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The Serum amylase test and Urine Amylase test is typically done
• To detect acute pancreatitis and to monitor its course.
Sometimes, it also done to monitor
• Chronic pancreatitis
• Other diseases of the pancreas: pseudocyst, cancer, or abscess.
The Amylase test is one of the first tests to be done when your doctor suspects pancreatitis. Pancreatitis is the inflammation (swelling) of the pancreas which may produce the following symptoms in you:
• Pain in abdomen- typically severe pain in upper abdomen. The pain feels like stabbing and tends to radiate to your back. You may feel little better on bending.
• Nausea and vomiting
• Loss of appetite
The Amylase test is also done when your doctor wants to monitor the progress of the pancreatic disease or to check the effect of the treatment.
Usually your doctor asks for serum amylase test where you have to give a small blood sample. The sample is taken using a thin needle from the vein of your arm.
Sometimes your doctor may order a urine amylase test where the level of amylase is estimated from a random urine sample or a 24-hour urine sample.
In special situations when you have fluid in abdomen, he may also ask to check for amylase levels in your peritoneal fluid.
Avoid alcohol: For any amylase test (serum amylase test or urine amylase test) you need to avoid drinking alcohol for minimum 24 hours prior to the test.
For the serum amylase test (blood test) you may need to avoid eating or drinking anything 2 hours before the test.
Discuss medicines: Some of the medicines may alter the level of amylase in your body and thus may affect the serum amylase test results. You need to inform your doctor about the medicines you take who might ask you to either stop the medicine or change its dose.
The following medicines that can affect the amylase levels are:
• Birth control pills
• Opioids such as codeine, morphine, etc.
• Cholinergic drugs
• Diuretics of thiazide group, such as chlorothiazide, metolazone etc.
Amylase is an important enzyme that helps to digest carbohydrates. It is mainly produced by the pancreas in the abdomen and salivary glands in the mouth.
The levels of amylase can be checked in various ways:
Blood amylase test: the serum amylase test measures the levels of amylase in your blood.
Urine amylase test: it detects the level of amylase excreted in urine. Both the tests help to detect abnormal levels of amylase in the body which usually indicates pancreatitis and sometimes other conditions.
Peritoneal fluid amylase test: the peritoneal fluid is checked for the abnormal levels of amylase.
Amylase has strong digesting properties. It is carried out by the pancreas though a thin tube-called pancreatic duct-to the small intestine where it digests the food. When this enzyme spills out of the duct into the pancreatic tissue it starts the break down, leading to pancreatitis- swelling of the pancreas.
Due to this event the amylase level in the blood, urine and abdominal fluid increases. So, when you are suspected to have pancreatitis your doctor collects the sample (usually blood) and check for the elevated levels of amylase. Significantly high levels of amylase usually suggest a diagnosis of pancreatitis.
Apart from this, your doctor may repeat the test during or after the treatment to check if it has worked. This is called monitoring of the disease. With improvement in the condition the amylase level comes down and becomes normal once you recover fully.
Your doctor usually orders a lipase test with a blood amylase test which is also known as Serum Amylase test if you are suspected to have pancreatitis. The amylase test is sensitive- suggesting high chances of pancreatitis with increased levels. However, it is less specific- meaning it doesn’t necessarily mean you have chances of only pancreatitis. It may indicate any other condition, where amylase level increases too. For this reason, a blood lipase test is also done which is more specific for detecting conditions of pancreas especially the acute pancreatitis. The two tests used along increase the chances of detecting or ruling out pancreatitis and other conditions.
Amylase is excreted from the body via urine. Your doctor may also order urine amylase test to detect abnormal levels of amylase in the urine. The levels of the amylase in urine alters according to the blood levels. However, the urine amylase levels take longer time to show rise or fall.
Sometimes your doctor may order the urine creatinine test with a urine amylase test. This helps him to calculate the amylase to creatinine ratio which indicates how well your kidneys are functioning.
During pancreatitis or certain pancreatic conditions, the amylase may spill out into the fluid within abdomen. Your doctor may take a small sample of the fluid and measure amylase in it. High level of amylase in the fluid suggests high chances of pancreatitis.
High amylase level mostly indicates a disease of the pancreas, typically pancreatitis. However, it may occur due to other organs such as disease of the salivary gland, intestine, etc.
The normal range may vary- 20 to 300 units per liter (U/L).
So, the blood levels above 300 U/L is generally considered high and levels below 20 U/L is considered low. However, there is no universally accepted range and the range may vary for different labs.
|High Amylase levels||Conditions|
|Above the upper limit (>300U/L)||• Pancreas- Pancreatitis (acute or chronic), tumor of pancreas, block in the pancreatic duct|
• Salivary gland- mumps, stone in the gland
• Abdomen issues- bowel obstruction, perforated ulcer, liver disease, choledochal cyst
• Abnormal pregnancy- Ectopic pregnancy
• Cancer- lung, liver, ovary
• Medicines- mesalazine, azathioprine, propofol
• Other conditions- diabetic ketoacidosis, ICU patients, trauma, macroamylasemia
|Above the upper limit by more than 3 times (>900U/L)||• Acute pancreatitis especially with high levels of lipase|
|Low amylase levels||Conditions|
|Below the lower limit (<20U/L)||• Cystic fibrosis|
• Chronic pancreatitis (due to damage to amylase producing cells)
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