See a Stanford specialist to learn about your treatment options. Visit our clinic to make an appointment. Amylase and lipase are key digestive enzymes. Amylase helps your body break down starches. Lipase helps your body digest fats. The pancreas is a glandular organ that sits behind the stomach and produces digestive juices that empty into the small intestine. The pancreas also produces both amylase and lipase, as well as many other enzymes. Inflammation of the pancreas, also called pancreatitis, commonly causes high levels of amylase and lipase in the bloodstream. Amylase and lipase tests are used to detect pancreatitis. The tests measure the amount of these enzymes circulating in your bloodstream. These enzymes are typically checked when you have symptoms of acute pancreatitis or another pancreatic disorder and your doctor wants to confirm the diagnosis. Symptoms of pancreatitis may include:
There are also many other potential causes of abdominal pain. Other causes include appendicitis, ectopic pregnancy in people with a uterus, and intestinal blockage, among others. Checking amylase and lipase levels is important to help determine if the cause of these symptoms is pancreatitis or something else. Enzymes are proteins produced by the body to do a particular job. The pancreas produces amylase to break down carbohydrates in food into simple sugars. The pancreas makes lipase to digest fats into fatty acids. Sugars and fatty acids can then be absorbed by the small intestine. Some amylase and lipase can be found in saliva and in the stomach. However, most of the enzymes made in the pancreas are released into the small intestine. In a typical person, a normal blood amylase level is around 23 to 85 units per liter (U/L), although some lab ranges for normal amylase go up to 140 U/L. Ranges for these levels depend on where the labs are processed. A normal lipase level can range from 0 to 160 U/L depending on the lab. When the pancreas is damaged, these digestive enzymes can be found in the blood at higher levels than normal. Amylase or lipase results that are more than three times the normal levels are likely to mean pancreatitis or damage to your pancreas. However, in rare cases, there can be significant damage to the pancreas without abnormal amylase or lipase levels. In these cases, abdominal pain is the most common symptom. Early in the course of damage to the pancreas, amylase or lipase levels may also be normal. To prepare for an upcoming amylase or lipase blood test, you may be asked to fast for 8 to 12 hours beforehand. You also may want to wear a loose-fitting or short-sleeve shirt so your doctor can easily access a vein in your arm. There are many reasons why you might be experiencing abdominal pain or other symptoms. Amylase and lipase tests are just pieces of the puzzle. Your doctor will first take a medical and family history, perform a physical examination, and ask if you’re taking any medications. An amylase or lipase test requires a health professional to take a small amount of blood from your vein. Usually, the test is administered as follows:
A small amount of pain and bruising is possible at the site of insertion. Excessive bleeding, fainting, lightheadedness, and infection are rare but possible. Since high amylase levels may be associated with decreased kidney function, your doctor may order other blood tests or a urine amylase test. When levels of lipase and amylase are higher than normal, it may indicate pancreatic injury or another disease. Most studies show that levels greater than three times the upper limit of normal usually lead to a diagnosis of pancreatitis, according to guidelines from the American College of Gastroenterology (ACG). Lipase levels alone can’t determine the severity of an acute pancreatitis attack. When these test results are abnormal, you may need other tests, such as:
Elevated amylase levels show your doctor that there’s a problem, but it may not necessarily involve your pancreas. However, lipase levels compared with amylase levels are usually more specific for pancreatic disorders. Evaluating the results of the two tests and your symptoms can help your doctor diagnose or rule out pancreatitis or other conditions of the pancreas. If you experience severe abdominal pain, see your doctor immediately. Based on the results of an amylase test, a lipase test, and your medical history, your doctor can decide if additional tests are needed or determine what type of treatment is needed. There are many reasons why someone might have abnormal levels of amylase in their blood. These include:
Lower than normal levels of amylase may indicate:
There are some medications that can increase the amount of amylase in your blood without any illness present:
Lipase levels may be abnormally high if someone is experiencing:
Abnormal levels of lipase may also exist in people with familial lipoprotein lipase deficiency. Drugs that may affect the levels of lipase in your bloodstream are the same ones known to affect the levels of amylase. There are a number of strategies and treatments that may help lower your lipase levels. These options include: Be sure to talk with your doctor before trying any natural remedies or other treatments to deal with lipase levels. Acute pancreatitis is rare during pregnancy. However, it can lead to problems with your baby if it does occur. Research from 2013 suggests that serum amylase and lipase levels don’t change during pregnancy and remain consistent with levels of women who are not pregnant. In other words, what’s considered normal levels of amylase and lipase is about the same in people who are pregnant and those who aren’t pregnant. Increases in serum amylase and lipase levels during pregnancy should be considered the same way they are in people who aren’t pregnant. Amylase and lipase tests help diagnose certain conditions, such as acute pancreatitis. The blood tests for these digestive enzymes determine if symptoms are related to low blood amylase and lipase levels. These tests also help doctors rule out certain conditions. If you are scheduled to get blood amylase or lipase tests, be sure to talk with your doctor about how to best prepare and how you can understand your results after the tests.
To diagnose pancreatitis and find its causes, doctors use
A health care professional will ask During a physical exam, the health care professional will
What tests do health care professionals use to diagnose pancreatitis?Health care professionals may use lab or imaging tests to diagnose pancreatitis and find its causes. Diagnosing chronic pancreatitis can be hard in the early stages. Your doctor will also test for other conditions that have similar symptoms, such as peptic ulcers or pancreatic cancer. Lab testsLab tests to help diagnose pancreatitis include the following: Blood tests. A health care professional may take a blood sample from you and send the sample to a lab to test for Stool tests. Your doctor may test a stool sample to find out if a person has fat malabsorption. Imaging testsHealth care professionals also use imaging tests to diagnose pancreatitis. A technician performs most tests in an outpatient center, a hospital, or a doctor’s office. You don’t need anesthesia, a medicine to keep you calm, for most of these tests. Ultrasound. Ultrasound uses a device called a transducer, which bounces safe, painless sound waves off your organs to create a picture of their structure. Ultrasound can find gallstones. Computed tomography (CT) scan. CT scans create pictures of your pancreas, gallbladder, and bile ducts. CT scans can show pancreatitis or pancreatic cancer. Magnetic resonance cholangiopancreatography (MRCP). MRCP uses a magnetic resonance imaging (MRI) machine, which creates pictures of your organs and soft tissues without x-rays. Your doctor or a specialist may use MRCP to look at your pancreas, gallbladder, and bile ducts for causes of pancreatitis. Health care professionals use MRCP to look at your pancreas, gallbladder, and bile ducts for causes of pancreatitis.Endoscopic ultrasound (EUS). Your doctor inserts an endoscope—a thin, flexible tube—down your throat, through your stomach, and into your small intestine. The doctor turns on an ultrasound attachment to create pictures of your pancreas and bile ducts. Your doctor may send you to a gastroenterologist to perform this test. Pancreatic Function Test (PFT). Your doctor may use this test to measure how your pancreas responds to secretin, a hormone made by the small intestine. This test is done only at some centers in the United States. |