What is the function of the pancreas in the human body? The work of the pancreas. The special role and importance for the whole organism as a whole

Pancreas, location, functions! Chronic pancreatitis, i.e. Inflammation of the pancreas affects men, women, and even children today.

The pancreas is an unusual organ. It is located deep in the middle part of the abdominal cavity. It simultaneously performs two important functions: digestive and endocrine.

On the one hand, it produces enzymes for the digestion of food. On the other hand, it produces the well-known hormone insulin, the lack of which leads a person to diabetes.

Knowing everything about the functions of the pancreas, you need to eat right those foods that will prevent the occurrence of acute and chronic inflammation, improve digestion. In this way, you can maintain and maintain digestion, and therefore your health.

Where is the pancreas located

This organ is located directly to the left and behind the stomach. If a person begins to have problems with the pancreas, pain appears in the region of the left hypochondrium.

The gland has a head, body and tail. The entire length of this small organ is approximately 15 cm, width 2-3 cm and the same thickness.

In the thickness of the gland there is a huge number of cells that produce enzymes for the digestion of food. Further, along the smallest tubules, the pancreatic juice passes into larger tubules, which, in turn, are combined into one powerful duct called the Wirsung duct.

It penetrates the entire thickness of the gland, starting from the tail, then passes through the body and head of the pancreas. It opens with an outlet or papilla directly into the duodenum. Often, the outlet for the pancreas and gallbladder are combined and their common opening opens into the intestine.

This is a very important point, because if there is a reflux of bile into the pancreas, this is fraught with inflammation and the development of acute pancreatitis!

In the gland, pancreatic juice enzymes are in an inactive state, and only when they enter the intestine and come into contact with food, they are activated and begin their work.

By the way, this is a very important point! Can you imagine what could happen if the pancreas produced enzymes in an active form? They would just digest their own gland! Nature itself protects us.

Unfortunately, this process occurs in acute pancreatitis. That is why, when a person has very severe pains in the upper abdomen on the left, as well as nausea and vomiting, the state of health deteriorates sharply, treatment should be carried out not at home, but in a hospital under the constant supervision of doctors. Otherwise, an unpredictable death is possible.

In general, 98% of the area of the gland falls precisely on the digestive cells, which, by the way, are called acini.

Only 2% of the cells, which are present in the form of inclusions between the acini, provide the hormonal function of this organ. These are the so-called islets of Langerhans, in which hormones are synthesized. Chief among them is insulin, the regulator of carbohydrate metabolism in the body.

DIGESTIVE FUNCTION PANCREAS GLANDS

The exocrine function of the pancreas is its participation in digestion. Thanks to the release of pancreatic juice, food is broken down and absorbed in the intestine.

Digestion begins in the mouth. Here, food is chewed, saponified by saliva enzymes and enters the stomach through the esophagus. And here begins the process of digestion of protein foods under the action of hydrochloric acid and pepsin.

For further processing, food goes to the duodenum 12. It is here that the Wirsung duct opens and pancreatic juice enters.

As part of the juice - several elements:

Bicarbonates are substances that have an alkaline reaction. They are designed to neutralize the acidic contents of the stomach, which enters the initial sections of the intestine;

Water and electrolytes- This is the environment of pancreatic juice in which enzymes reside. It should have a liquid, gel-like consistency. It largely depends on how much liquid we drink per day. If the pancreatic juice washes the food lump worse and the digestion of food will be incomplete. Organ failure will occur, which can also lead to inflammation.

Digestive Enzymes:

Proteases (Trypsin, as well as chymotrypsin, carboxypeptidase and elastase)- continue the breakdown of proteins, begun in the stomach, to peptides, and then to individual amino acids.

Amylase- this enzyme breaks down complex carbohydrates (polysaccharides) to simple components - oligosaccharides, then to glucose, which produces energy for our body.

Lipase- an enzyme that breaks down fats to end products (glycerol and fatty acids). This process is carried out in conjunction with bile acids, which are secreted from the gallbladder and saponify the fats of food.

After being broken down into end products, amino acids, glucose, fatty acids and triglycerides are absorbed into the blood. They are distributed to various tissues of our body. This process takes place in the lower intestines.

ENDOCRINE FUNCTION PANCREAS GLANDS

The location of the islets of Langerhans prevails in the caudal part of the gland, although they can also be found in other areas.

They are made up of cells of different structure. In particular, insulin is synthesized in beta cells. Alpha cells synthesize the hormone glucagon.

Responsible for the absorption of glucose, deposition in the liver and muscles in the form of glycogen, for the formation of glucose from fats and proteins, i.e. gluconeogenesis.

Glucagon provides opposite effects. For example, if the level of glucose in the blood decreases, it promotes the release of glycogen from the depot and energy production.

