heterogeneous, and acquires a gray tint. Upon examination, you can notice particles of undigested food and a large amount of unprocessed fats due to enzyme deficiency. Loose stools with pancreatitis are a common occurrence, although they may return to normal during the remission stage.

Where does it hurt

The localization of pain in pancreatitis is determined by the affected area:

the focus of inflammation is on the head of the pancreas - pain will occur in the epigastric region, closer to the right side;
if the process has formed in the middle part of the gland, the pain will be recognized at the top, in the middle, or radiate to the left side of the abdomen;
if the tail of the pancreas is affected, then the pain shifts deep to the left hypochondrium;
when the entire surface of the organ is affected, painful spasms are centered in the upper abdomen, become encircling in nature and can spread to the heart area.

Anatomical structure

The pancreas consists of three sections: head, body, tail. There are no clear boundaries between the departments; division occurs based on the location of neighboring formations relative to the organ itself. Each section consists of 3-4 lobes, which in turn are divided into lobules. Each lobule has its own excretory duct, which flows into the interlobular ones. The latter are combined into shares. Uniting, the lobes form the common pancreatic duct.

Opening of the common duct is variant:

Along the way, the common duct unites with the common bile duct, forming the common bile duct, which opens with one hole at the apex of the duodenal papilla. This is the most common option.
If the duct does not unite with the common bile duct, then it opens with a separate opening at the top of the duodenal papilla.
The lobar ducts may not be united into one common one from birth; their structure is different from each other. In this case, one of them unites with the common bile duct, and the second opens with an independent opening, called the accessory duct of the pancreas.

Position and projection onto the body surface

The organ is located retroperitoneally, in the upper part of the retroperitoneal space. The pancreas is reliably protected from injury and other damage, since in front it is covered by the anterior abdominal wall and abdominal organs. And at the back - the bony base of the spinal column and the powerful muscles of the back and lower back.

The pancreas is projected onto the anterior abdominal wall as follows:

Head – in the left hypochondrium;
Body – in the epigastric region;
The tail is in the right hypochondrium.

To determine where the pancreas is located, it is enough to measure the distance between the navel and the end of the sternum. Its bulk is located in the middle of this distance. The lower edge is located 5-6 cm above the navel, the upper edge is 9-10 cm even higher.

Knowledge of the projection areas helps the patient determine where the pancreas hurts. When it is inflamed, the pain is localized mainly in the epigastric region, but can radiate to both the right and left hypochondrium. In severe cases, pain affects the entire upper floor of the anterior abdominal wall.

Skeletotopia

The gland is located at the level of the first lumbar vertebra, as if going around it. High and low placement of pancreas is possible. High - at the level of the last thoracic vertebra, low - at the level of the second lumbar vertebra and below.

Syntopy

Syntopy is the location of an organ relative to other formations. The gland is located in the retroperitoneal tissue, deep in the abdomen.

Due to its anatomical features, the pancreas has a close interaction with the duodenum, aorta, common bile duct, superior and inferior vena cava, and superior branches of the abdominal aorta (superior mesenteric and splenic). Pancreas also interacts with the stomach, left kidney and adrenal gland, and spleen.

Important! Such close proximity to many internal organs creates a risk of spread of the pathological process from one organ to another. With inflammation of any of the above formations, the infectious process can spread to the pancreas and vice versa.

The head is completely enclosed by the bend of the duodenum, and this is where the common bile duct opens. In front of the head are the transverse colon and the superior mesenteric artery. At the back are the inferior vena cava and portal veins, renal vessels.

Features of symptoms of pancreatic disease

Untreated pancreatitis leads to a chronic form of the disease. To restore the pancreas, patients are prescribed Allohol, a choleretic drug that normalizes bile production and the performance of the gastrointestinal tract. There is a medicine containing an extract of the contents of the pancreas - “Pancreatin”. It helps the digestive system function by replenishing enzyme deficiency. Acute pancreatitis requires immediate medical examination; its danger lies in rapidly developing complications.

Acute pancreatitis

A severe form of acute pancreatitis is hemorrhagic pancreatitis - death of pancreatic tissue. Its main symptom is severe pain. The patient's condition rapidly deteriorates, blood pressure drops, tachycardia appears, and death is possible. Pancreatic disease is characterized by repeated vomiting, which leads to dehydration, so you need to drink water in small portions often. As a result of the action of enzymes, blue-violet spots may appear on the skin of the abdomen.

Chronic pancreatitis

Symptoms of the disease in the remission stage are absent or mild. As a rule, an aching, dull pain occurs after eating heavy fatty foods, and occasional vomiting is possible. Chronic pancreatitis is often accompanied by weight loss in the patient; this is due to pancreatic dysfunction, poor digestion of food and poor absorption. Exacerbation of the chronic form can be caused by excessive alcohol consumption and non-compliance with the diet, while the symptoms manifest themselves in the same way as during an acute attack of the disease.

Causes of pancreatic disease

The development of pathological processes in the pancreas may remain unnoticed for several months or even years. Since the organ gradually loses its functions, the disease will certainly make itself felt. Some factors can provoke inflammation and cause an attack:

alcohol consumption;
cholelithiasis;
overweight;
viral hepatitis;
poisoning;
heredity.

Find out what are the symptoms of pancreatitis in women.

The role of the pancreas and its functionality

Despite its small size, the pancreas is a very important organ!

The pancreas performs the most important functions in the human body: intrasecretory, exocrine or digestive. It is located retroperitoneally, and the omental bursa separates the stomach from the gland. Next to the gland is the left renal vein, vena cava and aorta. Conventionally, the pancreas is divided into sections:

body;
tail;
head.

Pancreatic juice enters the intestine through the Wirsung duct or, as it is otherwise called, the pancreatic duct. Before flowing into the intestine, it unites with the bile duct. The pancreas includes two parts, different in structure:

islets of Langerhans (produce glucagon and insulin);
glandular part (synthesizes pancreatic juice).

The cause of the onset of the disease or exacerbation is the person’s incorrect diet. Symptoms of diseases associated with the pancreas are very similar, these are dyspeptic and pain syndromes. The progression of pancreatic diseases is accompanied by digestive disorders. This is why following nutritional rules is an integral part of the healing process.

When the gland is healthy, enzymes do not affect its own tissues. During the inflammatory process, the process of self-digestion of pancreatic tissue begins and gland cells, which are rich in enzymes, are damaged. Enzymes come out and have a detrimental effect on tissues that have not yet been damaged, thus closing the circle.

What is the role of the pancreas in the human body in producing hormones?

The pancreas performs the most important functions. Therefore, it is necessary to monitor the work of this body. Every person should carefully monitor their diet and its components. When an organ malfunctions, the stomach often suffers. For recovery, a therapy method is chosen only under the supervision of a doctor. Under no circumstances should you treat it yourself. This will only worsen the patient's condition. A gastroenterologist will select suitable methods for you, taking into account the individual characteristics of your body.

The quality and proper functioning of the gland is influenced by various factors, the main ones being:

Poor nutrition.
Alcohol abuse in large quantities.
Fatty and floury foods.

For good functioning of the pancreas, they follow the correct diet, but this does not mean that you have to go on strict diets. Just limit yourself from eating large meals and drinking large quantities of alcoholic beverages. In order not to burden the digestive organs with heavy food, consume fatty and smoked foods as little as possible. You shouldn’t overeat too much at one time, it’s better to eat more often, but less.

