Reasons for Elevated Amylase and Lipase
Amylase and lipase are digestive enzymes. Amylase breaks down dietary starch, and lipase aids in the digestion of dietary fats. The pancreas produces these enzymes in large quantities and secretes them into the small intestine. Diseases of the pancreas most commonly cause elevated amylase and lipase, although other disorders may lead to abnormally increased blood levels of these enzymes.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Pancreatitis
Pancreatitis is the medical term for inflammation of the pancreas. The pancreas produces digestive enzymes and the blood sugar-regulating hormones insulin and glucagon. Acute pancreatitis occurs suddenly and is most often caused by gallstones passing through the common bile duct. The common bile duct and the pancreatic duct join together to transport digestive enzymes and bile to the small intestine. A gallstone in the common bile duct can cause increased pressure in the pancreatic duct, leading to pancreatitis. Acute pancreatitis causes a spike in blood amylase and lipase levels.
Chronic pancreatitis refers to persistent inflammation of the pancreas, which is most frequently due to prolonged, excessive consumption of alcohol. Blood amylase and lipase are typically elevated with chronic pancreatitis.
- Pancreatitis is the medical term for inflammation of the pancreas.
- A gallstone in the common bile duct can cause increased pressure in the pancreatic duct, leading to pancreatitis.
Pancreatic Cancer
Elevated Liver & Pancreas Enzymes
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Pancreatic cancer may cause elevation in blood amylase and lipase due to impingement on the duct system within the pancreas. According to the American Cancer Society, approximately 53,070 new cases of pancreatic cancer occurred in the United States in 2016 1. Pancreatic cancer was the fourth most common cause of cancer deaths in both men and women in 2016.
Pancreatic Trauma
A severe blow to the abdomen may cause pancreatic injury and a spike in blood amylase and lipase. The authors of an April 2008 research study published in the "Canadian Journal of Surgery" reported that the death rate due to pancreatic injury ranges from approximately 2 to 17 percent. The enzyme and/or hormone producing capacity of the pancreas may be diminished among those people who survive a pancreatic injury.
Intestinal Obstruction
What Does a Low Lipase Level Indicate?
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Intestinal obstruction is a possible cause of elevated blood amylase and lipase. With this condition, partially digested food and fecal material are unable to pass through the intestines. Tumors, loss of intestinal motility, kinks in the intestine, hernias and scar tissue may precipitate intestinal obstruction. Amylase and lipase are frequently elevated with this condition due to a backup of digestive fluids in the intestine.
- Intestinal obstruction is a possible cause of elevated blood amylase and lipase.
- Amylase and lipase are frequently elevated with this condition due to a backup of digestive fluids in the intestine.
Cholecystitis
Inflammation of the gallbladder is termed cholecystitis. Cholecystitis most commonly occurs due to gallstones and often provokes elevations in blood amylase and lipase. Acute cholecystitis typically causes severe pain and tenderness in the upper right abdomen that may be accompanied by nausea, vomiting, fever and chills. Chronic cholecystitis refers to ongoing inflammation of the gallbladder. People with this condition typically experience recurring pain in the right upper abdomen. Tenderness may occur but fever is usually absent.
- Inflammation of the gallbladder is termed cholecystitis.
- Acute cholecystitis typically causes severe pain and tenderness in the upper right abdomen that may be accompanied by nausea, vomiting, fever and chills.
Related Articles
References
- American Cancer Society: Cancer Facts and Figures -- 2016
- Cleveland Clinic Center for Continuing Education: Acute Pancreatitis
- Canadian Journal of Surgery: Outcomes after Pancreatic Trauma--Experience at a Single Institution
- Merck Manual Professional Version: Acute Cholecystitis
- Merck Manual Professional Version: Chronic Cholecystitis
- Merck Manual Professional Version: Intestinal Obstruction
- Afghani E, Pandol SJ, Shimosegawa T, et al. Acute pancreatitis-progress and challenges: a report on an international symposium. Pancreas. 2015;44(8):1195-210. doi:10.1097/MPA.0000000000000500
- Yadav D, Lowenfels AB. The epidemiology of pancreatitis and pancreatic cancer. Gastroenterology. 2013;144(6):1252-61. doi:10.1053/j.gastro.2013.01.068
- Krishna SG, Kamboj AK, Hart PA, Hinton A, Conwell DL. The changing epidemiology of acute pancreatitis hospitalizations: a decade of trends and the impact of chronic pancreatitis. Pancreas. 2017;46(4):482-488. doi:10.1097/MPA.0000000000000783
- Yoshida S, Okada H, Nakano S, et al. Much caution does no harm! Organophosphate poisoning often causes pancreatitis. J Intensive Care. 2015;3(1):21. doi:10.1186/s40560-015-0088-1
- Afghani E, Pandol SJ, Shimosegawa T. Acute Pancreatitis-Progress and Challenges: A Report on an International Symposium. Pancreas. 2015;44(8):1195–1210. doi:10.1097/MPA.0000000000000500
- Huh JH, Jeon H, Park SM, et al. Diabetes mellitus is associated with mortality in acute pancreatitis. J Clin Gastroenterol. 2018;52(2):178-183. doi:10.1097/MCG.0000000000000783
- Chatila AT, Bilal M, Guturu P. Evaluation and management of acute pancreatitis. World J Clin Cases. 2019;7(9):1006-1020. doi:10.12998/wjcc.v7.i9.1006
- Shah AP, Mourad MM, Bramhall SR. Acute pancreatitis: current perspectives on diagnosis and management. J Inflamm Res. 2018;11:77–85. Published 2018 Mar 9. doi:10.2147/JIR.S135751
- National Pancreas Foundation. Acute pancreatitis causes and symptoms.
- Mandalia A, Wamsteker EJ, DiMagno MJ. Recent advances in understanding and managing acute pancreatitis. F1000Res. 2018;7:F1000 Faculty Rev-959. Published 2018 Jun 28. doi:10.12688/f1000research.14244.2
- Uc A, Andersen DK, Bellin MD. Chronic pancreatitis in the 21st century - research challenges and opportunities: summary of a National Institute of Diabetes and Digestive and Kidney Diseases workshop. Pancreas. 2016;45(10):1365–1375. doi:10.1097/MPA.0000000000000713
- National Pancreas Foundation. Chronic pancreatitis causes and symptoms.
- Lew D, Afghani E, Pandol S. Chronic pancreatitis: current status and challenges for prevention and treatment. Dig Dis Sci. 2017;62(7):1702–1712. doi:10.1007/s10620-017-4602-2
Writer Bio
Dr. Tina M. St. John owns and operates a health communications and consulting firm. She is also an accomplished medical writer and editor, and was formerly a senior medical officer with the U.S. Centers for Disease Control and Prevention. St. John holds an M.D. from Emory University School of Medicine.