In addition to insulin, which you, of course, have heard and have an idea of, other hormones are also produced in the pancreas. In addition to glucagon, somatostatin and pancreatic polypeptide are synthesized.

The pancreas is one of the largest in the human body. Its feature is the ability to synthesize hormones and enzymes (enzymes) necessary for the digestion of food. Therefore, it belongs to the group of glands of mixed secretion.

The role of the pancreas in the human body is difficult to overestimate. The enzymes produced in it are directly involved in the exchange of the main source of energy - carbohydrates. And hormones, which are produced by special cells in the body of an organ, help control metabolic processes.

The gland got its name due to localization. When a person lies, its bulk is located precisely under the stomach. The body of the organ is divided into three parts - the "tail", for example, extends to the very gates of the spleen, going to the left and up. But the bulk is surrounded by the duodenum (duodenum), which is located under the stomach.

The body of the organ itself is located in the central part of the epigastrium and continues to the left side, in the direction of the spleen. It is located at the level of 1-2 lumbar vertebrae. The back of the gland is in contact with large vessels - the inferior vena cava and the aorta.

Organ structure

The gland of an adult healthy person has a weight of about 80-90 g. Its structure can be divided into two types - macroscopic and microscopic. Macroscopic structure - features of the organ morphology, its functional parts. The microscopic structure implies an overview of the tissues of the gland and specific cells.

Macroscopic elements include the following components:

The tissue of the organ is covered on the outside with a dense capsule of connective tissue. This helps to protect the gland from possible damage and prevents enzymes from entering the abdominal cavity.

The main glandular tissue consists of lobules, which are separated by strands of connective tissue. These strands contain vessels that feed the glandular tissue and nerves.

Pancreatic juice moves through several types of ducts:

The latter combines the first three types of ducts. They transport pancreatic juice. It is produced in the so-called acini - rounded formations consisting of glandular cells.

Between the acini are the islets of Langerhans. They do not contain ducts, and the structure of their cells differs from glandular ones. The islets of Langerhans consist of specialized cells called insulocytes, which produce certain hormones. These substances through the capillaries enter the general bloodstream, where they affect the entire body.

There are two main types of cells that synthesize specific hormones:

α-cells produce glucagon;
β-cells carry out the production of insulin - the most important component involved in energy metabolism.

There are also delta cells and PP cells, the main function of which is the synthesis of hormones that regulate hunger and pancreatic polypeptide.

Attention! The glandular tissue synthesizes aggressive enzymes, the action of which is aimed at the breakdown of nutrients. Therefore, during invasive diagnostic procedures, such as punctures, it is recommended to exercise maximum caution.

Main functions

The pancreas is called the gland of mixed secretion, because it synthesizes hormones that enter the bloodstream directly, and the usual enzymes that take part in the digestive process.

Participation in the process of digestion

This type of function is also called exocrine function, since the synthesized substance enters other organs, bypassing the bloodstream. The product of this activity is pancreatic juice. It contains a number of enzymes that are directly involved in the process of breaking down complex compounds in food into simpler ones.

Pancreatic juice is a product of pancreatic exo-secretion.

The main enzymes that are produced in the pancreas are trypsy, lipase and alpha-amylase.

Table. Detailed description of human pancreatic enzymes.

Place of synthesis	Fissile Substances	Signs of level violations
Exocrine cells of the pancreas. Formed in the form of trypsinogen, but under the action of enterokinase passes into the active form. Synthesized in acinar cells.	Protein molecules. It also activates proenzymes, which are produced by the gland, to their active state - enzymes.	Activation of enzymes begins in the tissues of the pancreas, which leads to swelling and gradual necrosis of the tissues of the gland.
Prolipase is synthesized in the glandular cells of the pancreas. It passes into the active form under the action of bile and colipase enzymes.	Triglycerides, fat-soluble vitamins (A, E, D, K), polyunsaturated fatty acids.	Increasing the volume and fat content of feces. The appearance of a putrid odor and a change in the color of the stool to dirty gray.
acinar cells of the pancreas.	Breaks down polysaccharides (starch) to oligosaccharides and monosaccharides. Its activity directly depends on calcium ions.	Feeling of heaviness in the stomach, the appearance of flatulence, heterogeneity of feces. The stool may be frothy.

Pancreatic juice is involved not only in the breakdown of food. It neutralizes acidic food masses that move from the stomach to the intestines. For the normal functioning of enzymes in the intestine, a neutral environment is maintained. The secretion of juice does not occur constantly, it directly depends on the intake of food. To activate the synthesis of pancreatic juice, the following factors are required:

Participation in hormonal metabolism

The endocrine role of the pancreas is due to hormones that are synthesized by the cells of the so-called islets of Langerhans. Below is a list of these hormones.

