Lipase Test

The blood test for lipase may be used along with a test for amylase to help diagnose pancreatitis (inflammation of the pancreas) and other pancreatic diseases. It is also used to a lesser extent in the diagnosis and follow-up of cystic fibrosis, coeliac disease, and Crohn’s disease.

A lipase test may be used if you show symptoms of a pancreatic disorder, such as severe abdominal pain, fever, loss of appetite, or nausea and to monitor the effect of treatment.

Normal values for lipase depend on the test used to measure it. In acute pancreatitis, lipase concentrations are very high, often 2 to 5 times normal. Slightly high lipase values may occur in other conditions such as kidney disease, salivary gland inflammation, or peptic ulcer disease. Occasionally lipase is high due to a tumour (cancer). A rapid and sharp rise of lipase in the blood within hours after the beginning of an attack, and a decline after about 4 days, usually indicates acute pancreatitis.

In acute pancreatitis, the changes seen in lipase concentrations are usually similar to those of another pancreatic enzyme called amylase, but remains elevated longer (for 5 to 7 days).

Lipase and amylase are sometimes used together to diagnose acute pancreatitis. Either lipase or amylase may be requested to help diagnose acute pancreatitis. Either test may also be used to monitor chronic pancreatitis. They may be moderately elevated in chronic pancreatic disease but levels can fall if the cells that produce amylase and lipase in the pancreas become damaged or destroyed. Drugs that may interfere with maintaining proper lipase levels include codeine, indomethacin and morphine.

Acute pancreatitis usually causes no long term damage, and often no further problems develop. Chronic pancreatitis may follow a series of acute attacks, but is almost always due to many years of alcohol abuse (although other conditions such as cystic fibrosis can also damage the pancreas). It causes permanent pancreatic damage with scarring and calcium deposits. Some people develop insulin-dependent diabetes (as insulin is produced by the pancreas, as well as digestive enzymes). There is often difficulty digesting foods, especially fats, causing abdominal pain, pale, bulky, greasy stools and loss of weight. Symptoms can often be controlled but the damage to the pancreas is usually irreversible.

Treatment depends upon the symptoms. If they are absent or mild, there may be no treatment. Acute pancreatitis causes severe pain that needs drug treatment and often causes vomiting with fluid loss that needs replacement by vein. Your doctor may suggest ​‘resting the pancreas’ by a spectrum of options ranging from not eating solid foods to a low-fat diet and frequent small meals. If you have chronic pancreatitis your doctor will strongly advise you to refrain from drinking alcohol. A low fat diet and oral pancreatic enzyme replacement are other possible choices.

In pancreatitis, the lipase concentration in the bloodstream rises quickly, but begins to drop in about 4 days. In other conditions, the rise is usually not as great, and the concentration is maintained for a longer period. Your doctor is the best one to determine if you have a pancreatic disorder based on your symptoms, medical history, and test results.