Pancreas function tests are used to assess the health of the exocrine pancreas, typically by assessing the levels of certain enzymes or digestive products in blood, feces, or urine.
Pancreas function tests are most commonly used to diagnose chronic pancreatitis. These include tests which document exocrine or endocrine gland insufficiency and tests which instead measure gradations of decreased secretory capacity.
Blood tests can evaluate the function of the gallbladder, liver, and pancreas. Levels of the pancreatic enzymes amylase and lipase can be measured. Blood tests can also check for signs of related conditions, including infection, anemia (low blood count), and dehydration. A tumor marker called CA 19-9 may be checked if pancreatic cancer is suspected.
Secretin is a hormone made by the small intestine and It stimulates the pancreas to release a fluid that neutralizes stomach acid and aids in digestion. The secretin stimulation test measures the ability of the pancreas to respond to secretin.
This test may be performed to determine the activity of the pancreas in people with diseases that affect the pancreas (for example, cystic fibrosis or pancreatic cancer).
During the test, a health care professional places a tube down the throat, into the stomach, then into the upper part of the small intestine. Secretin is administered by vein and the contents of the duodenal secretions are aspirated (removed with suction) and analyzed over a period of about two hours.
The fecal elastase test is another type of pancreas function test. The test measures the levels of elastase, an enzyme found in fluids produced by the pancreas. Elastase digests (breaks down) proteins. In this test, a patient’s stool sample is analyzed for the presence of elastase.
This imaging test can help assess the health of the pancreas. A CT scan can identify complications of pancreatic disease such as fluid around the pancreas, an enclosed infection (abscess), or a collection of tissue, fluid, and pancreatic enzymes (pancreatic pseudocyst).
An abdominal ultrasound can detect gallstones that might block the outflow of fluid from the pancreas. It also can show an abscess or a pancreatic pseudocyst.
In an ERCP, a health care professional places a tube down the throat, into the stomach, then into the small intestine. Dye is used to help the doctor see the structure of the common bile duct, other bile ducts, and the pancreatic duct on an X-ray. If gallstones are blocking the bile duct, they may also be removed during an ERCP.
In this test, a probe attached to a lighted scope is placed down the throat and into the stomach. Sound waves show images of organs in the abdomen. Endoscopic ultrasound may reveal gallstones and can be helpful in diagnosing severe pancreatitis when an invasive test such as ERCP might make the condition worse. A biopsy or sampling of the pancreas may also be possible with this type of ultrasound.
This kind of Magnetic Resonance Imaging (MRI) can be used to look at the bile ducts and the pancreatic duct.
Enzymes are proteins produced by the body to do a particular job. The pancreas produces amylase to break down carbohydrates in food into simple sugars. The pancreas makes lipase to digest fats into fatty acids. Sugars and fatty acids can then be absorbed by the small intestine. Some amylase and lipase can be found in saliva and in the stomach. However, most of the enzymes made in the pancreas are released into the small intestine.
The values of pancreas function test include normal amylase levels of 23-85 U/L (some lab results go up to 140 U/L) and lipase levels of 0-160 U/L.
Pancreatitis suspected amylase levels are > 200 U/L and lipase levels are > 200 U/L.
When the pancreas is damaged, these digestive enzymes can be found in the blood at higher levels than normal. Amylase or lipase results more than three times normal levels are likely to mean pancreatitis or damage to your pancreas. However, in rare cases, there can be significant damage to the pancreas without abnormal amylase or lipase levels. In these cases, abdominal pain is the most common symptom. Early in the course of damage to the pancreas, amylase or lipase levels may also be normal.
Lipase levels may be abnormally high if someone is experiencing:
Abnormal levels of lipase may also exist in people with Familial Lipoprotein Lipase Deficiency. Drugs that may affect the levels of lipase in your bloodstream are the same ones known to affect the levels of amylase.
There are many reasons why you might be experiencing abdominal pain or other symptoms. Amylase and lipase tests are just pieces of the puzzle. Your doctor will first take a medical and family history, perform a physical examination, and ask if you’re taking any medications.
An amylase or lipase test requires a health professional to take a small amount of blood from your vein.
When levels of lipase and amylase are higher than normal it may indicate pancreatic injury or another disease. Lipase levels alone can’t determine the severity of an acute pancreatitis attack. When these test results are abnormal, you may need other tests such as an ultrasound, CT scan, MRI scan, and endoscopy.
Elevated amylase levels show your doctor that there’s a problem, but it may not necessarily involve your pancreas. However, lipase levels compared with amylase levels are usually more specific for pancreatic disorders. Evaluating the results of the two tests and your symptoms can help your doctor diagnose or rule out pancreatitis or other conditions of the pancreas.
If you experience severe abdominal pain, see your doctor immediately. Based on the results of an amylase test, a lipase test, and your medical history, your doctor can decide if additional pancreas function tests are needed or determine what type of treatment is needed.
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