Amylase and lipase tests

Overview

Amylase and lipase are two enzymes (proteins that help with digestion) made by your pancreas. An amylase test and a lipase test measure the amount of these enzymes in your blood. High levels can signal that your pancreas is inflamed or damaged. The tests help doctors find the cause of belly pain and other symptoms.

These tests are very common. Any healthcare provider can order them when someone has belly pain, especially if pancreatitis is suspected.

The tests are done in people of all ages who have symptoms like severe upper belly pain, nausea, or vomiting. They are especially used in adults with risk factors such as gallstones or heavy alcohol use.

Symptoms

Common symptoms

• Severe pain in the upper belly that may spread to your back
• Nausea and vomiting
• Tenderness when touching the belly
• Fever or chills
• Rapid pulse

Symptoms in children

• Belly pain that makes them cry or unable to eat
• Vomiting
• Fussiness or lethargy (unusually tired)

Symptoms in older adults

• Belly pain that may be dull or vague
• Unexplained confusion or weakness
• Loss of appetite
• Nausea without vomiting

Causes

Main causes

• Pancreatitis (inflammation of the pancreas) – the most common reason for high levels
• Gallstones blocking the duct where the pancreas releases enzymes
• Alcohol use that irritates the pancreas
• High triglycerides (a type of fat in the blood)
• Some medicines (rarely)
• Trauma or injury to the belly
• Kidney problems that slow removal of enzymes

Risk factors

• Heavy or regular alcohol use
• Gallstones
• Family history of pancreatitis or high triglycerides
• Obesity
• Smoking
• Certain infections

When to see a doctor

See a doctor urgently if:

• If you have severe belly pain that does not go away
• If your belly pain is accompanied by fever, rapid pulse, or vomiting for more than a day

Book a routine appointment if:

• If you have mild belly pain that keeps returning
• If you have risk factors for pancreatitis (like heavy alcohol use or gallstones) and want a check-up

Diagnosis

A doctor will listen to your symptoms, examine your belly, and order a blood test to measure amylase and lipase levels. Often they will also check other things like liver function, triglycerides, and a complete blood count. Imaging tests like an ultrasound or CT scan may be done to look at the pancreas and gallbladder.

Tests that may be done

• Amylase blood test – measures the amount of amylase in your blood
• Lipase blood test – measures lipase, which is more specific for the pancreas
• Complete blood count (CBC) to check for infection or inflammation
• Liver function tests to see if the bile duct is blocked
• Abdominal ultrasound or CT scan to get pictures of the pancreas and nearby organs

What to expect at your appointment

The blood test is taken from a vein in your arm, just like any routine blood draw. It takes only a few minutes. You may need to fast (not eat or drink) for 8 to 12 hours before the test, depending on your doctor's instructions. The results usually come back within a few hours to a day. Your doctor will explain what the numbers mean and what to do next.

Treatment

Treatment depends on the cause of the abnormal test results. If high amylase and lipase are due to acute pancreatitis, the focus is on resting the pancreas, managing pain, and preventing complications. If gallstones are the cause, surgery to remove the gallbladder may be needed after the inflammation settles.

Self-care at home

• Do not eat or drink anything for a short period (as advised by your doctor) to give your pancreas a rest
• Once allowed, start with small, low‑fat meals
• Avoid alcohol completely – it is the most common trigger for recurrent pancreatitis
• Take pain relief as recommended by your doctor, but avoid high‑dose ibuprofen or aspirin if there is a risk of bleeding

Medical treatments

Doctors may provide intravenous (IV) fluids to prevent dehydration and pain relievers through a drip or injection. If you are unable to eat, you may receive nutrition through a tube. Antibiotics are not given unless an infection is confirmed. For high triglycerides, medicines to lower them may be prescribed. The specific medication will depend on your overall health and should be discussed with your healthcare provider.

When is surgery considered?

If gallstones are blocking the pancreatic duct, a procedure called ERCP (endoscopic retrograde cholangiopancreatography) may be done to remove them. Later, a cholecystectomy (removal of the gallbladder) may be recommended to prevent future attacks. Surgery is also considered for complications like an infected fluid collection (pseudocyst) that does not heal on its own.

Living with this condition

After an episode of pancreatitis, you will need to follow a low‑fat diet, avoid alcohol, and not smoke. Many people feel better and return to normal activities within a few days to a week for mild cases. Chronic pancreatitis may require ongoing care, including enzyme supplements and management of pain.

Lifestyle tips

• Stop smoking – it worsens pancreatitis and raises the risk of pancreatic cancer
• Avoid alcohol completely – even small amounts can trigger relapses
• Eat small, frequent meals with very little fat
• Drink plenty of water to stay hydrated

Diet and exercise

A low‑fat, high‑protein diet is often recommended. Good choices include lean chicken, fish, beans, rice, and vegetables. Avoid fried foods, butter, creamy sauces, and fatty cuts of meat. Gentle exercise like walking can help with recovery, but strenuous activities may need to be avoided until you feel stronger.

Mental health and emotional wellbeing

Living with a chronic health condition can be stressful and worrying. You may feel anxious about future attacks or frustrated with diet restrictions. It is normal to have these feelings. Talk to your doctor or a counsellor if they become overwhelming.

Prevention

Not all causes can be prevented, but you can lower your risk of pancreatitis. The most important steps are to avoid heavy alcohol use, maintain a healthy weight, and treat gallstones or high triglycerides early. If you have a family history, talk to your doctor about monitoring your levels.

Screening programmes

Routine screening for amylase and lipase in people without symptoms is not recommended. However, if you have risk factors like a strong family history of pancreatitis or known high triglycerides, your doctor may check your levels occasionally.

Complications

If left untreated

• Severe dehydration and shock from prolonged vomiting
• Infection of the pancreas that can spread to the blood (sepsis)
• Pseudocysts – pockets of fluid that can become infected or rupture
• Chronic pancreatitis leading to long‑term pain and digestion problems
• Diabetes if the pancreas stops making enough insulin

Long-term outlook

Most people with acute pancreatitis recover fully with treatment. The outlook depends on the cause. If you stop drinking alcohol and manage gallstones, the chance of recurrence is low. Chronic pancreatitis is a long‑term condition, but with good care – including diet changes, medicine, and avoiding triggers – most people can lead a full and active life. Your doctor will work with you to create a plan that keeps you healthy.

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