Lipase Test

What is the Lipase test?

A lipase test is a blood test performed in order to quantitatively measure the level of the enzyme lipase in your serum. Some conditions, notably acute pancreatitis can be diagnosed by assessing the increase in the levels of lipase in your blood.

What is Lipase?

Lipase is an enzyme produced by the pancreas, stomach, intestine, liver and a few other body tissues. It helps in the digestion of fats in your body. Lipase is responsible for the breakdown of triglycerides into free fatty acids and glycerol. Depending on the organ secreting them and the specific function ascribed to them, lipases may be divided into hepatic lipases, pancreatic lipases, hormone sensitive lipases and lipoprotein lipases.

Why has my doctor ordered the Lipase test for me?  

As serum lipase test is generally ordered to detect acute pancreatitis. Your physician may order a lipase test for you if you present with the features of acute pancreatitis. These include-

– Upper abdominal pain (aggravated after eating and radiating to the back)
– Tender abdomen
– Fever
– Tachycardia (rapid pulse)
– Nausea/Vomiting
– Anorexia (loss of appetite)

The reference range for serum lipase is 0-160 U/L. In acute pancreatitis, the levels of serum lipase will be markedly increased (5 to 10 times higher than normal). An increase in serum lipase levels is also seen in the following conditions-

– Chronic alcoholism
– An infection of the pancreas
– Pancreatic cyst
– Pancreatic malignancy
– Inflammatory bowel disease (Ulcerative colitis and Crohn’s disease)
– Cystic fibrosis
– Celiac disease
– Peritonitis (an inflammation of the inner lining of the abdominal wall)
– Bowel obstruction
– Diabetic ketoacidosis
– Gastrointestinal malignancy
– Chronic liver disease
– Renal failure (acute or chronic)

In the case of chronic pancreatitis, the levels of lipase are only slightly elevated. Therefore, it is the acute inflammation of the pancreas, whose diagnosis depends on assessing the elevation of lipase levels in the blood.

What is acute pancreatitis?

Acute pancreatitis is the sudden inflammation of the pancreas, an organ located in the abdomen behind the lower part of the stomach. The pancreas serves two important functions in your body-

– It regulates the sugar levels in the blood. The all-important hormone Insulin is secreted by the pancreatic cells, so is the glucagon-the counterpart of Insulin.

– It aids in the digestion of food. It is the source of pancreatic juices and bile, enabling the digestion of proteins, fats, and carbohydrates.

Given the dynamic roles that the pancreas plays in the metabolism of your body, any acute disorder of this vital organ can have serious implications. In many cases, the inflammation of the pancreas is self-limiting. In certain conditions, however, acute pancreatitis is an emergency condition. Early diagnosis and aggressive treatment are the only way to treat this ailment.

Chronic alcoholism and gallstones are the 2 conditions most commonly involved in the pathogenesis of acute pancreatitis. The other risk factors include-

– Abdominal trauma
– Infections
– Smoking
– Obesity
– Surgery
– Autoimmune diseases
– Drug-induced

How should I prepare for a Lipase test? What are the precautions that I need to undertake?

No specific preparation is required. You need to discuss with the physician your medical history. As a lipase test is a blood test and involves the standard techniques of venipuncture, you need to inform your physician if-

– You are taking any blood thinners
– You are suffering from any coagulopathy
– You also need to inform your physician if you are taking any medication (including supplements, ayurvedic or any illicit drugs) at the time of the test.  

Certain drugs may interfere with the levels of serum lipase; therefore, your physician may ask you to skip the following drugs before the test (if you are consuming them)-

– Birth control pills
– Indomethacin
– Codeine/morphine
– Certain diuretics
– Anti-viral drugs (Lopinavir/Ritonavir)
– Drugs with cholinergic activity (e.g. those used for glaucoma and myasthenia gravis)

Do I need to fast overnight?

Yes. Your physician will advise you to fast for 8-12 hours prior to the test. You will be asked not to drink water or take any food for this period.

Can I undergo Lipase test if I am pregnant?

It is perfectly safe to undergo lipase testin pregnancy or if you are breastfeeding your child.

Can children undergo the Lipase test?

Yes, children can safely undergo a lipase test.

How is the actual Lipase test performed?

It is a blood test carried out on an outpatient basis. It is a safe, minimally invasive and quick test. No sedation is required. The procedure can be carried out in a doctor’s clinic, a diagnostic center or in a hospital setting (in case you are already admitted to a hospital).

– You will be asked to sit on a comfortable chair or lie down on a hospital bed.

– The technician will apply a tourniquet proximally to the site chosen for venipuncture. This makes the veins more prominent, allowing easier access.

– The area is cleaned with a disinfectant. The area is allowed to dry. A sterile, single-use needle is used to puncture the vein and draw about 5 ml of blood.

– The pressure is applied to the vein with sterile gauze after the needle is withdrawn.

– The tourniquet is released. The blood sample is collected in a vial.
A small bandage is applied over the site from where blood has been drawn.

The entire procedure is over in a few minutes. In obese patients, patients belonging to the geriatric age group and very young children, venous access is sometimes difficult, leading to more than one prick.

How long does it take for the result of a Lipase test to be out?

You can get the results of your lipase test the very same day.

What are the risks involved?

A lipase test is a simple, risk-free and easy to perform the test. However, as is the case with any procedure involving venipuncture, the following complications may sometimes be seen.

– Bleeding, bruising or formation of a hematoma at the site of vascular invasion may be encountered.

– The sensation of a needle prick may be perceived as painful by some.

– You may also experience mild nausea and dizziness at the sight of blood. It is better to look away when the blood sample is being withdrawn in such a case.

– Infection at the site of venipuncture may be a late complication.

Consult your physician if you witness any signs of infection-an abscess or pus at the site of venous invasion.

What are the advantages and limitations of the Lipase test?

What is the cost of performing a Lipase test in India?

The cost of undergoing a lipase test in India ranges from INR 500-750; the actual cost varies as it depends on the city that you reside in and the diagnostic center that you choose.

What are the other tests that can diagnose acute pancreatitis?

Apart from the serum lipase test, the following are the tests that can be carried out to diagnose acute pancreatitis-

– Serum amylase test
– Trans-Abdominal ultrasound
– Endoscopic ultrasound
– Magnetic resonance cholangiopancreatography (MRCP)
– Computed Tomography (CT)

What is the treatment of acute pancreatitis?

The worldwide incidence of acute pancreatitis ranges between 5 and 80 per 100,000 population. The mortality rate of acute pancreatitis, despite the advances in the detection techniques and the subsequent interventions, remains high at around 10%. Early diagnosis and judicious intervention are required to treat this potentially fatal disease. The following steps can be taken-

Fluid replacement-Fluid replacement is the cornerstone of treatment in the first 24 hours. It prevents dehydration and ensures that the vital organs get suitable blood flow.

Nutritional Support-After the initial 48 hours when the pancreas and intestines are rested, the body’s calorie requirements are met. Depending on the condition of the patient, nutrition can be oral, via a nasogastric tube or through parenteral route.

Pain Control-Intravenous narcotics are potent enough to control the severe pain associated with acute pancreatitis.

Supportive care-Acute pancreatitis is a medical emergency that can lead to multi-organ involvement. Therefore, continuous monitoring of the patient’s vitals with symptomatic and supportive care is of paramount importance.

Treat the underlying cause-In all cases of acute pancreatitis, the underlying cause needs to be identified at the earliest and treated.