What is it about ?
The pancreas is a digestive gland that is located in the upper abdomen, behind the stomach. It has two functions:
- Produce and secrete hormones in the blood, such as insulin and glucagon to regulate the level of sugar in the blood (blood sugar) (endocrine secretion);
- Produce and secrete enzymes in the small intestine for the digestion of sugars, fats and proteins (exocrine secretion).
Pancreatic insufficiency means that the pancreas is not making enough hormones and not enough enzymes. The cause can be primary or secondary.
- The primary causes directly damage the pancreas;
- Secondary causes are problems with implications for the pancreas.
The main primary cause is chronic inflammation of the pancreas (chronic pancreatitis) following a excessive consumption of alcohol. Malnutrition, tumors, surgical removal of the pancreas, accident trauma and inherited disorders (for example, cystic fibrosis) can also cause pancreatic insufficiency.
An example of a secondary cause is an operation on the stomach.
How to recognize it?
Gastrointestinal symptoms are the most common: stomach pain after meals, diarrhea with oily and smelly stools and bloating. Sometimes you may notice droplets of fat on the stool. As they do not dissolve in water, they rise to the surface. Poor digestion can lead to weight loss.
Insulin deficiency causes an increase in the level of sugar in the blood (blood sugar). In diabetes can even develop: you are often thirsty and you often have to urinate.
A deficiency in vitamins and other nutrients can contribute to all kinds of illnesses.
How is the diagnosis made?
The doctor makes the diagnosis on the basis of a blood test. For each person presenting with prolonged diarrhea and weight loss, the pancreas is examined in particular by means of a measurement of insulin and digestive enzymes. A stool exam can determine an increase in the fat content in the stool.
What can you do ?
The most important thing is to stop drinking alcohol completely and immediately. It is not useful to temporarily drink less.
Due to the risk of undernutrition, a suitable diet is indicated. Eat several small energy meals a day, typically 3 main meals and 2 snacks. Vary the dishes and get enough fiber. Only 30 to 40% of the energy can come from fat. Also eat a lot of starchy foods (bread, potatoes, pasta, etc.). Limit foods high in protein (especially meat and fish) to 1 to 1.5 grams of protein per pound of body weight per day.
Stop smoking because tobacco causes scarring and further decreases the function of the pancreas.
Make sure you get enough physical activity.
What can your doctor do?
If your symptoms do not improve enough with diet, your doctor will additionally prescribe pancreatic enzymes in tablet form. Take them with meals to aid digestion.
In case of vitamin D deficiency, a supplement is administered.
The doctor will also check you regularly for the presence of diabetes and treat you if necessary. It is often necessary to start insulin at an early stage.
Want to know more?
- The pancreas (image) – Larousse
- Exocrine pancreatic insufficiency (video) – GI Society – Canadian Society of Intestinal Research
- Alcohol, the point on your consumption – Stop or else?
- Stop smoking. It’s possible – Tabacstop
- Physical activity – Eat Move – Health question
Are you looking for more specialized help?
- Find a registered dietitian – Professional Union of French-speaking dieticians
- Find a nutritionist doctor – Belgian Society of Nutritionist Doctors
- Smoking Assistance Center (CAF®) – FARES – Respiratory Affections Fund
- Tobacco specialists – FARES – Respiratory Affections Fund
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