The stimulation procedure itself is a long process and therefore requires a lot of patience. It will be better if you exclude from your diet all sweet, fatty and sour foods that irritate the digestive system. To stimulate the gland, you need to stick to the above diet for at least a month.

This organ is located in the area of the diaphragm - where the thoracic part of the spine passes into the lumbar part; its head is slightly to the right relative to the spine, and its tail goes to the left. Accordingly, if the head of the pancreas is inflamed, it hurts more in the area of the right hypochondrium, the body of the organ - pain in the center (“under the stomach”), and if the tail is affected – in the left hypochondrium. But usually the entire gland suffers, and the pain is usually in the left hypochondrium and epigastrium.

All work of the pancreas is under the control of the central nervous system. The vagus nerve activates its work, and the sympathetic nerve reduces its activity. Moreover, it should be noted that gastric juice also activates the work of the gland. With its increased production, the work of the gland also accelerates.

If a large amount of carbohydrates enters the stomach, the pancreas increases the production of amylase, which is necessary for their breakdown. On the contrary, when eating fatty foods, the intake of lipase into the intestine increases, and when proteins enter, trypsin increases.

Often, malfunctions occur in the functioning of the pancreas. Insufficient production of any of the hormones or enzymes leads to an imbalance in the body and is manifested by the following symptoms:

painful sensations in the right and left hypochondrium, which have a girdling character;
the occurrence of nausea;
the appearance of an unpleasant taste in the mouth;
increased body temperature;
loss of appetite and weight;
vomiting with a bitter or sour taste.

The main symptom of all diseases of the pancreas is pain. It can be regular or periodic, weaken or intensify depending on the position of the body. And since the role of the pancreas in the life of an individual’s body is very important, it is necessary to immediately consult a doctor when the first signs of illness appear. Otherwise, a late diagnosis can cause the following diseases:

diabetes;
pancreatitis;
cyst;
fistulas;
cancer.

Inflammation of the pancreas is treated in a hospital setting. Before this, the patient needs the following help:

put a cold compress on the stomach to slow down fermentation;
to relieve muscle spasms, take Drotaverine;
refuse to eat.

Medications for the treatment of pancreatitis:

H2-histamine blockers - to relieve pain in the gland ducts.
NSAIDs, analgesics and antispasmodics.
Medicines containing trypsin - to stimulate exocrine functions.

When secretion in the pancreas is disrupted and tissue dies, an abnormal cavity or bubble filled with fluid, called a cyst, appears. The disease can be congenital or acquired. Causes of the disease:

mechanical trauma of the pancreas;
incompletely cured acute or chronic form of pancreatitis;
helminthic infestations;
hemorrhage into the parenchyma.

A small tumor does not cause any discomfort, but as it grows, it puts pressure on neighboring organs, displacing them from their place. The following symptoms occur:

constant or paroxysmal pain in the area of cyst formation;
changes in body temperature;
bowel disorders.

With such a neoplasm, the production of enzymes and hormones is disrupted, which is the main role of the pancreas in the human body. The disease requires urgent surgical treatment in the following cases:

if obstructive jaundice appears due to blockage of the bile ducts;
there is a breakthrough of the cyst into the abdominal cavity;
the occurrence of bleeding;
inflammation.

All these troubles arise due to untimely treatment of the cyst.

The most important thing in the prevention and treatment of pancreas is proper nutrition. Taking into account the important role of the pancreas in the human body, it is necessary to treat it with care. If acute pancreatitis occurs, you must completely stop eating for two days to reduce the production of pancreatic juice.

fresh meat of poultry, rabbit and fish;
all fermented milk products;
soups cooked in vegetable broth with the addition of vermicelli and cereals;
rice, buckwheat, oats (for making porridge);
pasta only from durum wheat;
egg omelet;
jelly and jelly.

Food should be steamed or boiled. Vegetable oil and butter should not be subjected to heat treatment. It is recommended to maintain a drinking regime. Plain water at room temperature helps speed up the digestion of food and reduce the load on the gland.

In terms of size, the pancreas ranks second after the liver among organs that produce enzymes. Its formation begins already in the fifth week of pregnancy. In a newborn child, the gland is up to 5 cm long, in a one-year-old child - 7 cm, by the age of 10 its dimensions are 15 cm in length. It reaches its final size in adolescence, by the age of 16.

The head of the pancreas is its widest part, its width is up to 5 cm or more, the thickness varies from 1.5 to 3 cm. The body of the gland is the longest part, its width is on average 1.75-2.5 cm. Length tail - up to 3.5 cm, width about 1.5 cm.

Due to its deep location, diagnosing pancreatic pathologies is very difficult. Therefore, an important point in diagnosis is an ultrasound examination, which allows you to determine the shape and size of the gland, on the basis of which you can draw appropriate conclusions about its condition.

All organ sizes, as well as possible reasons for their changes, are recorded in detail in the ultrasound protocol. In an unchanged state, iron has a homogeneous structure. Small deviations from the normal sizes of the head, body and tail are permissible only if the biochemical blood test is good.

The length of the gland in an adult is from 15 to 22 cm, its weight is approximately 70-80 grams. The thickness of the head should not exceed 3 cm, other data indicate pathology.

The exocrine function consists of the production of the following enzymes that are part of pancreatic juice: trypsin, lipase and amylase:

Trypsin breaks down peptides and proteins. It is initially produced by the pancreas in the form of inactive trypsinogen, which is activated by enterokinase (enteropeptidase), an enzyme secreted by the intestinal mucosa. The pancreas is the only organ in the body that produces trypsin, so determining its level is more important in the study of the pancreas than the analysis of other enzymes. Determination of trypsin activity is an important point in the diagnosis of acute pancreatitis and identification of its pathogenesis.
Lipase is a water-soluble enzyme that digests and dissolves triglycerides (neutral fats). It is produced in the form of inactive prolipase, and then under the influence of other enzymes and bile acids it turns into an active form. Lipase breaks down neutral fats into higher fatty acids and glycerol. This enzyme is also involved in energy metabolism, ensuring the delivery of polyunsaturated fatty acids to tissues and the absorption of some fat-soluble vitamins. In addition to the pancreas, lipase is produced by the liver, intestines, and lungs, and each type of lipase is a catalyst for the breakdown of a specific group of fats. With hypofunction of the pancreas, lipase activity primarily decreases. The first sign of this is greasy gray-yellow stool.
Amylase (alpha-amylase) is necessary for processing carbohydrates entering the body. It is secreted by the pancreas and (to a lesser extent) the salivary glands. Changes in the content of this enzyme in the blood are characteristic of many diseases (diabetes mellitus, hepatitis, etc.), but primarily this indicates acute or chronic pancreatitis.

Unlike other substances involved in the digestion process, pancreatic enzymes are released only during meals - their active release begins 2-3 minutes after food enters the stomach and lasts 12-14 hours. Enzymes can perform their functions only if there is a sufficient amount of bile produced by the gallbladder.

Disorders of secretion, its decrease and deficiency of pancreatic enzymes in an adult are usually a consequence of chronic pancreatitis - inflammation of this organ, which is accompanied by the gradual degeneration of glandular tissue into connective tissue.

