Amylase Test

The blood test for amylase is used to diagnose acute pancreatitis (inflammation of the pancreas) and other pancreatic diseases. The swift rise of amylase at the beginning of a pancreatitis attack, and its fall after about 2 days, helps to pinpoint this diagnosis. Amylase is sometimes, although rarely, used in the diagnosis and follow-up of cancer of the pancreas, gallbladder disease and mumps.

An amylase test may be requested if you show symptoms of a pancreatic disorder, such as severe abdominal pain, fever, loss of appetite, or nausea. Urine amylase may be requested with or following a blood amylase test. One or both may also be requested when a doctor wants to monitor a patient to find out whether treatment is working and whether amylase levels are increasing or decreasing.

In pancreatitis which is a severe inflammation of the pancreas, amylase concentrations are usually very high, often 5-10 times normal. However, the degree of elevation does not correlate with the severity of pancreatitis. Increased amylase concentrations may also indicate cancer of the pancreas, acute appendicitis, gallbladder disease, a perforated ulcer, obstruction of the intestinal tract, mumps or ectopic pregnancy. Increased blood amylase with normal or low urine amylase may indicate decreased kidney function or the presence of macroamylase, when amylase is attached to other proteins and accumulates in blood. A high amylase result due to macroamylase is not an indicator of disease. Some people tend to have higher amylase levels than others; this includes people of African or Asian descent. Having slightly high results does not necessarily mean there is underlying disease.

In acute pancreatitis, elevated amylase concentrations usually parallel levels of another enzyme called lipase. Either amylase or lipase can be requested in order to help diagnose acute pancreatitis, but amylase is the most frequently used test.
Chronic (long-term) pancreatitis is often associated with alcoholism. It may also be caused by trauma to the pancreas or associated with genetic abnormalities such as cystic fibrosis. Amylase concentrations may be moderately elevated with chronic pancreatitis or may be decreased when the cells that produce amylase in the pancreas become damaged or destroyed.

Treatment depends upon the symptoms. If they are absent or mild, there may be no treatment; if they are more severe, your doctor may suggest 'resting the pancreas' using a range of options, from not eating solid foods to fasting combined with intravenous (IV) fluid replacement for several days to a few weeks (usually requiring admission into hospital). This use of medicines and surgery may also be considered for patients with severe symptoms. Sometimes you may need pain management medicines. Nutritional support, such as low-fat diets and frequent small meals, may help relieve symptoms. Oral pancreatic enzyme replacement is another possible option.