Some pathologies, for example, diabetes mellitus, can occur not only against the background of a decrease in the level of pancreatic hormones, but also as a result of impaired absorption of these substances. For example, type 1 diabetes mellitus is characterized by a violation of the activity of the immune system, when the body begins to synthesize antibodies that attack the tissue of the gland. In this case, the cells of the islets of Langerhans are destroyed, which is accompanied by a decrease in insulin levels. Treatment is aimed at replenishing hormone levels.

Type II diabetes occurs due to the loss of sensitivity of cells to insulin. Cells are oversaturated with nutrients, and therefore stop responding to it. In this case, the islets of Langerhans begin to synthesize more and more insulin, which leads to an increase in blood sugar levels. Treatment for type 2 diabetes involves taking medications to lower blood sugar levels.

Symptoms to look out for

Most often, the cause of violations of the pancreas is non-compliance with recommendations for rational nutrition. The result of pathologies of the organ may be a change in the number of enzymes or a violation of the hormonal background. The main symptoms that accompany violations in the activity of the pancreas are the following:

The most common violations of the work of the body:

Note! Only the attending physician can accurately determine the diagnosis. To do this, he needs to collect an anamnesis, examine the patient, and conduct the necessary tests.

Which doctor should I contact?

A gastroenterologist deals with the treatment of pancreatic diseases if the pathology affects the digestive function. If the hormonal balance is disturbed, the endocrinologist is engaged in treatment.

To maintain normal activity of the pancreas, it is enough to adhere to the principles of rational nutrition and not to abuse alcohol. Since this small organ regulates an important part of the metabolism, it is much easier to prevent violations of its activity than to treat it.

The main thing is timely, given how long the New Year holidays and long feasts are.

Surely this topic will appeal to many, because chronic pancreatitis, i.e. Inflammation of the pancreas affects both men and women, and even children.

The pancreas is an unusual organ. It simultaneously performs two important functions: digestive and endocrine. On the one hand, it produces enzymes for the digestion of food. On the other hand, it produces the well-known hormone insulin, the lack of which leads a person to diabetes.

Pancreas: location, functions everyone should know, so that by the localization of abdominal pain you can guess what kind of disease a person has: appendicitis, cholecystitis or pancreatitis. Knowing everything about the functions of the body, you can eat those foods that will prevent the occurrence of acute and chronic inflammation, improve digestion.

WHERE IS THE PANCREAS LOCATED

This organ is located directly to the left and behind the stomach. If a person begins to have problems with the pancreas, pain appears in the region of the left hypochondrium.

The gland has a head, body and tail. The entire length of this small organ is approximately 15 cm, width 2-3 cm and the same thickness.

This is a very important point, because if there is a reflux of bile into the pancreas, this is fraught with inflammation and the development of acute pancreatitis!

In the gland, pancreatic juice enzymes are in an inactive state, and only when they enter the intestine and come into contact with food, they are activated and begin their work.

By the way, this is a very important point! Can you imagine what could happen if the pancreas produced enzymes in an active form? They would just digest their own gland! Nature itself protects us.

In general, 98% of the area of the gland falls precisely on the digestive cells, which, by the way, are called acini.

Only 2% of the cells, which are present in the form of inclusions between the acini, provide the hormonal function of this organ. These are the so-called islets of Langengars, in which hormones are synthesized. Chief among them is insulin - the regulator of carbohydrate metabolism in the body.

DIGESTIVE FUNCTION PANCREAS GLANDS

The exocrine function of the pancreas is its participation in digestion. Thanks to the release of pancreatic juice, food is broken down and absorbed in the intestine.

For further processing, food goes to the duodenum 12. It is here that the Wirsung duct opens and pancreatic juice enters.

Juice contains several elements:

Bicarbonates are substances that have an alkaline reaction. They are designed to neutralize the acidic contents of the stomach, which enters the initial sections of the intestine;

Water and electrolytes - this is the environment of pancreatic juice in which enzymes reside. It should have a liquid, gel-like consistency. It largely depends on how much liquid we drink per day. If the pancreatic juice washes the food lump worse and the digestion of food will be incomplete. Organ failure will occur, which can also lead to inflammation.

Digestive Enzymes:

Proteases (Trypsin, as well as chymotrypsin, carboxypeptidase and elastase) - continue the breakdown of proteins, begun in the stomach, to peptides, and then to individual amino acids.

Amylase- this enzyme breaks down complex carbohydrates (polysaccharides) to simple components - oligosaccharides, then to glucose, which produces energy for our body.

ENDOCRINE FUNCTION PANCREAS GLANDS

The location of the islets of Langerhans prevails in the caudal part of the gland, although they can also be found in other areas.