Pancreatitis or inflammation of the pancreas

Pancreatitis or inflammation of the pancreas always goes along with serious pain in the abdominal area. The pain is bursting in nature, and depending on the affected area, it can radiate to the right or left hypochondrium; sometimes the pain can radiate to the epigastric region.

There are times when the patient clearly feels pain in the back or left shoulder blade. Pain in acute pancreatitis may resemble an attack of biliary colic, as it has the same set of symptoms:

vomiting mixed with bile;
pain in the right hypochondrium;
irradiation of pain to the back area.

Vivid pain sensations indicate the release of enzymes from the pancreas and a chemical effect on the tissue. When the main part of the parenchyma dies off, the pain becomes weaker and subsides. Girdle pain, pronounced, accompanied by repeated vomiting and all signs of intoxication, indicates pancreatitis, which has affected the entire gland. As for the body temperature, in case of purulent pancreatic necrosis it is elevated, normal in the edematous form and at the onset of collapse.

Attacks of pain with pancreatitis are very severe

During the course of the disease, the patient's skin becomes pale. If the face acquires a blue tint, this indicates a severe form of the disease, which is accompanied by severe intoxication and severe disturbances of peripheral circulation.

A third of all patients with acute pancreatitis develop jaundice.

Sometimes it happens that characteristic spots appear on the stomach, face, buttocks (in the form of hemorrhages like petechiae), or large round spots on the chest, stomach, back, which do not disappear when pressing on them. This is also a typical sign of the disease.

In the initial stages of the disease, the patient experiences constipation, after which the stool becomes unstable, so to speak, diarrhea and constipation alternate. The course of the disease is accompanied by the development of a lack of vitamins and minerals, patients lose a lot of weight, stomatitis, dry mucous membranes of the tongue and skin appear. The main treatment for pancreatitis is following a strict diet to restore and relieve the gland. The diet consists of refusing food for several days, after which the diet includes boiled and steamed foods.

Exocrine pancreatic insufficiency: diagnostic possibilities and methods of correction

