How do the pancreas and gallbladder work together

You likely don’t think much about your gallbladder, unless it has to be removed. It’s a pear-shaped organ that sits below your liver, waiting to be called into action. It's only about 3 to 4 inches long, and 1 inch across. It may be small. But the gallbladder plays a key role in digesting food and getting energy from it.

How the gallbladder works

There’s a reason your gallbladder sits so close to your liver, your body’s largest internal organ. Think of your liver as a factory. And your gallbladder as a warehouse next door. Your liver makes a powerful digestive juice called bile. Next, the bile passes to the gallbladder which concentrates and stores it for later use. Bile helps break down the food you eat.

Bile’s most important role is breaking down fats. This is the hardest part of food to digest. Carbohydrates and proteins tend to break down more easily. Fats need more chemical interaction in order to be changed into energy.

When you digest fatty food, your gallbladder releases bile. This digestive juice passes down a narrow tube (the cystic duct). It goes straight into the first section of your small intestine, just underneath your stomach (the duodenum). There, the strong chemicals go to work. They break down fatty bits into a liquid form that you can digest.

Working with the pancreas

Your bile travels down your cystic duct into your small intestine. Then another branch of ductwork, called the pancreatic duct, joins the channel. The pancreatic duct carries enzymes from your pancreas. Think of this as 2 rivers coming together. The digestive juices from the liver and the pancreas play a clear role in digestion. So do other enzymes in the small intestine. The bile breaks down fat into a form the body can use. Then the enzymes from your pancreas and your small intestine get to work. They let food pieces pass through the walls of your small intestine and into your blood in the form of energy.

What happens when the gallbladder is removed?

Your gallbladder does an important job. But it’s not a vital organ. If you get painful gallstones or a more rare condition such as gallbladder cancer, your healthcare provider may advise removing your gallbladder. In fact, gallbladder removal is one of the most common surgeries done in the U.S.

Once your gallbladder is removed, you can still break down fats in your small intestine. The bile simply flows directly from your liver to your duodenum, rather than passing through your gallbladder first.

Gut Health How Digestion Works Liver Gallbladder and Pancreas

Your pancreas plays a big role in digestion. It is located inside your abdomen, just behind your stomach. It's about the size of your hand. During digestion, your pancreas makes pancreatic juices called enzymes. These enzymes break down sugars, fats, and starches. Your pancreas also helps your digestive system by making hormones. These are chemical messengers that travel through your blood. Pancreatic hormones help regulate your blood sugar levels and appetite, stimulate stomach acids, and tell your stomach when to empty.

Pancreatic enzymes

Your pancreas creates natural juices called pancreatic enzymes to break down foods. These juices travel through your pancreas via ducts. They empty into the upper part of your small intestine called the duodenum. Each day, your pancreas makes about 8 ounces of digestive juice filled with enzymes. These are the different enzymes:

  • Lipase. This enzyme works together with bile, which your liver produces, to break down fat in your diet. If you don't have enough lipase, your body will have trouble absorbing fat and the important fat-soluble vitamins (A, D, E, K). Symptoms of poor fat absorption include diarrhea and fatty bowel movements.

  • Protease. This enzyme breaks down proteins in your diet. It also helps protect you from germs that may live in your intestines, like certain bacteria and yeast. Undigested proteins can cause allergic reactions in some people.

  • Amylase. This enzyme helps break down starches into sugar, which your body can use for energy. If you don’t have enough amylase, you may get diarrhea from undigested carbohydrates.

Pancreatic hormones

Many groups of cells produce hormones inside your pancreas. Unlike enzymes that are released into your digestive system, hormones are released into your blood and carry messages to other parts of your digestive system. Pancreatic hormones include:

  • Insulin. This hormone is made in cells of the pancreas known as beta cells. Beta cells make up about 75% of pancreatic hormone cells. Insulin is the hormone that helps your body use sugar for energy. Without enough insulin, your sugar levels rise in your blood and you develop diabetes.

  • Glucagon. Alpha cells make up about 20% of the cells in your pancreas that produce hormones. They produce glucagon. If your blood sugar gets too low, glucagon helps raise it by sending a message to your liver to release stored sugar.

  • Gastrin and amylin. Gastrin is primarily made in the G cells in your stomach, but some is made in the pancrease, too. It stimulates your stomach to make gastric acid. Amylin is made in beta cells and helps control appetite and stomach emptying.

Common pancreatic problems and digestion

Diabetes, pancreatitis, and pancreatic cancer are three common problems that affect the pancreas. Here is how they can affect digestion:

  • Diabetes. If your pancreatic beta cells do not produce enough insulin or your body can’t use the insulin your pancreas produces, you can develop diabetes. Diabetes can cause gastroparesis, a reduction in the motor function of the digestive system. Diabetes also affects what happens after digestion. If you don't have enough insulin and you eat a meal high in carbohydrates, your sugar can go up and cause symptoms like hunger and weight loss. Over the long term, it can lead to heart and kidney disease among other problems.

  • Pancreatitis. Pancreatitis happens when the pancreas becomes inflamed. It is often very painful. In pancreatitis, the digestive enzymes your pancreas make attack your pancreas and cause severe abdominal pain. The main cause of acute pancreatitis is gall stones blocking the common bile duct. Too much alcohol can cause pancreatitis that does not clear up. This is known as chronic pancreatitis. Pancreatitis affects digestion because enzymes are not available. This leads to diarrhea, weight loss, and malnutrition. About 90% of the pancreas must stop working to cause these symptoms.

  • Pancreatic cancer. About 95% of pancreatic cancers begin in the cells that make enzymes for digestion. Not having enough pancreatic enzymes for normal digestion is very common in pancreatic cancer. Symptoms can include weight loss, loss of appetite, indigestion, and fatty stools.

Your pancreas is important for digesting food and managing your use of sugar for energy after digestion. If you have any symptoms of pancreatic digestion problems, like loss of appetite, abdominal pain, fatty stools, or weight loss, call your healthcare provider.

Are gallbladder and pancreas connected?

Your pancreas and gallbladder are connected to each other by the common bile duct. Usually, bile passes from your gallbladder through the common bile duct on its way to your small intestine.

How does the gallbladder help the pancreas break down food?

Bile salts break down larger fat globules in food into small droplets of fat. Smaller fat droplets are easier for the digestive enzymes from the pancreas to process and break down. The bile salts also help the cells in the bowel to absorb these fat droplets.

How do pancreas and liver work together?

The pancreas and bile duct (biliary) systems together form an important part of the digestive system. The pancreas and liver produce juices (pancreatic juice and bile) which help in the process of digestion (i.e. the breakdown of foods into parts which can be absorbed easily and used by the body).

What do the pancreas liver and gallbladder have in common?

The biliary system, including the liver, pancreas and gallbladder, form a part of the body's digestive system that is responsible for nutrient absorption and waste disposal.