What Is the Pancreas?

Medically Reviewed by Jabeen Begum, MD on January 09, 2024
Written by Candina Jordan, Shawna Seed
8 min read

Your pancreas, a 6- to 10-inch-long elongated organ, sits in your upper left belly area, right behind your stomach. It plays a large role in digesting food and regulating blood sugar. By producing enzymes and hormones, your pancreas helps your body break down food, control your blood sugar, tell your stomach when to empty, and more. 

Your pancreas is shaped like an elongated pear that extends horizontally across your belly area. The widest part, called the head, is near the center of the belly, the point where the stomach meets the small intestine. The middle part of the pancreas is called the neck or body, and it extends to the left, where it tapers to a thin end called the tail. 

Several major blood vessels supply blood to your pancreas and other organs in your belly, including the superior mesenteric artery, the superior mesenteric vein, the portal vein, and the celiac axis. 

Almost 95% of your pancreas is made up of a type of tissue that produces digestive enzymes called exocrine tissue. The other 5% is made up of cells called islets of Langerhans, which produce hormones. 

Your pancreas makes about 8 ounces of digestive juices every day. These juices contain enzymes to break down your food. These enzymes empty into the upper part of your small intestine and include: 

  • Lipase, which works with bile produced by your liver to break down fat
  • Protease, which breaks down protein in your diet and protects you from some types of bacteria and yeast that live in your intestine
  • Amylase, which breaks down starches into sugar so your body can use them for fuel

The pancreas also produces hormones that are released directly into your blood. Hormones from your pancreas carry messages to other parts of your digestive system. The hormones produced by your pancreas are: 

Insulin

The beta cells in your pancreas produce insulin. They make up about 75% of the hormone-producing cells in your pancreas. Insulin helps your body use sugar for energy. 

Glucagon

Glucagon is produced by your alpha cells, which make up about 20% of the hormone-producing cells in your pancreas. Glucagon is a hormone that tells your liver to release extra sugar if your blood sugar gets too low. 

Gastrin

Gastrin is a hormone that tells your stomach to produce stomach acids. It's mostly produced in your stomach, but a small amount is produced in the pancreas. 

Amylin

Amylin is also produced in your beta cells. This hormone helps control your appetite and when the contents of your stomach are emptied. 

If your pancreas isn't working properly, you might be in pain and have digestive issues. There are several ways a doctor can check how well your pancreas is working. 

Lab tests

A sample of your blood will be taken and sent to a lab, where experts will check for abnormal levels of enzymes, blood sugar (glucose), and blood fats (lipids). A blood test also can show signs of infection or inflammation in your pancreas, gallbladder, bile ducts, or liver. You might also give a stool sample so the doctor can tell whether your body is absorbing fat properly. 

Imaging tests

Your doctor might order an ultrasound, CT scan, or MRI to get a better look at your pancreas. Imaging tests can show inflammation or swelling, an abscess or tumor, or problems like gallstones or a cyst. 

Pancreatic function test (PFT) 

This test checks how your body responds to a hormone that comes from your small intestine. First, you'll receive an injection through an IV that contains a substance called secretin that stimulates your pancreas. Then they'll place a tube down your nose and throat to suck out the fluid that your pancreas sends into your small intestine. (Your nose and throat are numbed.) The fluid will be analyzed in the lab to see how your pancreas is working. 

Endoscopic ultrasound (EUS)

Your doctor might recommend this test if something appeared abnormal on a previous test, or if you can't have a CT or MRI for some reason. It combines ultrasound with an upper endoscopy, which involves putting a long, flexible tube down your throat. The doctor can take tissue for testing – a biopsy – during this procedure if needed. 

Endoscopic retrograde cholangiopancreatography (ERCP)

This test isn't done very often. It uses an endoscope down your throat, too, but combines it with a type of X-ray called fluoroscopy instead of ultrasound. Contrast dye is injected into your digestive system, allowing the doctor to see your pancreas in more detail. Your doctor might remove something blocking a bile duct or place a stent during the procedure. You're not awake during an ERCP.

There are several common problems that can affect your pancreas, including: 

Diabetes

Diabetes happens when your pancreas doesn't produce enough insulin or your body can't effectively use the insulin it does produce. Insulin is a hormone that lets sugar into your blood cells so your body can use it for energy. When your body can't use insulin or there isn't any to use, too much sugar stays in your bloodstream. This can cause health problems such as heart disease, loss of vision, and kidney disease. 

Pancreatitis

Pancreatitis is inflammation of your pancreas. It happens when digestive enzymes build up in your pancreas and it starts digesting itself. This is usually caused by a gallstone that blocks the tube that empties the digestive enzymes out of the pancreas. This type of pancreatitis usually clears up when the gallstone is removed. Pancreatitis can also be caused by too much alcohol. This type of pancreatitis is known as chronic pancreatitis and doesn't clear up. 