They are made up of cells of different structure. In particular, insulin is synthesized in beta cells. Alpha cells synthesize the hormone glucagon.

Responsible for the absorption of glucose, deposition in the liver and muscles in the form of glycogen, for the formation of glucose from fats and proteins, i.e. gluconeogenesis.

Glucagon provides opposite effects. For example, if the level of glucose in the blood decreases, it promotes the release of glycogen from the depot and energy production.

The conclusion that suggests itself is that the hormones produced by the pancreas have a tremendous impact on the metabolism throughout the body, in every cell of ours.

The location of the pancreas in the initial sections of the intestinal tube is due to its digestive function. Digestive enzymes must enter the intestines on time and immediately act on the food bolus.

Dear friends! In the next article, we will analyze what pancreatic diseases are, what are their causes and how they should be treated.

The pancreas is an organ of the digestive system that provides the digestion of nutrients - fats, proteins, carbohydrates. However, the pancreas is an organ of the endocrine system. It secretes hormones into the blood that regulate all types of metabolism. Thus, the pancreas performs two functions - endocrine and exocrine.

endocrine function of the pancreas

The pancreas secretes into the blood five hormones that regulate mainly carbohydrate metabolism. The endocrine part of the pancreas makes up no more than 2% of the total mass of the organ. It is represented by the islets of Langerhans - clusters of cells that are surrounded by the pancreatic parenchyma.

Most of the islets of Langerhans are concentrated in the tail of the organ. For this reason, damage to the tail of the pancreas by an inflammatory process often leads to insufficiency of the endocrine function of the organ. The islets of Langerhans contain different types of cells that secrete different hormones. Most of all, they contain beta cells that produce insulin.

Functions of pancreatic hormones

The pancreas produces five hormones. Two of them significantly affect metabolism. These are insulin and glucagon. Other hormones are less important for the regulation of metabolism, or are secreted by the pancreas in small quantities.

Insulin An anabolic hormone whose main function is to transport sugar into the cells of the body. It lowers blood glucose levels by:

changes in cell membrane permeability to glucose
activation of enzymes that break down glucose
stimulate the conversion of glucose to glycogen
stimulate the conversion of glucose into fat
inhibition of glucose formation in the liver

Other functions of insulin

stimulates the synthesis of proteins and fats
prevents the breakdown of triglycerides, glycogen and proteins

Glucagon Takes an important part in carbohydrate metabolism. The main function of this pancreatic hormone is to stimulate glycogenolysis (the process of splitting glycogen, during which glucose is released into the blood).

In addition, glucagon:

activates the formation of glucose in the liver
stimulates the breakdown of fat
stimulates the synthesis of ketone bodies

Physiological action of glucagon:

increases blood pressure and heart rate
increases the force of heart contractions
promotes smooth muscle relaxation
enhances blood supply to muscles
increases the secretion of adrenaline and other catecholamines

Somatostatin It is produced not only in the pancreas, but also in the hypothalamus. Its only function is to suppress the secretion of other biologically active substances:

serotonin
growth hormone
thyroid-stimulating hormone
insulin
glucagon

Vasoactive intestinal peptide Stimulates intestinal peristalsis, increases blood flow to the digestive tract, inhibits the production of hydrochloric acid, enhances the production of pepsinogen in the stomach.

Pancreatic polypeptide Stimulates gastric secretion. Suppresses the exocrine function of the pancreas.

Physiological action of pancreatic glucagon

The exocrine function of the pancreas is the secretion of pancreatic juice. Through the duct system, it enters the duodenum, where it participates in the process of digestion. The secret of the pancreas contains:

enzymes - break down nutrients that enter the intestines with food
bicarbonate ions - alkalinize the gastric juice entering the duodenum from the stomach

The regulation of the exocrine function of the pancreas is carried out by hormones that are produced in the stomach and intestines:

cholecystokinin
secretin
gastrin

All these substances inhibit the activity of the pancreas. They are produced in response to stretching of the walls of the stomach and intestines. Their secretion is stimulated by pancreatic juice that enters the duodenum after eating.

Functions of pancreatic enzymes

The pancreas produces enzymes that digest all kinds of nutrients - carbohydrates, proteins and fats.

1. Proteases Enzymes that break down proteins. Considering that there are many types of proteins, the pancreas produces several types of proteolytic enzymes:

chymotrypsin
elastase
trypsin
carboxypeptidase

2. Lipase This enzyme breaks down fats.

3. Amylase An enzyme that breaks down polysaccharides (complex carbohydrates).

4. Nucleases Several types of enzymes that break down nucleic acids (DNA and RNA).

Pancreatic dysfunction

Some diseases of the pancreas are accompanied by dysfunction of this organ. Most often this occurs in acute or chronic pancreatitis, when, due to the inflammatory process, most of the pancreatic parenchyma is destroyed. Exocrine function is impaired over time in most patients with chronic pancreatitis. Endocrine - in about a quarter of patients.

