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At a Glance
When To Get Tested?
When you have symptoms of a pancreatic disorder, such as severe abdominal pain, fever, loss of appetite, or nausea
A blood sample drawn from a vein in your arm
Test Preparation Needed?
Your healthcare practitioner might instruct you to stop eating or drinking everything but water for 8 to 12 hours before the test. Alert your healthcare practitioner to all medicines, vitamins, supplements, and herbs that you are taking.
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What is being tested?
Lipase is an enzyme primarily produced by the pancreas to help digest dietary fats. This test measures the amount of lipase in the blood.
The pancreas is a narrow, flat organ about six inches long located deep within the abdominal cavity, below the liver and between the stomach and the spine. Its head section connects to the duodenum, the first part of the small intestine. Inside the pancreas, small ducts (tubes) feed digestive enzymes produced by the pancreas into the pancreatic duct. Lipase is transported through the pancreatic duct and into the first part of the small intestine, where it helps break down dietary triglycerides (a form of fat) into fatty acids.
Lipase is usually present in the blood in small quantities. When cells in the pancreas are injured, increased amounts of lipase enter the blood and result in higher concentrations in the blood. This can occur in conditions such as pancreatitis, or when the pancreatic duct is blocked by a gallstone or, in rare cases, by a pancreatic tumor.
How is the test used?
The blood test for lipase is most often used to help diagnose and monitor acute pancreatitis. It may also be used to diagnose and monitor chronic pancreatitis and other disorders that involve the pancreas.
The lipase test may be used along with a blood amylase test to detect pancreatic diseases. While the amylase test is sensitive for pancreatic diseases, it is not specific. That means an elevated amylase level may indicate a problem, but the cause may not be related to the pancreas. The lipase test, on the other hand, is more specific than amylase for diseases of the pancreas, particularly for acute pancreatitis and for acute alcoholic pancreatitis. An elevated lipase usually indicates a problem with the pancreas. Evaluating the results of the two tests together helps to diagnose or rule out pancreatitis and other conditions.
When is it ordered?
- Severe upper abdominal or back pain that radiates to the back or feels worse after eating
- Loss of appetite
- Nausea, vomiting
- Yellowing of the eyes or skin (jaundice)
- Rapid pulse
- Loose, fatty, foul-smelling stools (steatorrhea)
It may also be ordered at intervals when a healthcare practitioner wants to monitor someone with a pancreatic condition to evaluate the effectiveness of treatment and to determine whether the lipase levels are increasing or decreasing over time.
What does the test result mean?
A high lipase level in the blood may indicate the presence of a condition affecting the pancreas.
In acute pancreatitis, lipase levels are frequently very high, often 3 to 10 times higher than the highest reference value (often called the upper limit of normal). Lipase concentrations typically rise within 3 to 6 hours of an acute pancreatic attack, peak at 24 hours, and remain elevated for up to 8 to 14 days. Lipase levels cannot be used to determine the severity of an acute pancreatic attack.
A low level of lipase in the blood may indicate permanent damage to the lipase-producing cells in the pancreas. This can occur in chronic diseases that affect the pancreas, such as cystic fibrosis.
Is there anything else I should know?
The pancreas is the primary source of lipase, but cells in other areas of the body involved with digestion and nutrient absorption also produce lipase, including those in the tongue, stomach and liver.
Drugs that may increase lipase levels include pain medications like codeine, indomethacin, and morphine, birth control pills, thiazide diuretics, and cholinergic drugs, among others.
What are the long-term consequences of pancreatitis?
With acute pancreatitis, there is usually no long-term damage and often no further problems develop. Chronic pancreatitis, which may present as a series of acute attacks, can cause permanent damage. As the pancreas becomes scarred, some people develop diabetes and/or the inability to digest foods, especially fats, leading to malnutrition. The lack of normal pancreatic enzymes may lead to adverse effects on food digestion and waste production, causing malabsorption, abdominal pain, greasy stools, and the formation of stones in the pancreas. Complications also include pancreatic cancer as well as osteoporosis. Even if the disease is controlled, the damage is often irreversible. If the disease progresses, it could lead to death.
Do elevated lipase levels always mean I have a pancreatic condition?
In some cases, an elevated lipase level may be due to a condition other than pancreatitis. In pancreatitis, the lipase level rises quickly and drops in 8 to 14 days. In other conditions, the rise is usually not as great and the level may be maintained for a longer period. Moderately increased lipase values can occur in other conditions, such as kidney disease, and may also be due to decreased clearance from the blood, salivary gland inflammation, gallbladder inflammation, celiac disease, a bowel obstruction, or peptic ulcer disease. The lipase test is not, however, usually used to monitor these conditions. Your healthcare practitioner will determine whether you have a pancreatic disorder and will make a diagnosis based on your symptoms, medical history, and test results.
Sources Used in Current Review
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(August 3, 2015) Blood Tests for Acute Pancreatitis. Australian Prescriber. Available online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4653980. Accessed on 6/9/18.
(February 4, 2015) Lipase. Ridgeview Medical Center. Available online at http://health.ridgeviewmedical.org/library/content/1/3465. Accessed on 6/9/18.
(January 16, 2014) Lipase. Medscape. Available online at https://emedicine.medscape.com/article/2088094-overview?pa=1Bca9cuLavsFsT9GL7e8eoQT9rz9YndNJfwtmMwpSWTEyBZJFooCifR%2FyRZlK3B48SIvl8zjYv73GUyW5rsbWA%3D%3D#a4. Accessed on 6/10/18.
(November 2017) Definition & Facts for Pancreatitis. National Institute of Diabetes and Digestive and Kidney Diseases. Available online at https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis/definition-facts. Accessed on 6/10/18.
Sources Used in Previous Reviews
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Case-Lo, Christine. (Updated May 29, 2013.) Amylase and Lipase Tests. Healthline. Available online at http://www.healthline.com/health/amylase-and-lipase-tests. Accessed April 2014.
Al-Kaade, Samer. (Updated Jan. 29, 2013.) Exocrine Pancreatic Insufficiency. Medscape. Available online at http://emedicine.medscape.com/article/2121028-overview. Accessed April 2014.
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