Pancreatic cysts

Pancreatic cysts are sacs filled with fluid that grow on the pancreas. Many of these are benign (noncancerous). Some pancreatic cysts, though, are linked to pancreatitis and pancreatic cancer. 

Pancreatic cancer

Pancreatic adenocarcinoma is the most common type of pancreatic cancer. This type of cancer accounts for about 95% of pancreatic cancers. It starts in the tissue that makes digestive enzymes. The other 5% of pancreatic cancers start in the cells that produce hormones. 

Diabetes

This condition is usually treated with a combination of medicine, blood sugar monitoring, and lifestyle changes. 

Pancreatitis

If your pancreatitis comes on suddenly, that's called "acute" pancreatitis. It's sometimes the result of gallstones blocking bile ducts, causing enzymes to build up in your pancreas. You may need to stay in the hospital receiving IV fluids to keep you hydrated and medicine to manage your pain. If your gallbladder is the source of the problem, you may have surgery to remove it. Other causes of acute pancreatitis include injury to your pancreas, high triglyceride or calcium levels, and pancreatic cancer.

Chronic pancreatitis

This is a long-term condition. Common causes include excessive alcohol use, high triglycerides or calcium, damage from acute pancreatitis, or a genetic condition. In some cases, doctors can't find the cause. That's called "idiopathic" pancreatitis. Treatments for chronic pancreatitis include managing your pain and taking medicine to help your pancreas work better. You might have surgery to remove a part of your pancreas that is damaged or infected. In some cases, the entire pancreas will be removed.

Pancreatic cysts

Your doctor may decide to monitor a pancreatic cyst if your symptoms aren't too troublesome. The doctor will develop a treatment plan if the cyst grows or your symptoms worsen. A cyst can also be drained during an endoscopy. Some cysts have to be removed by surgery. 

Pancreatic cancer

Treatment for pancreatic cancer depends on how advanced the cancer is and where it is in your pancreas. You may have surgery, chemotherapy, radiation, or all three. If your cancer is very advanced, you may focus on treatment that manages your symptoms for as long as possible.

You and your doctor might decide the best treatment for you is to remove your entire pancreas, usually because of cancer or severe chronic pancreatitis. The surgery is called pancreatectomy.

When surgeons remove your entire pancreas, they have to remove other organs too, including your spleen and gallbladder, as well as lymph nodes and part of your small intestine and stomach. Without your pancreas to produce the hormones and enzymes you need, you'll have trouble managing your blood sugar and getting nutrients from your food. You'll have to take medicine to help with that. 

If your entire pancreas is removed, you'll probably have diabetes and need to take insulin for the rest of your life. In some cases, a surgeon may be able to retrieve some insulin-producing cells from your pancreas and implant them in your liver, which may provide you a natural source of insulin.

The surgery is done under general anesthesia. Some hospitals might offer a robotic or laparoscopic version, which is less invasive. But you may need to have what's called "open" surgery. The surgeon will make a long cut across your belly, providing access to the organs to be removed. 

You can take steps to help keep your pancreas healthy. They include: 

  • Drink alcohol in moderation. 
  • Don't smoke. Tobacco use is linked to 20% to 30% of pancreatic cancers. 
  • Keep your diet low in fat. High fat levels in your blood (triglycerides) put you at risk of pancreatitis.
  • Exercise 30 minutes a day and maintain a healthy weight. This will help you avoid gallstones and diabetes. 
  • Let your doctor know if you have a family history of pancreatic cancer, the BRCA2 gene linked to breast cancer, or familial atypical multiple mole melanoma (FAMMM) syndrome. Any of those diseases in your family increases your risk of pancreatic cancer. 

Over-the-counter pancreas health supplements are often marketed as a way to lose weight, especially in your belly. They may contain amylase, lipase, protease, lactase, and alpha-galactosidase. The supplements aren't regulated by the FDA. Information about dosage, ingredients, and side effects might be incorrect or missing. A healthy person probably doesn't need such a supplement. If you have a problem with your pancreas that affects your digestion, your doctor can prescribe medicine to help. 
 

Can you live without a pancreas?

Yes, you can live after having your pancreas removed. You'll need medication to replace digestive enzymes, and you'll probably have diabetes and need insulin for the rest of your life. 

What are the signs of pancreas problems?

If you have a problem with your pancreas, you're likely to have severe pain in your belly. It may spread to your back, and it may get worse after you eat. Nausea, vomiting, and a tender belly are some other common symptoms.

How does the pancreas connect with the rest of the digestive system?

Your gallbladder, liver, and spleen surround your pancreas. They are connected by ducts.