Pancreatic insufficiency can occur both with a general decrease in the production of all pancreatic enzymes, and with an isolated decrease in the production of one of them. Clinically, exocrine pancreatic insufficiency can manifest itself as diarrhea, flatulence, abdominal pain, nausea, repeated vomiting, decreased appetite, as well as such nonspecific symptoms as general weakness, decreased physical activity, weight loss, stunted growth (in severe forms of maldigestion). An important diagnostic sign of exocrine pancreatic insufficiency is a change in the nature of the stool, because manifestations of lipase deficiency develop before the decrease in amylase and protease activity. The stool becomes bulky, polyfecal matter is noted, the stool is grayish in color and has a “greasy” appearance, and steatorrhea appears. Diagnosis of pancreatic pathology is one of the most difficult problems of pediatric gastroenterology and is based on the analysis of the results of both laboratory and instrumental research methods. Determination of the content of pancreatic enzymes in the blood (a-amylase, lipase, trypsin and its inhibitor) makes it possible to judge the organic damage to the organ, the presence of damage to acinar cells, however, it reflects the exocrine function of the pancreas to a lesser extent. Normally, 60% of serum amylase is amylase from the salivary glands, the remaining 40% is from the pancreas [1]. An increase in the enzyme content in the blood serum is a fairly early marker of acute pancreatitis: an increase in amylase activity is observed within 2–12 hours from the onset of the disease. It should be noted that the sensitivity and specificity of this marker for pancreatitis in children is somewhat lower than in adults and amounts to no more than 80–90% [1], while up to 40% of pancreatitis in childhood can occur with normal serum amylase activity [2 ]. When assessing the results of a laboratory test, it should be remembered that hyperamylasemia is a nonspecific symptom and can be caused by another pathology: appendicitis, acute cholecystitis, diseases of the salivary glands, renal failure (due to decreased amylase clearance) (Table 2). For the differential diagnosis of hyperamylasemia, determination of the level of amylase isoenzymes can be used (Table 3). Serum lipase levels also tend to be elevated in acute pancreatitis and remain elevated longer than amylase levels. An increase in the activity of this enzyme in the blood is a more sensitive and specific marker of pancreatic damage, and when the level of both enzymes is simultaneously determined, the sensitivity of the method reaches 94% [3,4]. Important for the diagnosis of acute pancreatitis is the determination of the activity of other pancreatic enzymes in the blood serum, in particular elastase-1, trypsin and its inhibitor with the determination of the inhibitor/trypsin ratio, which decreases with organ pathology. Significant in the diagnosis of pancreatitis is the determination of the concentration in the blood and urine of phospholipase A2, a marker of the destructive process in the pancreas. According to N.B. Gubergrits (2001), the sensitivity of various pancreatic enzymes in the blood depends on the duration of the disease (Table 4) [5]. For the diagnosis of acute and exacerbation of chronic pancreatitis, determining the level of pancreatic enzymes in the urine is of great importance. In acute pancreatitis, the level of urine amylase (diastase) can be increased by 5–10 times. It should be recognized that scatological research has not lost its relevance to this day and is the most accessible method that can confirm the presence of exocrine pancreatic insufficiency; however, in contrast to determining the level of pancreatic enzymes in the blood, indicating direct damage to the organ, based on the results of scatology, carry out a differential diagnosing absolute and relative pancreatic insufficiency is reliably impossible. A stool examination should be performed before administering pancreatic enzymes. The accuracy of this method is also influenced by: the state of intestinal motility, the volume of bile secreted into the intestinal lumen, its qualitative composition, the presence of inflammatory processes in the intestines, etc. Analysis of the results of a scatological study allows us to identify the following symptoms: • steatorrhea - an increase in the content of neutral fat in the feces (steatorrhea type 1), fatty acids/soaps (type 2 steatorrhea) or a combination thereof (type 3 steatorrhea); • creativeorrhea – increased content of muscle fibers in the stool (++ or +++); • amilorrhea – the presence of starch grains in the stool. Persistent persistence of steatorrhea and creatorrhoea may most likely indicate the presence of exocrine pancreatic insufficiency in the patient, while amylorhea is detected in patients with pancreatic insufficiency quite rarely, since starch hydrolysis is often not impaired due to the high activity of intestinal amylase. A fecal lipidogram allows you to clarify the nature of steatorrhea and is of certain importance in assessing the effectiveness of enzyme therapy. The fat content in stool is assessed qualitatively (adding Sudan dye to the stool) or quantitatively. The latter is the most informative [6], allowing a total determination of the total amount of fat in feces, taking into account fat of exogenous (food) origin. Normally, the amount of fat excreted in feces should not exceed 10% of the fat introduced with food. In diseases of the pancreas, the amount of fat excreted in feces sometimes increases to 60% [7]. Determination of elastase-1 in feces allows one to assess the degree of exocrine pancreatic insufficiency and make a differential diagnosis between absolute and relative exocrine insufficiency. Elastase-1 is a proteolytic enzyme of the pancreas with a molecular weight of about 28 mDa. It is known that the enzyme does not change its structure as it passes through the gastrointestinal tract, which allows it to be considered a sensitive marker of exocrine pancreatic insufficiency. This technique has qualitative advantages over the methods used today for determining exocrine pancreatic insufficiency (stool lipid profile, coprogram) due to the greater specificity of the method and the lack of influence of enzymatic therapy on the results of the elastase test. The elastase content in feces should be above 200 μg/g. The level of fecal elastase from 200 to 100 µg/l indicates moderate exocrine pancreatic insufficiency, a decrease in the level of the enzyme in feces less than 100 µg/l indicates the presence of severe pancreatic insufficiency. This test has found wide use in patients suffering from cystic fibrosis and Shwachman's syndrome, since determining their level of fecal elastase makes it possible to monitor the condition of the pancreas without canceling enzyme therapy. Table 5 and Figure 1 present an algorithm for diagnosing exocrine pancreatic insufficiency based on the results of studying the level of elastase-1 in feces [8]. The previously widely used secretin-pancreozymine test (SPT) is a probe method for studying the exocrine function of the pancreas and is based on determining the content of bicarbonates and enzymes in the duodenal contents using a probe after direct stimulation of acinar and ductal cells of the pancreas. When conducting the study, the basal secretion is first determined by administering secretin (1 U/kg), which stimulates an increase in the volume of pancreatic secretion and the production of bicarbonates. Then cholecystokinin-pancreozymin (1 U/kg) is administered, which stimulates the production of enzymes and causes contraction of the gallbladder (stimulated secretion). Normal indicators of the secretin-pancreozymine test: bicarbonates - not less than 70 mmol/l, amylase - not less than 12,000 U/30 min., trypsin - not less than 3 U/30 min., lipase - not less than 65,000 U/30 min., steatorrhea – no more than 7 g/day. Based on the results obtained, it is possible to determine the types of pancreatic secretion to stimuli: • normosecretory response - increased enzyme activity, secretion volume and bicarbonate level; • hypersecretory type of secretion - an excessive increase in the concentration of enzymes with a normal or increased volume of secretion and bicarbonate levels, characteristic of mild inflammatory-dystrophic changes in the pancreas associated with hyperfunction of acinar tissue; • hyposecretory type of secretion – normal or reduced volume of juice and bicarbonate level with reduced enzyme activity, indicates a qualitative insufficiency of pancreatic secretion, characteristic of the development of pancreatic fibrosis; • obstructive type of secretion – a decrease in the volume of juice with a normal content of enzymes and bicarbonates, characteristic of duct obstruction (papillitis, duodenitis, spasm of the sphincter of Oddi, choledocholithiasis). It should be noted that in children the enzyme-synthesizing function of the pancreas is more often impaired; only with severe pancreatic insufficiency does the level of bicarbonates and secretion decrease. This test is currently not widely used due to the availability of modern sensitive and minimally invasive methods for assessing the structural and functional state of the pancreas. Instrumental research methods in the diagnosis of exocrine pancreatic insufficiency are of auxiliary value, allowing the assessment of the anatomical structure of the organ. Ultrasound examination of the pancreas is one of the leading methods of radiation diagnostics, which allows you to quickly, quite informatively, regardless of the severity of the patient’s condition, assess the condition of the pancreas: an increase in its size, changes in echo density (edema, compaction), the presence of echo-dense inclusions, the condition of the Wirsung duct. The acoustic characteristics of the unchanged pancreas include determination of the shape, contour, size, echogenicity of the internal structure and the state of the main pancreatic duct. Traditionally, in clinical practice, age standards for ultrasound sizes of the pancreas are used (Table 6). One of the main criteria for damage to the pancreas is a change in the size of the organ. Based on an analysis of more than 3,000 examined children, M.I. Pykov (1997) showed that an increase in the size of the pancreas, especially its tail part, and visualization of the dilated duct in children are evidence of increased pressure in the lumen of the duodenum. A number of authors consider a moderate increase in the size of the pancreas (or its parts) with unchanged echogenicity and homogeneous echostructure as a manifestation of functional changes in the organ of a compensated nature. At the same time, organic lesions of the pancreas are characterized by changes in size, contours, shape, echostructure and expansion of the main pancreatic duct [9]. Signs of chronic pancreatitis on ultrasound include: dilation of the pancreatic duct, detection of stones in the pancreatic duct, uneven edges of the pancreas/changes in the echostructure, the presence of pseudocysts [10,11]. Ultrasound scanners using the Doppler effect can provide data on blood flow in arterial and venous vessels. Taking into account that the earliest changes in the pancreas occur at the level of the microvascular bed, the importance of visualizing parenchymal blood flow in the pancreas for assessing its condition cannot be overestimated. The defeat of this organ is often accompanied by changes in hemodynamics in large vessels supplying blood to the upper parts of the digestive system. In the domestic literature there are only isolated reports on Doppler ultrasonography indices in normal and pathological conditions. According to V.V. Mitkova (1998), the frequency of visualization of small vessels of the pancreas using color Doppler scanning (CDS) and power Doppler (PD) ranges from 60 to 90%, with the largest number of vessels determined in the area of the head of the pancreas [12]. According to pulse-wave Doppler, the maximum systolic velocity in the small arteries of the pancreas is 30±1 cm/s, in the veins - 15 cm/s, the resistance index in the small arteries of the pancreas is 0.61±0.05. In acute pancreatitis, an increase in intraorgan blood flow is observed; as parenchymal edema increases, according to pulsed Doppler (PD), an increase in peripheral resistance indices in small arteries may be observed. As destructive processes develop in the pancreatic parenchyma, deformation of the vascular pattern in the destruction zone is recorded, and with ID - a decrease in peripheral resistance and identification of signs of arteriovenous shunting. In chronic pancreatitis, when performing CDK, a weakening of blood flow is observed, and in ID, a decrease in the speed of blood flow in the small vessels of the pancreas is observed. Endoscopic retrograde cholangiopancreatography (ERCP) is the “gold standard” for diagnosing pancreatic pathology. Using this technique, it is possible to detect expansion and deformation of the main pancreatic duct, detect duct strictures, calcium deposits on the walls of the duct, and calcification of the pancreatic parenchyma. The study also reveals changes in the biliary system: stenosing papillitis, choledocholithiasis, anomalies in the development of the bile ducts and gallbladder, etc. Indications for ERCP are: • recurrent chronic pancreatitis; • blunt abdominal trauma with severe pain; • duodenostasis; • jaundice of unknown etiology; • chronic calculous cholecystitis; • preoperative examination of patients. The main indications for computed tomography and magnetic resonance cholangiopancreatography in children: • complicated course of acute and chronic pancreatitis; • suspicion of a mass process in the pancreas and adjacent organs. Correction of pancreatic insufficiency is aimed at eliminating disturbances in the breakdown of fats, proteins and carbohydrates and involves prescribing a special high-calorie diet and enzyme replacement therapy, which can reduce the manifestations of maldigestion and malabsorption. Many enzyme preparations traditionally used by pediatricians have significant technological and pharmacological disadvantages, as well as low activity in the duodenum. When prescribing a particular drug, the doctor must first of all know its composition and have information about the activity of its components. Drugs for replacement therapy of exocrine pancreatic insufficiency in children should [13,14]: • contain lipase and be resistant to hydrochloric acid; • have a maximum effect at pH 5–7; • quickly and homogeneously mix with chyme and transport to the duodenum; • have a microtablet (microspherical) shape with a diameter of no more than 2 mm, providing a large surface of contact with the chyme. This promotes the simultaneous entry of the drug into the duodenum and the rapid release of lipase in the intestine; • be well tolerated; • not toxic. To ensure rapid and homogeneous mixing of enzymes with food chyme, to prevent intragastric inactivation and adequate passage from the stomach to the duodenum, new generation pancreatin enzyme preparations were created - Creon 10000, Creon 25000 and Creon 40000 in the form of mini-microspheres, the diameter of which does not exceed 1.4 mm. Creon 40000 mini-microspheres are coated with an enteric coating and enclosed in a gelatin capsule. When it enters the stomach, the capsule quickly dissolves, mini-microspheres are mixed with food and gradually enter the duodenum. When the pH of the duodenal contents is above 5.5, the membranes dissolve and the enzymes begin to act on a large surface. The mechanism of action of Creon 40000 allows you to reproduce the physiological process of digestion, in which pancreatic juice is secreted in portions in response to the periodic intake of food from the stomach. The drug is characterized by an optimal ratio of lipase and protease activity, as well as a high content of carboxylesterolipase and phospholipase A2 for the most effective breakdown of fats. The success of therapy for exocrine pancreatic insufficiency depends on many reasons. The most convenient and physiological way for the patient is to take enzyme preparations with meals. In the case of an adequately selected dose and form of the enzyme preparation, a significant improvement in the patient’s condition occurs. The criteria for the effectiveness of treatment are the disappearance of polyfecal matter, reduction or elimination of diarrhea, increase in body weight, disappearance of steatorrhea, amilorrhea and creatorrhoea. The dose of the enzyme preparation is selected individually within 1 week. treatment depending on the severity of exocrine pancreatic insufficiency. It is advisable to calculate the dose of the enzyme preparation based on lipase and start with a small one (1000 IU of lipase per kg of weight). If there is no effect, the dose of the drug is gradually increased under the control of scatological studies. For severe exocrine pancreatic insufficiency, we use 4000–5000 IU of lipase per kg of body weight. The duration of therapy is determined individually. Enzyme intake is stopped if clinical and scatological signs of maldigestion and malabsorption disappear.

