Lipase level question

John,

thanks for your reply and here is my background:

I went to the hospital with a tummy ache, vomiting and diarrhea. They ran a bunch of test including a scan and found my lipase was raised to 401 and concluded it was acute pancreatitis even though everything else came back normal. that was 4 hrs after my symptoms came on. They released me soon after that with little explanation.

3 days later i had my levels checked again and i was back to normal and this has been the case for the other 4 times I've had them check since. I've had every scan done which have come back normal (except for an EUS).

I've had a few of these "attacks" since May. It lasts for an hour or so, usually comes with a bout of diarrhea and 1 instance of vomiting. I feel fine after that outside of bloating the next day. The other odd thing is the 5 times it's happened, its happened at either 11 pm or early morning, 5 am.

My GP thinks its not pancreatitis and told me that the ER isn't great a making diagnosis. My GI won't say what caused it.

Everything I've heard and read about the pain associated with pancreatitis doesn't even come close to the mild pain i experience, plus it disappears after a couple of hours.

Every hospital and lab will have their own normal range limits but your age, gender and any medications will also play a factor on the results. If you have high cholestrol that will actually have an effect on pancreatitis blood work as well (usually won't show pancreatitis blood work). Another thing, when the pancreas is inflamed, it stays inflamed for a couple days, so your lipase would normally reflect it (meaning they stay elevated). Usually they ask you to fast prior to taking the test because foods can inflame the pancreas. The ER is horrible and I mean horrible with any pancreas related problems. From my experience they don't have the knowledge and assume things rather than actually looking into things. Pancreatitis is very painful and you wouldn't be able to handle the pain after eating (I was already on pain medication and couldn't handle the pain associated with chronic pancreatitis), this was before I knew I had CP due to a rare condition I was born with. My blood work never showed pancreas related anything but my liver enzymes would always elevate. After over a year of tests and being treated like an addict (ER doctors really are horrible) I found out I had Pancreas Divisium (born with two pancreatic ducts that never fused together which caused chronic pancreatitis) my GI doctor still thought my symptoms were IBS related. Once I saw a pancreas specialist that's when I found out I had CP. I would ask your doctor for a MRCP if you haven't had one already. It's the only noninvasive test to look at a working pancreas. An EUS and ERCP are used for treatment purposes because they can cause an attack. I've had 10 ERCPs and had probably five attacks afterwards. I'm currently waiting for my surgery date to have my pancreas removed and my islet cells transplanted to my liver. Do you still have your gallbladder? All the ducts are connected, maybe they're looking in the wrong spot.

@Shortie79, Do you have any references for EUS causing attacks? From what I know it is a fairly low-risk procedure. The risk can increase some when it is accompanied by a fine needle biopsy:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3442204/

@tony96724, There could be a lot of things causing your issues. Have you ruled out Celiac diease?

There are many things that can cause slight elevations of lipase. The levels you experienced would not typically be enough to make a "textbook" diagnosis of acute pancreatitis.

40 yr old male that liked to have the occasional craft brew on the weekends. I don't take any meds nor have any pain after eating.

i had a CT, MRCP and a Xray, all of which came back clear outside of a hatial hernia? My most recent "attack" was last Monday. I had my physical the next day where they ran a bunch of blood tests. lipase and amalyse came back in the normal range. They did however find i have hypothyroidism and slightly high cholesterol.

I'm baffled and my Doctors can seem to pinpoint what is causing these attacks once every 3 weeks or so.

I'm pretty fit, maintain a healthy lifestyle.

I do not have a reference regarding EUS material, I am simply stating what my pancreas specialist has told me in the past. I do, do a ton of research because I used to be a paralegal prior to all my medical issues. I had inquired about an EUS before but my specialist wanted to perform an ERCP instead due to the results of my MRCP. He also stated the MRCP was the gold standard of noninvasive tests and the other two were used for treatments nowadays due to the potential risks. I am usually one to ask a ton of questions but if it doesn't pertain to me then I am not going to inquire further. The reference material you posted the first time is from the hospital I go too. I know the needles can cause the risk from an EUS and the dye can cause the risk from an ERCP. Every patient can react differently which is why they normally keep you in the hospital after the procedure.

Have you been screened for cystic fibrosis? You're young like me and according to my specialist, unless you have a family history, cystic fibrosis or Pancreas Divisium, then pancreatitis is uncommon amongst the younger adults. I'm not a drinker and they screened me to cystic fibrosis before they found the two ducts. There's also a test to check if your pancreas is producing enough digestive enzymes … I believe it's called an EPI test. If the pancreas isn't producing the correct amount, it can cause symptoms, but not pancreatitis symptoms. Its just not digesting properly and you would need to supplement them (easy fix). I would look for a pancreas specialist, just because you're seeing a GI doesn't mean they know the pancreas. The pancreas is one of the hardest organs to diagnose due to its location.