Pancreatic Insufficiency

Chronic inflammation can negatively impact the pancreas, potentially impairing it’s ability to produce and secrete digestive enzymes.

Digestive Enzymes

Pancreatic insufficiency occurs when the pancreas is unable to produce and/or secrete enough digestive enzymes, such as amylase, lipase, and protease, to properly digest food in the small intestine. This will cause malabsorption of nutrients in the small intestine, resulting in nutrient deficiencies. Undigested food particles, from the lack of digestive enzymes, can pass through the gut barrier and into the bloodstream, leading to a potential immune reaction.

Pancreatic insufficiency can also alter the production of gut hormones, such as cholecystokinin (CCK) and secretin. This alteration can further impair the digestive process and contribute to the development of leaky gut. These hormones have many different actions in the body.

Cholecystokinin (CCK)

Primarily produced by I-cells in the lining of the duodenum, the first part of the small intestine. CCK has several functions:

• Stimulating the gallbladder to contract and release bile, which helps in the digestion and absorption of fats and fat-soluble vitamins.
• Stimulating the pancreas to secrete pancreatic enzymes, aiding in the digestion of proteins, carbohydrates, and fats.
• Slowing down gastric emptying to ensure that the chyme (partially digested food) moves at an optimal pace through the small intestine, allowing for proper digestion and nutrient absorption.
• Regulating appetite by acting on the brain to induce satiety, or a feeling of fullness, thereby reducing food intake.

Secretin

Produced by S-cells in the lining of the duodenum in response to the acidic chyme entering from the stomach. Secretin has several functions:

• Stimulating the pancreas to release bicarbonate-rich pancreatic juice, which helps neutralize the acidic chyme, creating a more optimal pH environment for the function of digestive enzymes in the small intestine.
• Enhancing bile production in the liver, which aids in the digestion and absorption of fats and fat-soluble vitamins.
• Regulating gastric acid secretion by inhibiting the release of gastrin, a hormone that stimulates the production of stomach acid.
• Slowing down gastric emptying, similar to CCK, to ensure adequate time for digestion and nutrient absorption in the small intestine.

Together, cholecystokinin and secretin help coordinate the digestive process, regulating the release of bile and pancreatic juices and ensuring the optimal environment for digestion and absorption of nutrients in the small intestine.