Violation of exocrine function is accompanied by indigestion and dyspeptic symptoms. This condition is characterized by the following symptoms:

polyfecal matter
frequent and loose stools
the presence of fat in the stool
flatulence
weight loss

In case of violation of the endocrine function of the pancreas, diabetes mellitus usually develops. It is milder than classic type 1 diabetes because not all beta cells in the islets of Langerhans are destroyed. However, after a few years from the onset of the disease, the patient usually needs insulin injections. Sometimes it is possible to normalize the level of glucose in the blood with the help of diet and hypoglycemic drugs.

It is an important organ of the digestive system with a mixed function: external (exocrine) and internal (endocrine). The function of external secretion is to secrete pancreatic juice, which contains digestive enzymes necessary for the complete digestion of food. The endocrine function consists in the production of appropriate hormones and the regulation of metabolic processes: carbohydrate, fat and protein.
What does the pancreas do?

exocrine function

Every day the pancreas produces 500-1000 ml of pancreatic juice, consisting of enzymes, salts and water. Enzymes produced by the pancreas are called "proenzymes" and are produced by the pancreas in an inactive form. When a lump of food enters the duodenum, hormones are released, with the help of which a chain of chemical reactions is launched that activates the enzymes of pancreatic juice. The most powerful stimulant of pancreatic secretion is hydrochloric acid of gastric juice, which, when it enters the small intestine, activates the secretion of secretin and pancreozymin by the intestinal mucosa, which in turn affects the production of pancreatic enzymes.

These enzymes include:

Amylase, which breaks down carbohydrates;

Trypsin and chymotrypsin, involved in the process of protein digestion, which begins in the stomach;

Lipase responsible for the breakdown of fats that have already been exposed to bile from the gallbladder.

Additionally, pancreatic juice contains trace elements in the form of acidic salts, which ensure its alkaline reaction. This is necessary to neutralize the acidic component of food from the stomach and create suitable conditions for the absorption of carbohydrates.

The secretion of pancreatic juice is regulated by nervous mechanisms and is associated with food intake, i.e. food of various composition stimulates the production of juice of different volume and content of enzymes. It accumulates in the interlobular ducts, which merge into the main excretory duct, which flows into the duodenum.

endocrine function

The internal secretory function of the gland is to secrete the hormones insulin and glucagon into the blood. They are produced by groups of cells interspersed between the lobules and do not have excretory ducts - the so-called islets of Langerhans, located in significant numbers in the tail of the gland. The islets of Langerhans are composed primarily of alpha cells and beta cells. Their number in healthy people reaches 1-2 million.

Insulin is produced by beta cells and is responsible for the regulation of carbohydrate and lipid (fat) metabolism. Under its influence, glucose enters from the blood into the tissues and cells of the body, thereby lowering the blood sugar level. Beta cells make up 60-80% of the islets of Langerhans.

Glucagon is produced by alpha cells and is an insulin antagonist, i.e., increases blood glucose levels. Also, alpha cells are involved in the production of the substance lipocaine, which prevents fatty degeneration of the liver. Their share in the islets of Langerhans is about 20%.

The islets of Langerhans also contain small amounts of other cells, such as delta cells (1%), which secrete the hormone ghrelin, which is responsible for appetite and stimulates food intake. PP cells (5%) produce a 36 amino acid pancreatic polypeptide that inhibits pancreatic secretion.

The destruction of beta cells leads to inhibition of insulin production, which can trigger the development of diabetes. Symptoms of this are constant thirst, itching, increased urine output.

The pancreas is in close relationship with other organs of the digestive tract. Any damage to it or failures in activity negatively affects the entire digestive process.

The pancreas is located in the abdominal cavity behind the stomach, closely adjoining it and the duodenum, at the level of the upper (first or second) lumbar vertebrae. In the projection on the abdominal wall, it is 5-10 cm above the navel. The pancreas has an alveolar-tubular structure and consists of three sections: head, body and tail.

The head of the pancreas is located in the bend of the duodenum so that the intestine surrounds it in the shape of a horseshoe. It is separated from the body of the gland by a groove along which the portal vein passes. The blood supply to the pancreas is carried out through the pancreatic-duodenal arteries, the outflow of blood occurs through the portal vein.

