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Although uncommon, lupus can attack the pancreas, an organ near the stomach that helps the body process food into nutrients. 

The pancreas is very important, since it produces the enzymes that the body uses to breakdown proteins, sugars, fats, and starches into a form that the body’s cells can use for energy. It also produces hormones that regulate digestion, blood sugar levels, and whether we feel hungry or full. This makes it vital to maintaining a healthy weight and to a functional metabolism in general. The pancreas also holds channels that connect the liver to the rest of the digestive system. Bile from the liver drains through the pancreas into the first part of the small intestine, called the duodenum, where it begins to digest the broken-down food. 

The hormones that the pancreas produces include:

  • Insulin – Insulin signals the body to store sugar in the cells instead of letting it freely flow in the bloodstream. 
  • Glucagon – Glucagon signals the body to release stored sugars into the bloodstream to supply energy to the cells.
  • Gastrin and Amylin – Gastrin and Amylin signals the stomach to produce gastric acid or continue digestion.

When lupus causes inflammation to the pancreas, these hormones might not be produced in adequate amounts.


What is the Digestive System?

Systemic lupus erythematosus (SLE) can have an effect on most organs in the body, including the organs of the digestive system. You can read more about the effects of lupus on the microbes that live in the digestive system here. This also includes the pancreas.

The digestive system is a series of organs that are responsible for taking in and processing food, extracting nutrients, absorbing water, and breaking down complicated molecules, including toxins. The digestive system also regulates the flow of nutrients, vitamins, minerals, and sugars in the bloodstream, keeping the levels balanced and the cells of the body healthy. The dietary intake of each individual person has a large effect on the digestive system. You can read more about important nutrients like Omega-3 fatty acids and lupus here

The digestive system works like a disassembly line, breaking down food into molecules that the body can use. 

First, food and water is taken in through the mouth, crushed into smaller pieces by teeth, moved around by the tongue, partially digested by saliva, before being swallowed to the esophagus. 

From there, it is broken down in the stomach by gastric acid and enzymes, before entering the small intestine where it is digested and nutrients are absorbed into the body through the membrane. 

In the large intestine, whatever material remains is collected, drained of any residual water, and finally excreted from the body as feces. 

The liver, pancreas, gallbladder, and other organs support this system with regulatory hormones, additional enzymes, and areas that process certain molecules. The kidneys are not considered part of the digestive system, but they do support it by filtering out waste products from the bloodstream.


Pancreatitis and Lupus

Pancreas-related problems are a rare symptom of autoimmune diseases such as lupus. Specifically, Lupus causes inflammation and swelling as it attacks the cells of the pancreas, a condition known as pancreatitis. Pancreatitis interferes with how the organ produces enzymes and hormones, and blocking the ducts that carry bile from the liver to the intestines. 

The symptoms of pancreatitis includes abdominal pain (including pain that feels like it’s at your back,) nausea, vomiting, and fever. 

Other causes of pancreatitis, including gallstones, alcohol use, genetic disorders, infections, or injuries to the abdomen, are much more common. It is estimated that only about 2-4% of cases of pancreatitis are caused by autoimmune disease, according to the National Library of Medicine. However, lupus medications such as immunosuppressants and the stress on the body from lupus can make the pancreas more vulnerable to infection and damage. You can read more about lupus medications here

Diabetes and Lupus

Diabetes is one of the major issues that can come about when the pancreas is damaged. Diabetes is a condition where the body doesn’t receive enough of a signal from the hormone insulin to properly modulate blood sugar levels in the body. When a carbohydrate or sugar-rich meal is digested, this lack of insulin causes a surge of sugar in the blood that can lead to problems in the kidney, heart, brain, and other organs. Diabetes can occur when the body stops reacting to insulin, but also if the pancreas is damaged and doesn’t produce enough insulin. 

For many reasons, including damage to the pancreas, people with SLE have a very high risk of developing diabetes. You can read more about diabetes and lupus here. Having both diabetes and SLE causes them to ‘feed into’ each other, one condition making the other worse and so on. It is important to treat both diabetes and SLE individually to get both under control.


Treating Pancreatic Issues and Lupus

People with lupus who have diabetes have to take regular insulin injections to maintain proper blood sugar. 

Treatment with lupus medications, such as corticosteroids or azathioprine, reduces inflammation and, as a consequence, reduces damage to the pancreas as well as other organs. 

However, some of the medications for lupus can have poor interactions with diabetes, with corticosteroids causing weight gain and prednisone leading to worse insulin resistance – and, as a consequence, worse diabetes! It is important to make sure that your medicine regimen is safe for both conditions.


A Lupus Warrior’s Takeaway

If you start feeling symptoms of pancreatitis, it is worth getting checked out as soon as possible. This is because not only can the issues have serious consequences, but the symptoms of pancreatitis can also be symptoms of more urgent and serious conditions. Leaving possible pancreatitis for too long can, potentially lead to complications like scarring as the damage gets worse.

In other words, get checked out if you can, and make sure that your treatment team is aware of any diabetes or potential pancreas issues.

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