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Once produced, bile salts flow through the bile ducts in the liver to the common bile duct that connect the liver, the gallbladder and the the small intestines. Scientists created a working guitar the size of a red blood cell to illustrate the possible uses of nanotechnology. Produced in the liver by specialized cells called hepatocytes, bile salts comprise about 10 percent of bile. Once produced, these salts flow through the bile ducts in the liver to the common bile duct that connects the liver, the gallbladder and the small intestines.
People who have had their gallbladder removed no longer have the site where bile is stored, concentrated and made available for digestion. One other function of bile salts that many people don't know about is that it kills harmful bacteria.
The pancreas is a pale pink glandular organ which is found under the stomach and along the initial part of the small intestine or duodenum.
Pancreatic enzymes are used to break down proteins, starches and fats in the diet allowing them to be absorbed through the intestinal wall.
Pancreatic insufficiency is caused when the cells responsible for enzyme production begin to atrophy or shrink. Diagnosis of pancreatic insufficiency is based on clinical signs and specialized blood and fecal tests which measure digestive enzymes. Dogs with pancreatic insufficiency may also have an overgrowth of bacteria in their intestines which can lead to a vitamin B12 (cobalamin) deficiency. The prognosis is good for pancreatic insufficiency if the dog is treated with supplemental pancreatic enzymes.
Islet Cell Transplant for Chronic PancreatitisUCSF is the only center west of the Mississippi offering islet transplantation  for managing the diabetes resulting from last resort removal of the pancreas. Department Launches Center for Hernia Repair & Abdominal Wall ReconstructionLed by Hobart W. Normally, digestive enzymes secreted by the pancreas do not become active until they reach the small intestine.
Chronic pancreatitis is inflammation of the pancreas that does not heal or improve-it gets worse over time and leads to permanent damage. Hereditary pancreatitis can present in a person younger than age 30, but it might not be diagnosed for several years. Most people with chronic pancreatitis experience upper abdominal pain, although some people have no pain at all. People with chronic pancreatitis often lose weight, even when their appetite and eating habits are normal. Chronic pancreatitis is often confused with acute pancreatitis because the symptoms are similar. In more advanced stages of pancreatitis, when malabsorption and diabetes can occur, the doctor may order blood, urine, and stool tests to help diagnose chronic pancreatitis and monitor its progression. After ordering x rays of the abdomen, the doctor will conduct one or more of the tests used to diagnose acute pancreatitis-abdominal ultrasound, CT scan, EUS, and MRCP. Treatment for chronic pancreatitis may require hospitalization for pain management, IV hydration, and nutritional support. When a normal diet is resumed, the doctor may prescribe synthetic pancreatic enzymes if the pancreas does not secrete enough of its own.

People with chronic pancreatitis are strongly advised not to smoke or consume alcoholic beverages, even if the pancreatitis is mild or in the early stages.
Inflammation associated with recurrent bouts of pancreatitis causes scarring and blockage of the pancreatic ducts. Removing the entire pancreas provides significant pain relief, but leaves patients severely diabetic because they no longer have pancreatic islets, which produce insulin.
People with chronic pancreatitis who continue to consume large amounts of alcohol may develop sudden bouts of severe abdominal pain. As with acute pancreatitis, ERCP is used to identify and treat complications associated with chronic pancreatitis such as gallstones, pseudocysts, and narrowing or obstruction of the ducts.
In cases involving persistent pain, surgery or other procedures are sometimes recommended to block the nerves in the abdominal area that cause pain. When pancreatic tissue is destroyed in chronic pancreatitis and the insulin-producing cells of the pancreas, called beta cells, have been damaged, diabetes may develop.
From here, they either flow into the intestines or are stored in the gallbladder, depending on what stage the digestive process is in. Acting in the same manner as detergents, bile salts break fats from foods into smaller particles. The liver still secretes bile, but without the gallbladder, normal digestive processes may be disrupted.
GSIJW981: Schematic illustration of the canine gastrointestinal system showing the location of the pancreas. While these enzymes are formulated in either tablet or powder form, the powder formulations have been shown to be more effective. The pancreas is a large gland behind the stomach and close to the duodenum-the first part of the small intestine. But when the pancreas is inflamed, the enzymes inside it attack and damage the tissues that produce them. Chronic pancreatitis, like acute pancreatitis, occurs when digestive enzymes attack the pancreas and nearby tissues, causing episodes of pain.
The chronic form of pancreatitis can be triggered by one acute attack that damages the pancreatic duct.
Episodes of abdominal pain and diarrhea lasting several days come and go over time and can progress to chronic pancreatitis.
The pain may spread to the back, feel worse when eating or drinking, and become constant and disabling.
The weight loss occurs because the body does not secrete enough pancreatic enzymes to digest food, so nutrients are not absorbed normally. As with acute pancreatitis, the doctor will conduct a thorough medical history and physical examination. Nasogastric feedings may be necessary for several weeks if the person continues to lose weight. The enzymes should be taken with every meal to help the person digest food and regain some weight.
After removal of the pancreas, patients are completely dependent on external sources of insulin and their blood sugar can be extremely difficult to control.
Chronic pancreatitis also can lead to calcification of the pancreas, which means the pancreatic tissue hardens from deposits of insoluble calcium salts.

Trauma to the pancreas and hereditary pancreatitis are two known causes of childhood pancreatitis. When food is present in the intestines, bile flows through a sphincter between the common bile duct and intestines to aid in the digestion of fats. Research has shown that in addition to aiding in the digestion of fats, these salts may act as hormones. These dogs have diarrhea with the stools being foul smelling, light yellow to gray colored and greasy in appearance due to undigested food.
The pancreas secretes digestive juices, or enzymes, into the duodenum through a tube called the pancreatic duct. A diagnosis of hereditary pancreatitis is likely if the person has two or more family members with pancreatitis in more than one generation. In some cases, abdominal pain goes away as the condition worsens, most likely because the pancreas is no longer making digestive enzymes. Blood tests may help the doctor know if the pancreas is still making enough digestive enzymes, but sometimes these enzymes appear normal even though the person has chronic pancreatitis. The next step is to plan a nutritious diet that is low in fat and includes small, frequent meals. In addition to pain, patients may also develop malabsorption because the function of digestive enzymes is compromised. If diabetes occurs, insulin or other medicines are needed to keep blood glucose at normal levels. Children with cystic fibrosis-a progressive and incurable lung disease-may be at risk of developing pancreatitis. If there is no food in the intestines, the bile is stored and concentrated in the gallbladder. This action of breaking fats into small particles increases the total surface area of the fats to be digested. Bile salt supplements can be taken with meals to aid in the digestion of healthy fats; a lack of bile can cause constipation.
A dysfunction in this area can result in the lack of insulin which causes diabetes mellitus.
Pancreatic enzymes join with bile-a liquid produced in the liver and stored in the gallbladder-to digest food.
A health care provider works with the patient to develop a regimen of medication, diet, and frequent blood glucose monitoring. Another role of the salts is aiding in the proper digestion and absorption of the fat-soluble vitamins — vitamins A, D, E and K. A second function is the production and secretion of pancreatic enzymes which aid in the digestion of food.

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