Literature 1. Lerner A., Branski D., Lebenthal E. Pancreatic diseases in children // Pediatr. Clin. North Am. 1996. Vol. 43. R. 125–156. 2. Cox KL, Ament ME, Sample WF, Sarti DA, O'Donnell M., Byrne WJ The ultrasonic and biochemical diagnosis of pancreatitis in children // J. Pediatr. 1980. Vol. 96 (3 Part 1). R. 407–411. 3. Frank B., Gottlieb K. Amylase normal, lipase elevated: is it pancreatitis? A case series and review of the literature // Am. J. Gastroenterol. 1999. Vol. 94. R. 463–469. 4. Russell MK Acute pancreatitis: a review of pathophysiology and nutrition management // Nutr. Clin. Pract. 2004. Vol. 19. R. 16–24. 5. Gubergrits N.B., Golubova O.A. Laboratory diagnosis of pancreatic diseases / Medical laboratory diagnostics (programs and algorithms) / ed. A.I. Karpishchenko. St. Petersburg, 2001. 6. Henderson D.M. Pathophysiology of the digestive organs. M.: Binom, 1997. P. 288. 7. Korovina N.A., Levitskaya S.V., Budakova L.V., Kameneva O.P. Diagnosis of pancreatitis in children. M., 1989. 24 p. 8. Belmer S.V., Gasilina T.V. Digestive pancreatic insufficiency in children. Differentiated approach // Russian Medical Journal. 2007. No. 1. P. 57–60. 9. Pykov M.I. Doppler examination of pancreatic vessels in children // Ultrasound and functional. diagnostics. 2001. No. 2. P. 53–57. 10. Zagorenko Yu.A. Clinical and pathogenetic assessment of information content and modern possibilities for optimizing ultrasound diagnostics of chronic recurrent pancreatitis // Med. visual 2002. No. 1. P. 48–58. 11. Zubarev A.V. Ultrasound monitoring of the treatment of acute pancreatitis // Med. visual 2000. No. 4. P. 21–24. 12. Mitkov V.V., Bryukhovetsky Yu.A., Kondratova G.M. Color Dopplerography and eneogetic Doppler in ultrasound examinations of the pancreas. Clinical physiology. Diagnostics - new methods. M., 1998. pp. 177–180. 13. Yakovenko E.P. Enzyme preparations in clinical practice // Clinical pharmacology and therapy. 1998. No. 7. P.17–20. 14. Graham DY Treatment of exocrine pancreatic insufficiency // Pract.Gastroenterol. 1980. Vol. 4. R. 18–23.

Chronic pancreatitis: symptoms

Chronic pancreatitis is a progressive disease. As the disease progresses, normal pancreatic tissue is replaced by connective tissue. The most common cause of chronic pancreatitis is alcohol abuse. The second place among the causes of pancreatitis is pathology of the biliary tract.

Other factors leading to pancreatitis include: operations and injuries on the pancreas, biliary tract, liver, viral hepatitis B and C, severe disorders of fat metabolism. A destructive diet is a starting factor for the development of the disease. The periodicity of the course of chronic pancreatitis is represented by two periods: the acute period and remission.

Symptoms of exacerbation of the disease: periodic or constant pain, which has varying intensity, most often occurs half an hour after the last meal in the epigastric region, in the hypochondrium. The pain radiates to the arm, back, sternum and shoulder blade. If the entire pancreas is affected, the pain will be girdling. At the same time, nausea and vomiting are added to the girdle pain, which does not bring the patient even the slightest relief.

Signs of indigestion also make themselves known: disturbances in appetite, flatulence, body temperature rises, general weakness of the body, and fatigue are noted.

If a patient suffers from chronic pancreatitis for more than ten years, then it is not the pain syndrome that comes to the fore, but the insufficiency of the functional gland. A decrease in juice production has its own distinctive signs: abnormal stool (mushy consistency, no more than 3 times a day, gray, shiny, unpleasant smell, traces of food that has not been digested), flatulence.

Constant overeating puts a strain on the pancreas!

Disruption of the digestive process during illness leads to vitamin deficiency, deficiency of fats, proteins, carbohydrates, various micro and macroelements. In other words, there are big problems with the absorption of useful food components.

The patient experiences sudden weight loss, development of anemia, dysbacteriosis, and osteoporosis. That is why part of the treatment is good nutrition, following a proper diet that helps preserve nutrients in the body.

Exacerbation of chronic pancreatitis causes the development in the early stages of hypoglycemic conditions, such as trembling in the body, cold sweat, and weakness of the body. With a long course of the disease, a more serious disease may develop over time - diabetes mellitus (secondary). The treatment process begins in the hospital with forced fasting, which later smoothly turns into a strict diet: warm dishes, boiled and steamed, and perhaps the use of light soups.

Pancreas cancer

Cyst, chronic pancreatitis, tumors (benign) of the pancreas - precancerous diseases. When exposed to certain factors, they can become malignant. Such factors include smoking, drinking alcohol, and insufficient amounts of vegetables and various fruits in the patient’s diet.

Diabetes mellitus doubles the risk of developing pancreatic cancer. One in twenty cases of pancreatic cancer is associated directly with chronic pancreatitis. Treatment should begin with eliminating the factor that caused the development of the disease. Signs of gland damage vary depending on which part is affected.

