Lipase is the preferred laboratory test for diagnosing acute pancreatitis, as it is the most sensitive and specific marker for pancreatic cell damage. Additional laboratory testing, such as complete blood count (CBC) and lactate dehydrogenase (LDH) tests, are useful to obtain prognostic information.
When comparing different studies, serum lipase offers a higher sensitivity than serum amylase in diagnosing acute pancreatitis.
We recommend estimating lipase levels alone for the diagnosis of acute pancreatitis as it is more sensitive than amylase, lasts longer, and is elevated in conditions like hypertriglyceridemia where amylase may be normal [3,4]. However, amylase levels continue to be frequently ordered concurrently [5].
There are a few things you must completely avoid, such as alcohol and fried/greasy/high fat foods (such as creamy sauces, fast food, full fat meat and dairy, and anything fried). These foods can cause your pancreas to release more enzymes at once than it normally would, leading to an attack.
In a retrospective study of 151 patients with acute pancreatitis,2 the sensitivity of lipase was 96.6% and the specificity was 99.4%. In contrast, the sensitivity of amylase was 78.6% and the specificity was 99.1%.
Lipase is also thought to be more specific for the pancreas than amylase due to its relative but not exclusive organ specificity.
The sensitivity and specificity of amylase at 3-fold above normal limit were 62.8% and 99.2% while those of lipase were 96.1% and 99.1% respectively.
Fried foods and high-fat foods
The pancreas helps with fat digestion, so foods with more fat make the pancreas work harder. Other examples of high-fat foods to avoid include: high-fat dairy products, such as cream, whole milk, and full fat cheeses. processed meats, such as hot dogs and sausage.
Pancreatitis is the redness and swelling (inflammation) of the pancreas. It may be sudden (acute) or ongoing (chronic). The most common causes are alcohol abuse and lumps of solid material (gallstones) in the gallbladder. The goal for treatment is to rest the pancreas and let it heal.
Because your pancreas produces and secretes enzymes based on what's in your small intestine, eating may worsen the inflammation by increasing production and early activation of the enzymes.
Lipase has a slightly longer half-life and its abnormalities may support the diagnosis if a delay occurs between the pain episode and the time the patient seeks medical attention. Elevated lipase levels are more specific to the pancreas than elevated amylase levels.
Recent literature has reported a negative predictive value of serum lipase in diagnosing acute pancreatitis to be between 94% and 100%, and a normal blood lipase level in acute pancreatitis is an extremely rare event. Here we reported two cases with normal serum amylase and lipase levels.
Laboratory Testing
Elevated amylase levels are sensitive but not specific for the diagnosis of pancreatitis because many other conditions may cause high amylase levels (Box 7‐3). Lower amylase levels are found in alcoholic pancreatitis, and levels may be normal in acute pancreatitis secondary to hyperlipidemia.
In cases of acute pancreatitis, serum activity for both enzymes is greatly increased. Serum lipase is now the preferred test due to its improved sensitivity, particularly in alcohol-induced pancreatitis. Its prolonged elevation creates a wider diagnostic window than amylase.
Direct Pancreatic Function Test. Serum trypsinogen is considered a sensitive and specific test for advanced pancreatic insufficiency, although its accuracy for earlier stages of pancreatic insufficiency is low.
The most common causes of acute pancreatitis include gallstones, alcohol use, and hypertriglyceridemia.
The many causes of pancreatitis include long-term alcohol abuse, gallstones, and certain inherited conditions, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH).
Emotional stress can excite the vagus nerve (connects the brain with the stomach) and causes the stomach to be stimulated to produce excessive amounts of acid. As noted, this increase in acid stimulates an increase in pancreatic secretion production. This can exacerbate pancreatitis once it has been established.
The salivary enzyme alpha-amylase has been proposed to indicate stress-reactive bodily changes. A previous study by the authors revealed marked increases in salivary alpha-amylase following psychosocial stress, indicating a stress-dependent activation of salivary alpha-amylase.
If your amylase levels are higher than normal, you may have 1 of many conditions. These include: Sudden swelling of the pancreas (acute pancreatitis) Chronic pancreatitis that suddenly gets worse.
Lipase is the preferred laboratory test for diagnosing acute pancreatitis, as it is the most sensitive and specific marker for pancreatic cell damage. Additional laboratory testing, such as complete blood count (CBC) and lactate dehydrogenase (LDH) tests, are useful to obtain prognostic information.