Intenstines are pretty flexible organs. You can train them to hold more by practicing eating more, basically. And you can train yourself to ignore the signals your body is sending you that you are full, and you can even train to resist the urge to vomit (to an extent). I imagine these guys are in a large amount of discomfort after eating all that food. They probably go lie down for 12 hours after accepting their trophy.
The pancreas is not an issue. Even though they ate a lot of food, the food is still digested at a steady pace. So it’s not like they are getting 20,000 calories of blood sugar in an hour. It’s going to be paced over the day as they digest it. It could maybe be an issue if the food was very sugary, like cookies, because your body absorbs that quicker, but I think usually these contests feature meat and bread. If they overate like this every day, they’d have issues, but a once a month binge won’t really bother their bodies if they eat healthy the rest of the time.
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