The pancreas is a small organ with two substantial functions--production of insulin to regulate use of blood sugar and production of digestive enzymes that break down dietary fats, starches and proteins into absorbable components. Pancreatic insufficiency describes the medical condition that results from inadequate production and release of pancreatic digestive enzymes. A variety of inflammatory, inherited and acquired conditions can cause pancreatic insufficiency, which leads to malnutrition due to the inability to digest food.
Alcoholic Chronic Pancreatitis
Chronic pancreatitis represents a persistent inflammation of the pancreas, which provokes progressive damage, scarring and loss of function. Inflammation causes swelling of the tubes within the pancreas that transport the digestive enzymes, which build up within the tissues. The combined effects of the inflammatory reaction and the presence of backed-up digestive enzymes destroys the acinar cells, which produce digestive enzymes. The loss of acinar cells within the pancreas is irreversible. Over time, pancreatic insufficiency develops as increasing numbers of acinar cells are lost.
Protracted, excessive consumption of alcohol is the leading cause of chronic pancreatitis, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Most cases of alcoholic pancreatitis develop after years of serial attacks of alcohol-induced acute pancreatitis.
Cystic Fibrosis
Cystic fibrosis is an inherited condition that causes production of abnormally sticky, thick secretions. Cystic fibrosis affects the composition of the pancreatic digestive fluids, which do not flow normally through the pancreas due to increased thickness. The National Heart, Lung and Blood Institute explains that thick fluids clog the tubular transport system within the pancreas, provoking inflammation and a series of progressive degenerative changes that mirror those seen with other forms of chronic pancreatitis. Pancreatic insufficiency commonly develops, leading to malnutrition with large volume, loose stools possessing a greasy texture and a foul odor. Children with cystic fibrosis often fail to meet normal growth milestones due to ongoing nutritional deficits related to pancreatic insufficiency.
Pancreatic Cancer
Pancreatic cancer may cause pancreatic insufficiency. The National Cancer Institute reports that approximately 95 percent of pancreatic cancers arise from the cells of the exocrine pancreas--those involved in the production and transport of digestive enzymes and fluids. Cancerous pancreatic tumors, or ductal adenocarcinomas, may block the duct responsible for the secretion of digestive enzymes into the intestine, leading to pancreatic insufficiency. Alternatively, the cancer cells may increasingly encroach on normal acinar cells, leading to their demise. Often, both processes contribute to pancreatic insufficiency. The American Cancer Society estimates the occurrence of more than 43,100 new cases of pancreatic cancer in the United States in 2010, with men and women equally affected.
References
- National Institute of Diabetes and Digestive and Kidney Diseases: Chronic Pancreatitis
- Merck Manual for Healthcare Professionals: Chronic Pancreatitis
- National Heart, Lung and Blood Institute: Cystic Fibrosis
- American Cancer Society: Cancer Facts and Figures 2010
- National Cancer Institute: General Information About Pancreatic Cancer
