Pancreatic insufficiency

Synonyms in a broader sense

Definition

Pancreatic insufficiency (pancreatic insufficiency) is a disease of the pancreas which, depending on its form, is associated with a reduced, insufficient production of important digestive enzymes or hormones.

Causes

Insufficiency of the pancreas can have a variety of causes, but they all have in common that they all cause destruction of the pancreatic tissue. Pancreatic insufficiency (insufficiency of the pancreas) is therefore a consequence, not a disease in its own right. In adults, the cause of insufficiency is usually chronic inflammation of the pancreas (pancreatitis), i.e. pancreatitis.

In this case, the inflammation initially causes an increased release of pancreatic enzymes. This excess of digestive enzymes can lead to the pancreas itself being attacked and, as a result of this damage, no longer being able to produce enzymes or hormones, resulting in pancreatic insufficiency. However, a malignant tumour (pancreatic carcinoma), a cyst (a fluid-filled cavity in the pancreas) or fibrosis can also cause pancreatic insufficiency.

Fibrosis is a pathological proliferation of connective tissue in an organ, resulting in hardening and scarring and the organ can no longer perform its function. This can also occur in the pancreas. Fibrosis usually occurs in the course of cystic fibrosis, a hereditary disease. Certain diseases of the gastrointestinal tract, such as Crohn’s disease and peptic ulcers, or even autoimmune diseases such as systemic lupus erythematosus, can also lead to pancreatic insufficiency.

Symptoms of pancreatic insufficiency

Pancreatic insufficiency (weakness of the pancreas) leads to a deterioration in the function of the cells and even to their destruction, which leads to loss of function. This leads to an insufficient production of pancreatic enzymes. These enzymes play an important role in the digestion of carbohydrates, fats and proteins.

If they are missing, the body is no longer able to break down the food into smaller portions, which are later absorbed by the intestines and can thus enter the blood and other organs. This leads to a disturbed digestion, also called maldigestion. It manifests itself in general symptoms such as nausea, vomiting, cramping or so-called colicky abdominal pain in the entire digestive tract.

This means that the pain can be in the upper abdominal area, but can also occur in the entire area of the intestine. Further consequences of pancreatitis are flatulence (also called meteorism) and diarrhoea. In steatorrhoea, also known as “fatty stools”, a light, brownish shiny colour is characteristic for these diarrhoea cases.

This typical picture of stool is caused by the body’s inability to digest the fats contained in food, so that they leave the body more or less undigested and thus unused. As a result of the poor digestive system, weight loss occurs and even with good nutritional intake, weight gain is insufficient. Furthermore, the fat-soluble vitamins A, D, E and K can no longer be absorbed by the intestines, which leads to further deficiency symptoms in the body.

This leads to a deficient or missing production of insulin, so that the metabolic state of a diabetic develops. Carbohydrates and sugars cannot be absorbed via the blood by muscles and organs, especially the liver, because the hormone insulin is missing. The consequences are, too high “sugar levels” in the blood and an insufficient supply of energy for muscles and organs. Over the years, the consequences develop similar to those of normal diabetes: poorly healing wounds, impaired vision or sensitivity disorders in the legs. Glucagon, the antagonist of insulin, which can convert carbohydrates, fats and proteins into quickly effective energy-providing substances if necessary, can also only be formed insufficiently, so that on the other hand hypoglycaemia can easily occur, which in turn can lead to concentration problems, exhaustion and even unconsciousness.