You've been given a referral for amylase or lipase. Or the numbers are already on the form and you don't understand what they mean. Let's go through this calmly, without panic.
What amylase, lipase, and diastase are
Amylase is an enzyme that breaks down starch into simpler sugars. Most amylase is produced by the pancreas and salivary glands. A small amount of the enzyme in blood and urine is normal.
Lipase is another enzyme produced by the pancreas.
Diastase was described in 1833 by the French chemist Payen as an enzyme that breaks down starch (in fact, it is a mixture of enzymes).
Blood amylase: what the test shows
The test measures the amount of amylase in blood or urine. It is used to diagnose pancreatic diseases, including pancreatitis — inflammation of the gland. And to monitor chronic pancreatitis.
Changes in levels are visible in blood earlier than in urine. That is why a urine test is often done together with or after a blood test.
Blood lipase: what the test shows
The lipase test is measured in blood. It is ordered when pancreatitis is suspected, as well as for pain in the upper abdomen, nausea, and vomiting. The result is always compared with symptoms and other examinations.
Why enzymes rise
A high level of amylase in blood or urine occurs in acute pancreatitis. Another cause is blockage of the pancreatic duct. Sometimes a pancreatic tumor or other conditions manifest this way.
The most common causes of acute pancreatitis are gallstones that block the outlet from the gland, and a large amount of alcohol. Less often the culprits are trauma, certain medications, or a high blood calcium level.
Low amylase is uncommon. It occurs in chronic pancreatitis with cell damage, kidney and liver diseases, and cystic fibrosis.
How to understand test results
The numbers on the form are compared with the reference values of the specific laboratory. There is no single number for everyone, so look at the norms next to your result.
- High amylase in blood or urine — possible acute pancreatitis, duct blockage, pancreatic tumor.
- High amylase in abdominal fluid — a sign of acute pancreatitis or intestinal obstruction.
- Low amylase — a rare variant, occurs in chronic pancreatitis, kidney or liver diseases.
Before a blood test, you must not drink alcohol for 24 hours. The doctor may ask you not to eat for 2 hours before the test. Tell them about your medications in advance: some affect the result.
When the test is ordered and when to see a doctor
The test is ordered for symptoms of pancreatic disease: pain in the upper abdomen that radiates to the back, loss of appetite, nausea and vomiting, elevated temperature, rapid heartbeat, yellowing of the skin and eyes.
Another reason is monitoring an already known chronic pancreatitis, pancreatic tumor, or cystic fibrosis. The test may be ordered after removal of gallstones.
Elevated enzymes on their own are not a reason to call an ambulance. Call 103 or 112 if sudden severe abdominal pain does not go away, radiates to the back, the abdomen is bloated, the heartbeat is rapid or it is hard to breathe, and the skin around the navel or on the side has turned blue.
Take the results to the doctor who ordered the test. They will compare the numbers with your symptoms and, if necessary, order additional examinations, such as a CT scan.
This text is for reference. It does not replace a consultation with a doctor who sees you and your test results as a whole.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer