Looking at the 'spleen and stomach' of the Donguibogam through the lens of modern medicine reveals a remarkable organ at its core: the pancreas. Situated above the navel behind the stomach, this small yet essential organ performs two primary roles. One is an endocrine function that secretes insulin to regulate blood glucose, and the other is an exocrine function that secretes digestive enzymes, which is our focus today.
The digestive enzymes secreted by the pancreas resemble specialized chefs who chop, boil, and prepare ingredients: amylase breaks down carbohydrates, protease breaks down protein, and, most importantly, lipase breaks down fat. These enzymes must break food down into tiny pieces before the small intestine can absorb those nutrients effectively. Without this process, even the finest meals remain unusable to the body.
What happens when pancreatic function declines? In pancreatic exocrine insufficiency, the pancreas fails to release sufficient digestive enzymes, leaving food improperly broken down. Because fats demand far more lipase for digestion than other nutrients, a decrease in pancreatic function impairs fat digestion first. This aligns remarkably with the Donguibogam's teaching that the transportation and transformation function of the spleen and stomach has weakened.
Unabsorbed fats pass straight from the small intestine down to the large intestine, appearing as steatorrhea. Have you ever noticed stools that look sticky, oily, float in water, or stick to the toilet bowl? Far from ordinary constipation or diarrhea, this is a strong sign that the body is failing to absorb nutrients properly. Such symptoms provide clear evidence of malabsorption extending beyond simple dyspepsia.
Chronic pancreatic hypofunction does not stop at steatorrhea. Over time, absorbing protein and carbohydrates also becomes difficult, resulting in chronic malabsorption where one loses weight and energy despite eating well. Because fat-soluble vitamins such as vitamins A, D, E, and K are absorbed alongside fats, impaired fat digestion readily causes deficiencies in these essential vitamins. In severe cases, this can lead to systemic problems including osteoporosis, reduced vision, weakened immunity, and muscle loss, substantially reducing quality of life.
Pancreatic dysfunction stems from various causes. Most commonly, chronic pancreatitis damages pancreatic tissue. It can also arise from genetic disorders such as cystic fibrosis, pancreatic cancer, postoperative complications following gastrectomy, or even autoimmune diseases. Thus, pancreatic hypofunction is not mere dyspepsia, but an important condition requiring identification and treatment of its root cause.
Diagnosis involves stool examinations such as the fecal elastase test to measure pancreatic enzyme levels, or the secretin stimulation test to evaluate pancreatic function directly. Imaging studies like computed tomography and magnetic resonance imaging also help identify structural issues in the pancreas. While modern medicine specifies the exact functions of the pancreas, it connects deeply with the Donguibogam's broader perspective on the transportation and transformation function of the spleen and stomach. Every day, the body works tirelessly through this delicate process to turn food into vital energy. Listening closely to the signals your body sends is essential.