In the body of the pancreas, the anterior, posterior and inferior surfaces are distinguished. It also distinguishes the upper, front and lower edges. The anterior surface adjoins the posterior wall of the stomach, slightly below. The posterior surface is adjacent to the spine and abdominal aorta. Vessels of the spleen pass through it. The lower surface is below the root of the transverse colon. The tail of the gland is cone-shaped, directed upward and to the left, and reaches the hilum of the spleen.

The pancreas consists of 2 types of tissue with different functions (endocrine and exocrine). Its main tissue is made up of small lobules - acini, which are separated from each other by layers of connective tissue. Each lobule has its own excretory duct. Small excretory ducts are interconnected and merge into a common excretory duct, which runs in the thickness of the gland along its entire length, from tail to head. At the right edge of the head, the duct opens into the duodenum, connecting with the common bile duct. Thus, the pancreatic secret enters the duodenum.

Between the lobules are groups of cells (Islets of Langerhans) that do not have excretory ducts, but are equipped with a network of blood vessels and secrete insulin and glucagon directly into the blood. The diameter of each island is 100-300 µm.
Size of the pancreas

In terms of size, the pancreas is the second largest enzyme-producing organ after the liver. Its formation begins as early as the fifth week of pregnancy. In a newborn child, the gland has a length of up to 5 cm, in a one-year-old - 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 average width is 1.75-2.5 cm. Length tail - up to 3.5 cm, width about 1.5 cm.

Due to the deep location, the diagnosis of pancreatic pathologies is very difficult. Therefore, an important point in the diagnosis is an ultrasound study, 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 dimensions of the organ, as well as the possible causes of their changes, are recorded in detail in the ultrasound protocol. In an unchanged state, iron has a homogeneous structure. Small deviations from the normal size of the head, body and tail are only acceptable if the biochemical blood test is good.

The size of the pancreas is normal

The length of the gland of 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 in the production of the following enzymes that are part of the pancreatic juice: trypsin, lipase and amylase:

Trypsin breaks down peptides and proteins. It is initially produced by the pancreas as an 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 the determination of its level is more significant 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 the identification of its pathogenesis.

Lipase is a water-soluble enzyme that digests and dissolves triglycerides (neutral fats). It is produced as an inactive prolipase, and then, under the influence of other enzymes and bile acids, it passes into the active form. Lipase breaks down neutral fats into higher fatty acids and glycerol. Also, this enzyme is involved in energy metabolism, providing 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, lungs, and each type of lipase is a catalyst for the breakdown of a certain group of fats. With hypofunction of the pancreas, lipase activity decreases first of all. The first sign of this is greasy, grey-yellow stools.

Amylase (alpha-amylase) is necessary for the processing of carbohydrates entering the body. It is secreted by the pancreas and (to a lesser extent) by the salivary glands. Changes in the content of this enzyme in the blood are characteristic of many diseases (, etc.), however, first of all, this indicates.

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 only perform their functions if there is enough bile produced by the gallbladder. Bile activates enzymes and also breaks lipids into smaller droplets, i.e., prepares them for splitting. Pancreatic enzymes are produced in an inactive form and are activated only in the duodenal lumen by the action of enterokinase.

Symptoms of pancreatic enzyme deficiency

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 a gradual degeneration of glandular tissue into connective tissue.

In the first place among the causes leading to pancreatitis is alcohol abuse, among other reasons, one can single out improper, irrational nutrition, concomitant diseases (cholelithiasis), infections, injuries, and taking certain medications.

The lack of trypsin, lipase and amylase causes serious disorders of the digestive process.

Common symptoms of pancreatic problems include:

pain in the upper left side of the abdomen under the ribs, which often occurs after eating, but may not be associated with eating;

decrease or complete disappearance of appetite;

changes in stool color and consistency.

The severity of these symptoms depends on the degree of damage to the gland. As a result of poor digestion, the body lacks nutrients, and metabolic disorders can lead to,.

Lipase deficiency is characterized by steatorrhea (excessive excretion of fat with feces), the stool may be yellow or orange, sometimes there is a release of liquid fat without feces; loose, oily stool.

With a lack of amylase, there is intolerance to foods rich in carbohydrates, frequent, loose, watery voluminous stools due to excess starch, malabsorption (malabsorption of nutrients in the small intestine, accompanied by beriberi, weight loss), a high content of opportunistic microflora in the intestine .

Trypsin deficiency is expressed in moderate or severe creatorrhoea (increased content of nitrogen and undigested muscle fibers, i.e. protein in the feces), the stool is mushy, fetid, and anemia may develop.

Since the process of splitting complex food molecules is disrupted, and it is not fully absorbed by the body, even with enhanced nutrition, weight loss, vitamin deficiency, dry skin, brittle nails and hair can be noted. When poorly processed food enters the large intestine from the small intestine, flatulence (increased gas formation and gas discharge), frequent defecation occurs.

