Bengaluru gastroenterologist explains what a shrunken pancreas is, reveals 4 common symptoms to watch out for

Know about this structural issue of pancreas and what may happen if you leave it unregulated for long-term.

The pancreas is a vital organ that supports important physiological systems, including digestion, endocrine and metabolic functions. One of its primary roles is to regulate blood sugar levels by producing hormones such as insulin.

Now there are many ways in which the pancreas's hormone or enzyme production can be affected, depending on the underlying issue, whether it is inflammation, cysts, tumours or metabolic problems. Disturbances can also occur if there are structural changes, such as shrinkage.

Addressing one of the structural changes, Dr Harshavardhan Rao, HOD and consultant, department of gastroenterology at Ramaiah Memorial Hospital, Bengaluru, shared with HT Lifestyle insights on shrunken pancreas, highlighting when it should raise concern and which symptoms you need to look out for to identify it early.

What is a shrunken pancreas?

According to the gastroentrologist, a shrunken pancreas is medically referred to as pancreatic atrophy. Explaining what it means, he said, “This term usually implies some loss of tissue or tissue damage due to a variety of reasons. Alternatively, it can also be the result of normal ageing.” He also mentioned that it can also be the result of normal ageing. “A shrunken pancreas can be a part of normal ageing. Just as our skin wrinkles or muscles lose mass as we get older, the pancreas can naturally decrease in size,” the doctor said.

This means ‘shrunken pancreas’ needs to be assessed alongside the patient's general health and medical history to understand its cause.

After CT or MRI scanning, the gastroentrologist explained that if symptoms or risk factors are present, further medical evaluations are recommended to determine the cause of pancreatic damage.

Common causes

Dr Rao listed out some of the most common risk factors that make one likely to get a shrunken pancreas:

• Ageing: The most frequent cause of a small pancreas in older adults.
• Previous Inflammation: You may have had a history of Acute pancreatitis (commonly due to alcohol intake or gallstones) years ago that healed but left the organ slightly scarred.
• Reduced blood flow: Narrowing of the arteries supplying the pancreas (common in smokers or those with high blood pressure) can lead to tissue shrinkage.
• Early-stage chronic pancreatitis: A slow-burning inflammation often due to chronic alcohol/tobacco use. Early stages of chronic pancreatitis can be asymptomatic and detected incidentally.

Symptoms

Sudden and unexplained drop in weight is a matter of concern. (Unsplash)

According to the doctor, symptoms that warrant further examination include:

• Unexplained weight loss.
• Loss of appetite, loose or oily stools that are foul-smelling and difficult to flush.
• Dull, boring pain in the upper abdomen that may radiate to the back and flare up after eating certain foods.
• Uncontrolled blood sugar levels.

When these symptoms show up, Dr Rao recommended these tests:

• Stool tests: To check for fat content or ‘elastase’ (an enzyme marker). These are not sensitive and tend to be abnormal only in the late stages of chronic pancreatitis.
• Blood work: To check haemoglobin, liver function tests, blood sugar (HbA1c) and nutrient levels (Vitamin D, B12.)
• Imaging: Most patients may require an endoscopic ultrasound or MRI abdomen (with MRCP.)

Healthy lifestyle habits

While you cannot ‘regrow’ pancreatic tissue, you can prevent further damage. The doctor recommended these preventive measures:

• Abstinence from alcohol: Alcohol is the primary toxin for the pancreas. Even "moderate" drinking can accelerate atrophy.
• Quit smoking: Smoking is a major risk factor for both chronic pancreatitis and pancreatic cancer.
• Low-fat / no processed food diet: Keep your blood fats in check to prevent bouts of acute inflammation.
• Stay active: Helps manage blood sugar levels and overall metabolic health.

In the end, it is important to go for a regular follow-up. The gastroentrologist recommended 6-12 months to keep potential long-term complications in check. These include weakened bones (osteoporosis) from poor vitamin D absorption, significant malnutrition leading to muscle loss and fatigue, a slightly increased risk of pancreatic cancer over time due to chronic inflammation and atrophy, and issues related to uncontrolled blood sugar or diabetes.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.