What are pancreatic enzymes?
The pancreas consists of various cells, such as the so-called islet cells: They produce various hormones such as insulin, glucagon and somatostatin and release these into the blood as required. Doctors refer to this as the endocrine function of the pancreas.
However, the islet cells only make up around one to two percent of the total weight of the pancreas. The remaining cells produce one to two liters of digestive juice per day. This juice contains various enzymes. They are released into the intestine and help to digest the ingested food. Doctors call this exocrine pancreatic function. The juice contains the following pancreatic enzymes, among others:
- Enzymes that break down carbohydrates (alpha-amylase, glucosidases)
- Enzymes that break down fat (lipase, phospholipase A and B, cholesterol esterase)
- Enzymes that break down nucleic acids (deoxyribo- and ribonucleases)
- Enzymes that break down proteins (trypsin, chymotrypsin, elastase, collagenase, kallikrein, carboxypeptidase)
When are the enzyme levels elevated?
The pancreatic enzymes can be detected either in the blood or in the stool, some also in the urine.
If the enzymes are elevated in the blood, stool and/or urine, this may indicate damage to the pancreatic cells. This can be the case, for example, in acute or chronic inflammation of the pancreas (pancreatitis). Pancreatitis can be triggered by diseases of the bile ducts, excessive alcohol consumption and, less frequently, by infections, operations or medication. The most important pancreatic enzymes that the doctor will have determined if pancreatitis is suspected are amylase and lipase.
When are the enzyme levels too low?
In the case of chronic pancreatitis or pancreatic cancer, the gland may no longer produce enough digestive enzymes (exocrine pancreatic insufficiency). If this is suspected, the amount of elastase in the stool is usually measured and a special test is carried out (secretin-pancreozymin test).
