Lipase test: what the result means

Lipase is an enzyme produced mainly by the pancreas, and it is released into the small intestine, where it helps break down the fats in food. A small amount of lipase normally circulates in the blood of a healthy person, but when pancreatic cells are damaged — by inflammation or a blocked duct, for example — much more of the enzyme reaches the blood. That is why a blood lipase test is used first and foremost when acute pancreatitis is suspected. Lipase is considered a more sensitive and more specific marker of pancreatic damage than amylase, so these two tests are often ordered together. Less often, a markedly reduced lipase can show that the pancreatic cells producing the enzyme are irreversibly damaged, as happens in chronic pancreatitis or cystic fibrosis.

• When severe abdominal pain comes on suddenly, often spreading to the back, together with nausea or vomiting — when acute pancreatitis is suspected
• When there is abdominal bloating, tenderness on palpation, fever or a faster heartbeat
• To monitor an already known chronic disease of the pancreas, or to assess how well treatment is working
• When intestinal obstruction or inflammation of the peritoneum (peritonitis) is suspected
• When jaundice appears together with other signs of a digestive disorder

A markedly raised lipase is most often considered a sign of acute pancreatitis — the enzyme reaches the blood once pancreatic tissue has been damaged. Other causes: a blocked pancreatic or bile duct, pancreatic cancer, intestinal obstruction, a perforated stomach ulcer, kidney failure or inflammation of the salivary glands. The cause is established by a doctor together with other tests.

• Acute inflammation of the pancreas (pancreatitis)
• A blocked pancreatic or bile duct, a pancreatic pseudocyst
• Pancreatic cancer
• Intestinal obstruction or a perforated ulcer
• Chronic kidney disease
• Gallbladder disease, diabetes, inflammation of the salivary glands
• Alcohol misuse

Symptoms that can go with a raised lipase

• Severe abdominal pain spreading to the back
• Nausea and vomiting
• Diarrhoea
• Abdominal bloating or tenderness
• Fever
• A faster heartbeat
• Jaundice

• An amylase test and imaging of the pancreas — these help refine the diagnosis of pancreatitis
• Liver and bile duct markers, if a blocked duct is suspected
• Kidney function markers, if chronic kidney disease is suspected
• An assessment of alcohol use with a doctor
• When to repeat the test while the course of treatment is being followed

Low lipase

A low lipase level occurs less often than a raised one and can show that the pancreatic cells producing this enzyme are irreversibly damaged. That is typical of chronic pancreatitis or cystic fibrosis, where the amount of working pancreatic tissue falls over time. Always discuss what the value means with your doctor, together with other tests of pancreatic function.

• Chronic pancreatitis with long-term damage to pancreatic tissue
• Cystic fibrosis

Alongside a low result, these are usually looked at:

• An assessment of pancreatic function together with other tests and imaging methods
• An assessment of nutrition and digestive problems, if chronic pancreatic insufficiency is suspected
• When to repeat the test while the condition is followed over time

Related pages: amylase, pancreatic amylase, GGT, ALT.