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.
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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.
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. Pancreatic cancer was the fourth most common cause of cancer deaths in both men and women in 2016. Symptoms of pancreatic cancer include weight loss, fatigue, nausea and vomiting, abdominal or back pain, and voluminous, greasy stools.
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 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.
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.
- 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