Symptoms of the disease

At the very beginning, the disease proceeds quite unnoticed; the patient does not always have health complaints, even from the digestive side. The cause for alarm is pain, which is localized in the stomach and hypochondrium. Sometimes the pain becomes irritating and can radiate to the back. The pain gets worse as night goes on. Subsequently, the patient notes weight loss, for no apparent reason, as well as weakness, fatigue and heaviness in the epigastric region.

When pancreatic cancer develops, diet is not the most important thing; it is more important to start surgical treatment.

At the moment when the tumor reaches a sufficient size, another symptom is added - jaundice. It grows quickly, the skin acquires a greenish-brown tint. This is due to compression of the bile duct by the tumor. Further, itching of the skin is added to the symptoms, and the stool becomes discolored.

The patient loses his usual appetite, is worried about nausea, and belching appears. There is a reluctance to eat meat, as well as fatty foods. The loss of fluid in the body increases, and weight loss becomes more significant. Following a diet becomes a prerequisite for a speedy recovery.

Pancreatic cyst: clinical picture

When secretion in the pancreas is disrupted and tissue dies, an abnormal cavity or bubble filled with fluid, called a cyst, appears. The disease can be congenital or acquired. Causes of the disease:

mechanical trauma of the pancreas;
incompletely cured acute or chronic form of pancreatitis;
helminthic infestations;
hemorrhage into the parenchyma.

A small tumor does not cause any discomfort, but as it grows, it puts pressure on neighboring organs, displacing them from their place. The following symptoms occur:

constant or paroxysmal pain in the area of cyst formation;
changes in body temperature;
bowel disorders.

if obstructive jaundice appears due to blockage of the bile ducts;
there is a breakthrough of the cyst into the abdominal cavity;
the occurrence of bleeding;
inflammation.

All these troubles arise due to untimely treatment of the cyst.

Signs of cancer of the tail and body of the gland

Symptoms depend on the location of the pancreatic lesion

This type of disease is even more rarely detected. The reason for this is the location of the tumor, which only reaches the bile duct if it is significant in size. The tumor quickly grows into the upper arteries and veins. In one out of five cases, diabetes mellitus (secondary) develops due to the death of those cells that are responsible for the production of insulin.

From the tail, the tumor sometimes grows into the vessels of the spleen and portal vein. All this leads to an increase in the size of the spleen. It is in this location that the pain is especially pronounced, since the tumor grows into the nearby nerve plexuses.

For most tumors, only palliative treatment is acceptable. In the early stages, tumors that secrete specific hormones are diagnosed. Tumors of this type are characterized by slow growth, but this does not prevent them from having a dramatic effect on the state of hormones in the body.

Symptoms will directly depend on the type from which the disease grows.

If a large amount of glucagon is produced during illness, the person will suffer from dermatitis, and the level of glucose in the blood will increase. Diseases of the pancreas, in particular cancer, are dangerous due to possible early metastasis to the tissue of the liver, bones, lymph nodes, lungs, etc. This is the whole insidiousness of the disease. To determine the correct direction of treatment, it is necessary to diagnose the body using a biopsy. Surgery is still important when detecting a tumor in the pancreas.

The role of diet in the treatment of pancreas

Sudden inflammation of the gland responsible for the digestive process causes acute pancreatitis. When exocrine functions are disrupted, enzymes stop entering the duodenum and they are digested inside the gland. Toxins are produced that are dangerous to other internal organs. Pancreatitis develops as a result of tissue destruction in the ducts due to increased pressure during enzyme activity, and subsequently the tissue structures of the gland are damaged. Due to inflammation, the role of the pancreas in the body for digestion is reduced. The disease is characterized by the following symptoms:

constant dull or cutting pain in the abdomen on the left or right side;
possible state of shock;
belching, hiccups, nausea, vomiting with bile occurs;
diarrhea.

As a result of malfunctions, the pancreas stops producing the required amount of insulin (type 2 diabetes) or does not produce it at all (type 1). Symptoms of the disease:

frequent urination;
strong thirst;
rapid weight loss with normal appetite;
weakness, tiredness, fatigue;
numbness of the limbs;
heaviness in the legs;
dizziness;
poor wound healing;
cramps in the calf muscles.

In some cases, there are no signs of thirst and an increase in the amount of urine. But with the disruption of the role of the pancreas in the human body, over time, the patient will definitely pay attention to the characteristic symptoms of diabetes - general weakness, bad mood, pustular lesions of the dermis, constant weight loss.

Therapy depends entirely on the type of disease. The first type is treated with insulin, in the complete absence of its production in the body. To treat the second type, they first use a diet, and then switch to the tablet form of antidiabetic drugs.

Prohibited products:

Fatty foods, fried foods;
Sausages, canned food, smoked meats, pickles;
Jellied meat, aspic;
Alcohol;
Sour juices;
Strong tea and coffee;
Confectionery (cakes, pastries), ice cream;
Hot spices, herbs and seasonings, mustard, horseradish.

Prevention of pancreatic diseases, diet

Diet plays a vital role in the treatment and prevention of pancreatic diseases. A list of products that are recommended for consumption by people with pancreatic diseases has been determined. It is imperative to add bread to your daily diet (white, maybe black, only if it was baked yesterday). The menu for a patient with glandular diseases must include first courses: milk and vegetable soups, cabbage soup, borscht.

Diet is the basis for pancreatic health!

As second courses, you can eat beef, boiled fish or in the form of steamed cutlets. It is possible to eat rabbit meat, stews and lean chicken. Vegetables in all possible forms, except fried ones, are also not prohibited. Cereals, dairy products and dishes made from them, cereals and pasta are also included in the diet for the treatment and prevention of pancreatic diseases.

Fats should be eliminated from the diet; you can consume butter, but in small quantities, like vegetable oil. It is permissible to eat one boiled egg per day. From drinks you should choose jelly, weak tea, compote or jelly. The diet should not include:

food that is too cold or hot;
meat and fish broths;
fatty fish and any meat;
chocolate;
spices;
ice cream;
sour apples;
alcohol;
mushrooms.

An important point: dishes must be cooked boiled or steamed; adding spices to them is prohibited. As a disease prevention, it is useful, first of all, to follow a special diet and give up negative habits: smoking, snacking, excessive alcohol consumption, a diet rich in too fatty foods.

All of the above should be avoided. It is very useful to treat yourself with herbal teas made from nettle, dandelion, blueberry, rosehip and lingonberry as a preventive measure for diseases. If you feel problems with the pancreas approaching, take care of your health in advance: give up spicy foods, very fatty dishes, give up abnormal snacks and drinking alcoholic beverages.

To avoid illness, be sure to diversify your diet with healthier foods. It is most beneficial to eat food at least 4-5 times a day with equal intervals between meals. And you shouldn’t overeat, it also negatively affects the gastrointestinal tract, causing a number of various diseases. The pancreas is exposed to external influences... What diseases can there be? Watch the video:

https://youtube.com/watch?v=JtBzHUPTdyw

The largest glands in our body are the liver and pancreas. The anatomy of these main organs of the digestive system has one interesting feature. These glands are formed during the development of the embryo in the wall of the duodenum. Then, gradually growing, they significantly go beyond its limits.

The second largest gland of the digestive tract is the pancreas, the anatomy, functions and diseases of which will be discussed in this article. It is second in size only to the liver. The pancreas is located in the loop of the duodenum, in front of it is the lower surface of the stomach. It is precisely because of its position that this body received its name.

