Introduction
The value in the blood count where we speak of lipase is the pancreatic lipase. This is an enzyme that is produced in the pancreas. It is secreted into the small intestine to digest fat.
The lipase has a reference value of 30-60 U/l. If this value is exceeded, this is called increased lipase. This value is determined when acute inflammation of the parotid gland is suspected, to control chronic pancreatitis and in cases of unclear upper abdominal pain.
Causes
Causes for increased lipase can be many and varied. Probably the best known cause is pancreatitis, or inflammation of the pancreas. In acute pancreatitis, the level rises up to 80 times in the first few hours.
It takes over a week for the value to return to normal. The situation is different with chronic pancreatitis. In this case, the pancreatic cells are destroyed and less lipase is produced.
If one speaks of a slight increase, one means that the value increases only about 5 times the normal value. There are many possibilities for this. Either it is an acute flare of pancreatitis or it can remain within the normal range.
Even a very early blood sample taken in the case of acute pancreatitis can initially only result in a slightly increased value. In this case the blood sample should be taken again after a few hours if the symptoms are clear. Other clinical pictures in which the lipase level may be slightly elevated are Ulcers in the stomach or small intestine (ulcer disease), intestinal obstruction (ileus), chronic inflammatory bowel disease, inflammation of the gallbladder (cholecystitis) due to gallstones, viral hepatitis, kidney failure, in our country very rarely typhoid and mumps, as well as sarcoidosis with pancreatic involvement.
Stress directly has no influence on the lipase value. However, there are individual stress management mechanisms that can have an influence over some corners. The most common reason for pancreatitis with lipase elevations is too much alcohol.
So if you tend to consume alcohol because of stress and also eat a lot of fatty foods, you have an increased risk of pancreatitis. Opiates increase lipase. This includes, for example, other drugs that can also increase lipase.
- Morphine
- Oxycodone
- Fentanyl
- Meperidine
- Codeine
- Azathioprine
- Bethanechol
- Furosemide
- Heparin
- Indomethacin
- Methacholine
- Methylprednisolone
- Narcotics
- Oral contraceptives (“pill”)
- Pentazocin
- Secretin and sulfisoxazole
In this context we also speak of pancreatic amylase (alpha-amylase). It is important for the digestion of sugar and is produced in the pancreas and then secreted into the small intestine. If the blood level is elevated, the first thing the doctor thinks of is acute pancreatitis.
The amylase is only elevated for about 2-5 days, which is shorter than the lipase. The normal value of the pancreas-specific amylase is up to 50 U/l. The amylase level is often elevated even without a detectable cause.
It is sufficient to have only the lipase determined if pancreatitis is suspected, as the informative value is better here than with the amylase. The differential diagnoses for elevated amylase are also possible, just like for elevated lipase. If the total amylase is too high (there are amylases from the pancreas and the parotid glands), one should also think of diseases such as inflammation of the parotid gland (parotitis).
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