With reduced secretion of enzymes by the pancreas, replacement therapy is prescribed, however, enzymes of plant origin cannot fully compensate for the insufficiency of its external secretion.

If the outflow of enzymes into the intestine is disturbed, this can lead to irritation of the tissues of the gland and its swelling, and subsequently to destruction and.

When the islets of Langerhans are affected, insulin production is suppressed and clinical symptoms of type 1 diabetes are observed, the severity of which will depend on the number of preserved and fully functioning beta cells. Deficiency in glucagon secretion is not felt as strongly, as there are other hormones that have a similar effect: for example, steroid hormones produced by the adrenal glands that increase blood glucose levels.

The most common pathologies of the pancreas are pancreatitis (acute or chronic), stones in the excretory ducts, pancreatic adenocarcinoma, diabetes, necrosis.

With inflammation (pancreatitis) and damage to the pancreas, the following symptoms are noted:

Pain in left side under ribs;

Cardiopalmus;

Yellowness of the skin and eye proteins;

Vomiting, diarrhea;

In some cases, a state of shock.

In acute pancreatitis, the pain is severe, acute, begins suddenly, may have a shrouding character, that is, cover the entire left side and go behind the back. The pain is not relieved by antispasmodics, it decreases in a sitting position or when leaning forward. In some cases, an increase in the pancreas is physically felt: there is a feeling of fullness from the inside, pressure on the area of \u200b\u200bthe ribs, which interferes with normal breathing.

The stronger the pain, the more the gag reflex increases. Sometimes attacks of vomiting begin earlier than the pain syndrome: it usually occurs in the morning or during meals, as a result of gastric spasm. Vomiting has a bitter or sour taste, after it comes temporary relief. It can be either periodic or systematic. In the event of an acute attack of pancreatitis, it is necessary to consult a doctor and receive treatment in a hospital, since this disease will not go away on its own. With persistent vomiting, the stomach is cleaned with a probe and special enzymes are administered to calm the excessive aggressiveness of the stomach and pancreas.

Symptoms of pancreatitis are sometimes similar to signs of osteochondrosis of the lumbar spine, an attack of pyelonephritis or shingles. Pancreatitis can be differentiated as follows: with osteochondrosis, palpation of the vertebrae is painful; with (herpes virus) a rash appears on the skin; in acute pain is aggravated by tapping on the back in the projection of the kidneys, and then blood appears in the urine. All these signs are absent in pancreatitis.

In the case of chronic pancreatitis, the pain is less severe, exacerbations usually occur after a diet violation (eating a large amount of fatty foods) and alcohol abuse. To date, it has not been precisely established how alcohol affects the pancreas: either it prevents the outflow of pancreatic juice, or changes its chemical composition, thereby provoking an inflammatory process. Another reason may be blockage of the excretory ducts of the gland by gallstones. In chronic pancreatitis, the risk of developing an oncological process in the pancreas increases: it occurs in 4 cases out of 100 in patients with pancreatitis.

With a constant pain syndrome, a feeling of addiction may appear, and the person will no longer feel pain so sharply. This is dangerous because you can miss the development of necrosis or serious complications. The human body has a certain margin of strength and resistance and can independently regulate metabolic processes for a long time even in the presence of some disorders, but with the depletion of internal resources, the process of development of pancreatic tissue necrosis can be very fast and irreversible.

Diagnostics

If pancreatitis is suspected, the doctor interrogates and examines the patient, paying attention to the color of his skin and mucous membranes. Sometimes the pain can have different localization depending on which part of the gland is damaged. If it hurts above the navel in the right hypochondrium, then the head of the gland is involved in the pathological process, if in the left - the tail. Vague girdle pain in the upper abdomen indicates the defeat of the entire gland. It is possible to differentiate problems with the pancreas and the transverse colon as follows: the doctor palpates the painful area, first in the supine position, and then on the left side. With the defeat of the pancreas, the pain in the position on the side will be less severe, with problems with the transverse colon, it will remain the same.

From laboratory tests, the determination of the levels of amylase, lipase, trypsin in the blood serum is prescribed. With a general blood test, an increase in the level of leukocytes is observed. Additionally, the activity of liver enzymes can be investigated: ALT and alkaline phosphatase, as well as bilirubin, their increase may be a sign of an attack of pancreatitis provoked by gallstones. Also, a urine test for amylase is performed using a PABA (PABA) test, a stool test for the presence of chymotrypsin, trypsin and high fat content. To detect disorders of carbohydrate metabolism, the amount of glucose in the blood is determined.

Of the instrumental methods can be used:

Radiography - with its help it is determined whether the pancreas is enlarged or not;

Computed tomography or MRI - to clarify the diagnosis, identify pancreatic necrosis or fluid accumulation in the abdominal cavity;

Ultrasound - to study the structure and nature of the contours of the gland, the state of the common excretory duct, to determine the presence of gallstones.

