Questions in the Gastroenterology and Liver Diseases Forum have been answered by Dr. Kevin Pho who is board certified in Internal Medicine and by doctors from Henry Ford Health System.

Question Title: Lipase levels

Forum: The Gastroenterology and Liver Diseases Forum
Topic: Digestive


I am wondering why my lipase levels would be elevated. I have had severe acid reflux problems for the past four years and when I am in the middle of a severe attack, my lipase is elevated to the mid 200's when I'm not in the middle of an attack it is normal. Could this indicate my gall bladder is involved? I had an EGD done and the doctor found bile in my stomach. He reasons that this would be a good reason to remove the gall bladder. Oh, also, I do not drink alcohol so that would not be a reason for the elevated levels. Thanks.

Dear Autumn,

Elevated lipase levels are commonly seen in acute pancreatitis (inflammation of the pancreas gland). The most common causes of pancreatitis in the United States are alcohol related and gallstones. You did not mention whether or not you had an abdominal ultrasound or CT scan to look for gallstones and image the pancreas. In many patients with biliary pain, particularly in patients with acute cholecystitis (gallbladder inflammation) fever, jaundice and abnormal liver enzymes may be present. Elevated lipase levels have greater sensitivity and specificity than amylase in diagnosing acute pancreatitis. On the other hand, lipase is not completely specific for the pancreas. Lingual, gastric, intestinal and hepatic isolipases have been isolated. Their clinical significance is unclear. I would recommend that you have a thorough evaluation of your gallbladder and pancreas prior to proceeding with gallbladder surgery. If the underlying attacks are caused by gastroesophageal reflux, removing your gallbladder will not prevent subsequent episodes. I hope you find this information helpful.

This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.

If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians’ Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.

HFHSM.D.-ym
*Keywords: elevated lipase, gastroesophageal reflux, acute pancreatitis




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