The pancreas has both endocrine and exocrine functions. The latter is carried out by acini, which produce special digestive enzymes. The most important of these enzymes are amylolytic and lipolytic, as well as trypsin. They are secreted in an inactive form by the acini and are activated under normal conditions only in the cavity of the duodenum. As for the endocrine function, it belongs to the pancreatic islets (or islets of Langerhans).

Pancreas in diabetes mellitus

Often, malfunctions occur in the functioning of the pancreas. Insufficient production of any of the hormones or enzymes leads to an imbalance in the body and is manifested by the following symptoms:

painful sensations in the right and left hypochondrium, which have a girdling character;
the occurrence of nausea;
the appearance of an unpleasant taste in the mouth;
increased body temperature;
loss of appetite and weight;
vomiting with a bitter or sour taste.

diabetes;
pancreatitis;
cyst;
fistulas;
cancer.

As a result of malfunctions, the pancreas stops producing the required amount of insulin (type 2 diabetes) or does not produce it at all (type 1). Symptoms of the disease:

frequent urination;
strong thirst;
rapid weight loss with normal appetite;
weakness, tiredness, fatigue;
numbness of the limbs;
heaviness in the legs;
dizziness;
poor wound healing;
cramps in the calf muscles.

In some cases, there are no signs of thirst and an increase in the amount of urine. But with the disruption of the role of the pancreas in the human body, over time, the patient will definitely pay attention to the characteristic symptoms of diabetes - general weakness, bad mood, pustular lesions of the dermis, constant weight loss.

fresh meat of poultry, rabbit and fish;
all fermented milk products;
soups cooked in vegetable broth with the addition of vermicelli and cereals;
rice, buckwheat, oats (for making porridge);
pasta only from durum wheat;
egg omelet;
jelly and jelly.

role of the pancreas in the human body

The pancreas is a large gland that is an organ of the digestive system. By synthesizing hormones, the organ normalizes protein, fat and carbohydrate metabolism. The first mention of iron dates back to the beginning of the first millennium AD. In the multi-volume compendium of religious, legal and ethical rules of Judaism, it is compared to nothing less than the “Finger of God.”

Anatomically, the organ has an elongated shape. It is located behind the stomach, and the pancreas got its name because in the supine position the gland actually ends up under the stomach. There is a head, body and tail. According to statistics, about 60% of pathologies occur specifically in the head, adjacent to the duodenum and located in its bend. Visually, the intestine wraps around the head of the pancreas.

Functions of the pancreas in the human body:

Humoral function. As is already known, the pancreas is responsible for the breakdown of food. The humoral function is associated with the fluids of the animal body. It is responsible for the distribution of substances obtained from food and the further supply of the body with them. In addition, regulation of the volume of pancreatic juice is also considered a humoral function. This feature helps, depending on the type of food, to secrete the right amount of juice and synthesize those enzymes that are required specifically for good digestibility of these products.

The digestive function ensures the process of digesting food. The juice produced, rich in enzymes, breaks down food into the smallest components. Thanks to this, substances penetrate into the blood and spread throughout the body.

Endocrine function is necessary for the synthesis of enzymes and hormones, without which normal human life is impossible. In particular, insulin normalizes sugar in urine and blood. And if this indicator deviates more or less from the norm, there is a high probability of developing serious diseases.

The secretory function is represented by pancreatic juice, which contains organic substances and enzymes.

If the pancreas does not perform its function, the organ itself is digested. It has a close relationship with the thyroid gland, so the most common complications are of a secretory nature, for example, diabetes mellitus.

Pancreatic dysfunction, when the gland becomes inflamed, turns into pancreatitis - an equally dangerous disease, the treatment of which is based on medication, surgery and folk treatment.

The pancreas is one of the organs of the human digestive system that performs intrasecretory and exocrine functions.

Functions of the pancreas in the human body: humoral, digestive, secretory.

The pancreas maintains hormonal balance and is directly involved in complex digestive processes. The structure of the organ is alveolar-tubular. If we consider the size of the pancreas, it is the second largest organ after the liver. Moreover, any fluctuations and deviations from the norm in these indicators can signal a particular pathology. Most of it produces its own enzymes, which subsequently enter the pancreas.

Maintaining a reasonable, balanced diet and avoiding smoking, excessive alcohol and drug use will help keep your pancreas healthy and functioning properly.

Pancreas: anatomy

In humans, this organ has a wedge-shaped shape. Its head is thickened, and the middle part is more or less prismatic. His tail is narrowed. You probably have a rough idea of where the pancreas is. Its anatomy and physiology, however, require detailed consideration.

The organ of interest to us is located on the posterior abdominal wall somewhere at the level of the 2nd and 3rd lumbar vertebrae. In the horizontal direction, the pancreas is elongated so that its tail reaches the spleen, and the head is located in the loop of the duodenum. The head is somewhat thickened in the anteroposterior direction. It has a hook-shaped process directed downwards. As for the body of the pancreas, it is shaped like a triangular prism. The peritoneum covers its anterior surface, which faces the posterior surface of our stomach. It is separated from the latter by a narrow cavity of the omental bursa. The pancreas (its anatomy will be clearer to you if you study the photographs presented in the article) is in contact with the posterior surface of the adrenal gland and the upper edge of the left kidney.

Its length in an adult is about 15-25 cm, and its thickness is approximately 2-8 cm. The pancreas weighs from 65 to 160 g. When fresh, it is pinkish-gray in color. The capsule covering it is very thin.

We examined in general terms the structure of the pancreas. Its anatomy, however, is a fairly broad topic. We invite you to study this issue in more detail.

Excretory ducts and lymphatic vessels

The pancreas has many lymphatic vessels and excretory ducts. Its anatomy suggests familiarity with them. The main excretory ducts, of which there are usually two in humans, run from the tail to the head of the pancreas, passing along its entire axis. The main ducts along their path receive many branches that carry secretions from the lobules. They stand out clearly in white against the background of the pancreatic parenchyma, which has a gray-pink color. At the confluence of the main excretory duct into the duodenum, its diameter reaches 2-3 mm. The tail and body are supplied by a number of branches of the splenic artery.

The anatomy of the pancreas is marked by the presence of a dense network of lymphatic vessels, which is closely connected with the network of the duodenum, gallbladder and bile ducts. Lymph from it flows to many regional lymph nodes, which are located in the stomach, hilum of the liver, mesentery, spleen and left adrenal gland.

We hope you understand the topographic anatomy of the pancreas.

The role of nerve impulses in the regulation of secretory activity

Since the experiments conducted by I.P. Pavlov, the fact has been established that the secretory action relates to parasympathetic impulses. Nerve impulses play an important role in regulating the secretory activity of the pancreas. If the vagus nerve is irritated or if a person uses certain parasympathicotronic pharmacological substances, secretory granules quickly dissolve and are released from the acinar cells. However, under these conditions, pancreatic juice is rich in organic substances and enzymes, so it is released in rather meager quantities.

The mechanism of action of sympathetic impulses is more complex. According to some reports, if the celiac nerve is subjected to short-term irritation, pancreatic secretion is inhibited. However, with fairly long-term stimulation, the same effect is observed as with irritation of the vagus nerve. It should also be noted that transection of the celiac and vagus nerves, which innervate the organ of interest to us, does not prevent the separation of pancreatic juice rich in enzymes. This is explained by the fact that not only their impulses stimulate pancreatic secretion. A complex neurohumoral mechanism operates, in which secretin plays an important role. This is a special hormone produced by the duodenum (its mucous membrane).

