Most of us can point to where our heart or our lungs are. Far fewer could find the pancreas on a diagram, and fewer again could name a single symptom of pancreatic trouble. It sits quietly behind the stomach, roughly the size of your hand, doing two entirely separate jobs at once.
That matters more after 50. Gallstones become more common with age, alcohol takes a cumulative toll, and pancreatic conditions tend to announce themselves quietly, with vague symptoms that are easy to put down to “just getting older”.
TL;DR
- The pancreas has two jobs: producing digestive enzymes that break down food, and producing insulin and glucagon to control blood sugar.
- Acute pancreatitis is a medical emergency. Sudden, severe upper abdominal pain that bores through to your back and eases when you lean forward needs immediate assessment, not a wait-and-see approach.
- Gallstones and alcohol cause the large majority of acute pancreatitis cases, and both are partly within your control.
- Pale, oily, foul-smelling stools that float, along with bloating and weight loss despite eating normally, can signal exocrine pancreatic insufficiency, which is treatable with enzyme capsules taken at meals.
- New-onset diabetes after 50 with unexplained weight loss deserves a proper GP conversation, as does painless yellowing of the skin or eyes.
- Irish supports include the HSE Chronic Disease Management Programme, the Long Term Illness Scheme, CORU-registered dietitians and the Irish Cancer Society Support Line on 1800 200 700.
What your pancreas actually does
Think of it as two organs sharing one address.
The exocrine pancreas, around 95% of the tissue, produces digestive enzymes: lipase for fat, amylase for carbohydrates, proteases for protein. These travel down a duct into the small intestine every time you eat. Without them, food passes through largely undigested, taking its calories and its fat-soluble vitamins with it.
The endocrine pancreas is the smaller portion, clusters of cells called the islets of Langerhans, which produce insulin and glucagon to keep blood glucose in a safe range. When this part struggles, the result is diabetes. Both functions dip gently with age in most people, which is normal. Problems arise when disease, rather than time, is doing the damage.
Acute pancreatitis: the one that cannot wait
Acute pancreatitis happens when the digestive enzymes activate inside the pancreas rather than in the intestine, and the organ begins to digest itself.
The pain is distinctive: it builds over minutes to hours in the upper abdomen, is severe and constant rather than crampy, and bores straight through to the back. Many people find it worse lying flat and easier when curled forward. Vomiting is common and brings no relief.
This is a 999 or 112 call. Most cases settle with fluids, pain relief and monitoring in hospital, but a minority become severe, and that is not a distinction to make from your kitchen.
Two causes account for most cases. The first is gallstones, which can lodge where the bile duct and pancreatic duct meet and block the flow of enzymes. The second is alcohol, usually after years of heavy drinking, though a single very heavy session can trigger an attack.
When digestion stops working properly
Repeated inflammation can leave permanent scarring, a condition called chronic pancreatitis. Enzyme-producing tissue is gradually replaced by fibrous tissue and the pancreas can no longer keep up with meals. This is exocrine pancreatic insufficiency, and it is missed far more often than it should be.
The signs are practical rather than dramatic:
- Stools that are pale, greasy, unusually smelly and difficult to flush
- Bloating, wind and discomfort after eating, particularly after fatty meals
- Weight loss despite a normal appetite and normal portions
- Fatigue, or signs of vitamin A, D, E and K deficiency, since these need fat to be absorbed
A GP can start with a straightforward stool test measuring faecal elastase, alongside blood tests. Treatment is pancreatic enzyme replacement therapy: capsules taken with every meal and snack that supply what the pancreas no longer makes. Taken correctly, and the timing genuinely matters, they can transform how someone feels. Supply has come under pressure across Europe in recent years, so if your usual brand is unavailable, speak to your pharmacist rather than going without.
Damage to the islet cells can also cause a form of diabetes that follows pancreatic disease or surgery, sometimes called type 3c. It is managed differently from ordinary type 2 diabetes, which is one reason an accurate diagnosis is worth pushing for.
The symptoms worth taking to your GP
Pancreatic cancer has a reputation for being caught late, and the reason is uncomfortable: its early symptoms are genuinely unremarkable. Several hundred people in Ireland are diagnosed each year, most of them over 60. Alert without alarmed is the sensible middle ground.
Book an appointment if you notice:
- Yellowing of the skin or the whites of the eyes, particularly if painless, along with dark urine or pale stools
- Unexplained weight loss you did not set out to achieve
- Persistent upper abdominal or mid-back pain that does not settle over weeks
- New diabetes after the age of 50 in someone with no obvious risk factors, especially alongside weight loss
- A sudden change in digestion with no other explanation
Almost all of these turn out to have ordinary explanations. Say them out loud anyway. Ireland’s National Cancer Control Programme publishes referral guidance for exactly this situation, and your GP can arrange urgent imaging and specialist referral where the picture warrants it.
Practical protection
Mind your alcohol intake. The HSE low-risk guidelines are fewer than 11 standard drinks a week for women and fewer than 17 for men, with at least two alcohol-free days. Alcohol is directly toxic to pancreatic tissue and the damage accumulates. Our guide to alcohol and ageing covers why the same drink hits differently at 60.
Stop smoking. Smoking roughly doubles the risk of pancreatic cancer and is one of the few risk factors you can remove outright. The HSE Quitline is free on 1800 201 203, with nicotine replacement therapy at no cost.
Keep gallstones in mind. A steady weight rather than rapid loss, enough fibre and regular activity all reduce gallstone risk, and with it the commonest cause of acute pancreatitis.
Eat in a way the pancreas can manage. Smaller, more frequent meals, moderate fat rather than fat-free, plenty of vegetables and pulses, less ultra-processed food.
Irish supports worth knowing about
If you live with diabetes, the HSE Chronic Disease Management Programme provides free structured GP reviews for medical card and GP visit card holders, and the Long Term Illness Scheme covers diabetes medicines at no charge regardless of income. The Drug Payment Scheme currently caps household medicine costs at €80 a month for everyone else.
For nutrition, ask your GP about a community dietitian or find a CORU-registered practitioner through the Irish Nutrition and Dietetic Institute. Getting enzyme dosing and meal structure right is the difference between managing and struggling. The Irish Cancer Society Support Line on 1800 200 700 is staffed by cancer nurses and open to anyone with a worry, including before any diagnosis exists.
The takeaway
You do not need to become an expert on your pancreas. Know three things: sudden severe pain boring through to your back is an emergency, greasy floating stools and unexplained weight loss deserve a stool test rather than a shrug, and painless jaundice or new diabetes after 50 warrants an appointment this week rather than next month.
Beyond that, the advice is the same reassuringly ordinary advice that protects your heart, your liver and your brain. Drink less, do not smoke, eat real food, keep moving. At Críonna Health, we believe understanding your body is the foundation of ageing well, and knowing which symptoms to raise is a skill worth having long before you need it.
This article is for general information and does not replace advice from your GP or healthcare team. In an emergency, call 999 or 112.
📷 Photo by AllGo – An App For Plus Size People on Unsplash