Treatment

With an attack of acute pancreatitis, complete fasting is necessary for 1-2 days, since pancreatic juice in this case will be produced in a minimal amount, and the load from the gland will be removed. Usually appetite decreases or even disappears a few days before the exacerbation. During this period, you need to drink alkaline water (mineral water without gas, baking soda solution) or rosehip broth.

In case of severe pain in the abdomen, severe vomiting or moderate pain for several days, you should definitely contact a medical institution, since such symptoms can also be signs of cholecystitis, appendicitis, peptic ulcer or intestinal obstruction.

In the case of acute pancreatitis, hospitalization and treatment in a hospital is necessary. To prevent dehydration and normalize pressure, a dropper is placed. Painkillers and drugs that suppress the secretion of enzymes are prescribed. In the first 3-4 days they are administered intravenously, and after some relief they are taken in the form of tablets. Ice may be applied to the area of the pancreas to reduce pain.

Painkillers

The most commonly used antispasmodics: Baralgin, No-Shpa, Papaverine, Drotaverine, with moderate pain, Acetaminophen or Ibuprofen can be used. Sometimes analgesics are used: Aspirin, Paracetamol. Anticholinergic and antihistamine drugs can also be used: Atropine, Platifillin, Diphenhydramine.

Antacids

To relieve pain and prevent irritation and ulceration of the gastric mucosa, drugs are used in the form of suspensions and gels that neutralize hydrochloric acid (Almagel, Phosphalugel) and agents that reduce its production (Contralok, Omez, Omeprazole, Gastrozol, Proseptin, Ocid). In hospitals, H2-blockers Ranitidine, Famotidine or their analogues Acidex, Zoran, Gasterogen, Pepsidine are prescribed.

Enzyme preparations

In order to reduce the production of enzymes, Kontrykal or Aprotinin are used. After the removal of an acute attack and in chronic pancreatitis, enzyme therapy is prescribed to maintain pancreatic function and improve digestion. The most common drugs are Pancreatin, Mezim, Festal, Creon, Panzinorm. However, they are made on the basis of pork protein, so if you have an allergic reaction to pork, you should not take them. In children, such an allergic reaction can cause intestinal obstruction. In this case, herbal preparations based on rice fungus or papain are prescribed: Unienzyme, Somilase, Pepfiz.

Enzymes are taken immediately after meals, the dose is prescribed by the doctor individually. The course of treatment is long, often maintenance therapy becomes necessary throughout life.

Of the other drugs stimulate the secretion of the pancreas, pilocarpine, morphine, vitamin A, magnesium sulfate, lower - histamine and atropine. In violation of exocrine function, insulin preparations are prescribed to regulate the level. Self-medication with damage to the pancreas is unacceptable. This can result in her necrosis, diabetes mellitus or blood poisoning.

Complications of chronic pancreatitis can be blockage of the blood vessels of the organ, bile ducts, gland cyst, infection or necrosis of its tissues (necrosis).

Surgery

The pancreas is a very delicate and sensitive organ, so any surgical intervention is highly undesirable. An operation may be required in case of blockage of the ducts of the gland, in the presence of a cyst, with stones in the gallbladder (sometimes the gallbladder itself is removed), if necessary, remove part of the pancreas due to the development of pancreatic necrosis.
How to take care of the pancreas?

As part of the "Health" program, the head physician of the EXPERT polyclinic, MD, Professor Sabir Nasredinovich Mehdiyev tells how to maintain the health of the pancreas:

The role of diet in the treatment of the pancreas

Dieting is a very important element in the treatment and prevention of exacerbations of pancreatitis. If this is neglected, any medication may be powerless. Since the qualitative and quantitative ratio of enzymes produced by the gland varies depending on the composition of the foods consumed at one meal, it is recommended to switch to a separate diet in order to reduce the load on the gland, i.e. eat proteins and carbohydrates at different meals. You should also not overeat: the daily calorie content of the diet should not exceed the norm corresponding to age, gender and physical energy costs.

Prohibited Products:

Fatty foods, fried foods;

Sausages, canned food, smoked meats, pickles;

Aspic, aspic;

Alcohol;

acidic juices;

Strong tea and coffee;

Confectionery (cakes, pastries), ice cream;

Hot spices, spices and seasonings, mustard, horseradish.

Allowed products:

Chicken, turkey, rabbit, fish - cod, bream, pike perch, pike;

Steamed dishes;

Kefir, curdled milk;

Non-acidic cottage cheese, unleavened cheese;

Vegetables boiled or baked;

Vegetable, cereal, vermicelli soups;