Functions of the pancreas

Its role in the processes of metabolism and digestion is very great. It secretes pancreatic juice into the duodenum. This juice contains enzymes such as lipase, trypsin, lactase, maltase, etc. They take part in the digestive processes. Another important function of the pancreas is the production of hormones (glucagon, lipocoin, insulin). By producing glucagon and insulin that enter directly into the blood, this organ regulates fat and carbohydrate metabolism in our body. These hormones have the opposite effect. Insulin lowers and glucagon increases blood sugar levels. A change in its level can lead to a disease such as diabetes.

What is the role of the pancreas in the human body in producing hormones?

The pancreas (PG) is located behind the stomach on the posterior abdominal wall, slightly extending into the left hypochondrium.
It consists of three main parts: head, body and tail. The head is adjacent to the duodenum, which clasps it in the form of a horseshoe. The organ has a light pink tint, width - about 9 cm, thickness - up to 3 cm, and length - 25 cm. The mass of the pancreas is about 80 grams and on the outside it is located in a thin capsule. The internal surface of the organ consists of cells and tubes, between which vessels and ducts pass.

The main role of the pancreas in digestion is to produce enzymes that aid in the digestion process. The most important of them are:

Amylase - it promotes the breakdown of carbohydrates into sugar molecules, which are absorbed by the intestines.
Lipase – breaks down lipids into glycerol and fatty acids, promotes the absorption of vitamins K, E, D, A.
Nuclease - divides nucleic acid into nucleotides, which are absorbed during digestion and used to build genetic structures.
Trypsinogen - participates in the synthesis of trypsin, which breaks down proteins and peptides.
Phospholipase is a group of enzymes necessary for the restoration of cell membranes.

Without the listed substances, it is impossible to digest food, and therefore absorb nutrients, so the role of the pancreas in the digestion process is very large. An individual simply cannot exist without receiving vitamins, microelements, fats, proteins and carbohydrates.

The production of these substances is another important function of the pancreas. These include:

Insulin is a protein hormone. It takes part in metabolic processes and affects the absorption of fats, amino acids and carbohydrates. Thanks to it, the cells of the body are nourished. When there is a lack of insulin, nutrients are not delivered to where they are most needed. The most well-known disease that worsens an individual’s quality of life and is characterized by a lack or complete absence of insulin is diabetes mellitus.
Glucagon - the effect of this substance is completely opposite to insulin. The main role of the pancreatic hormone is to activate all reserves of carbohydrates and turn them into energy so that the body functions and functions normally. This hormone also normalizes blood glucose levels.

Insulin production increases with increased glucose levels, and if there is less glucose in the blood, then glucagon production increases.

At the initial stage of poor gland function, it can be difficult to diagnose the functioning. At this stage, some symptoms associated with discomfort and pain arise, at which a person may already feel the need for treatment or surgery. The acute form of pancreatitis requires surgical intervention in approximately 25% of cases.

Presence of pain in the upper abdomen.
Pain in the heart area, although there are no abnormalities in the electrocardiogram readings.
General weakness.
Appetite disappears and a feeling of nausea occurs.
Vomit.
Rapid onset of fatigue.
Flatulence.
Diarrhea.
Changes in enzyme production.
If the gland does not function, intestinal obstruction may occur.
Unpleasant taste in the mouth.
Bloating.

In some cases, there is a rise in temperature, pale skin color, rapid pulse and low blood pressure. When treating pancreatitis, you need to know that it can be acute and chronic. The acute form is expressed by severe inflammation and appears when there is an excess of enzymes. Accompanied by heartburn and stomach irritation.

Pancreatic cancer is expressed by infection of cells and spreads throughout the organ, infecting the surrounding vessels and nerves. If treatment is not started in time, the cancer will spread throughout the abdominal cavity and the gland will stop functioning.

Diabetes occurs when the gland stops producing insulin, or the body does not absorb what is already produced. Both options are dangerous, each in their own way. When this disease occurs, glucose begins to accumulate and is not absorbed by the body, because there is not the required amount of insulin for its absorption by cells.

Diabetes is divided into two types:

Insulin dependent.
Insulin independent.

In the first type of disease, sugar levels are regularly measured and a certain dose of insulin is injected into the body. In the second case, insulin is produced on its own, but tissue cells do not absorb it. High sugar content contributes to various disorders in the functioning of nerves and kidneys, and vision deteriorates. Patients often experienced heart failure and even stroke.

To apply a specific treatment method, it is necessary to find out the cause of the disease. If a disease is acquired due to bad habits, they are abandoned and replaced with medications. Treatment for more serious illnesses requires surgical intervention, chemotherapy, or regular insulin intake.

Acute pancreatitis

He appears suddenly. Its main symptoms are pain, often vomiting, diarrhea, dyspepsia, weakness, and emaciation. In acute pancreatitis, pain is usually felt in the left side. Unpleasant sensations can take on the character of “girdling” pain. In other words, they can spread to the entire left side and also extend to the back.

If symptoms of acute pancreatitis appear, you should consult a doctor, as this disease does not go away on its own. In addition, severe complications cannot be ruled out. Acute pancreatitis involves monitoring the patient and injecting him with drugs that reduce pain and inflammation.

Chronic pancreatitis

Its exacerbation is characterized by less intense pain. In addition, they tend to recur from time to time (after alcohol abuse or dietary errors). This disease does not require emergency surgery. However, this does not mean that it does not need to be treated. With chronic pancreatitis, as with any other dysfunction of the organ of interest to us, there is a failure of the digestive process. This negatively affects the health of the body.

Diabetes

This disease is more severe than pancreatitis. Today, unfortunately, medicine still does not know how to cure it. Diabetes mellitus occurs as a result of a deficiency in the body of such an important hormone as insulin. Due to its deficiency, metabolism is disrupted. Without insulin, the body cannot absorb glucose, which is the most important source of energy. Because of this, its level in the blood increases and in the tissues decreases. Diabetes mellitus requires constant monitoring.

Physiology

When food enters the stomach cavity and its subsequent evacuation into the cavity of the small intestine, the pancreas begins to actively secrete digestive enzymes. These metabolites are initially produced in an inactive form, as they are active metabolites that can digest their own tissues. Once they enter the intestinal lumen, they are activated, after which the cavity stage of food digestion begins.

Enzymes that carry out intracavitary digestion of food:

Trypsin.
Chymotrypsin.
Carboxypeptidase.
Elastase.
Lipase.
Amylase.

After digestion is complete, the broken down nutrients are absorbed into the blood. Normally, in response to an increase in blood glucose, the pancreas will immediately respond by releasing the hormone insulin.

Insulin is the only glucose-lowering hormone in our body. This is a peptide whose structure is a chain of amino acids. Insulin is produced in an inactive form. Once in the bloodstream, insulin undergoes several biochemical reactions, after which it begins to actively perform its function: to utilize glucose and other simple sugars from the blood into tissue cells. With inflammation and other pathologies, insulin production decreases, a state of hyperglycemia occurs, and subsequently insulin-dependent diabetes mellitus.