Serum lipase slightly elevated and serum amylase normal

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Hi Folks!  Just a quick history of mine: i have been suffering from persistent abdominal pain (burning type of pain) for the past two to three years and since then i have had frequent bowel moments (usually take Imodium once or twice a week to hold my BMs).I have been to numerous GI specialists and almost all of them diagnosed me with IBS-D . I have undergone numerous tests in the past four to 5 months i.e Stool Occult blood( Normal) Celiac disease test (Normal), H.pylori test (Normal),stool culture MacConkey agar ( Normal), CT scan abdomen and Pelvis with contrast (Normal) , Thyroid Profile test (Normal) ,FreeT4(Normal), Calprotection (Normal) and numerous other tests which came back normal.. I recently had a colonoscopy.. The GI doctor found nothing while doing the procedure but my biopsy report came back as " MILD CHRONIC INFLAMMATION OF THE TERMINAL ILEUM". And secondly i am just fed of this persistent pain in my abdomen and loose stools (been on numerous antibiotics as well and some of them usually did make my condition even worst).  I also have recently drawn a blood test of serum lipase and serum amylase and have found that serum lipase is slightly elevated ( normal range is 0-60 IU/L mine is 72 IU/L) and serum amylase is normal. Please help me interpreting this result.. am i suffering from Pancreatitis? 

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  • Posted

    I have burning pain in the upper left side of my colon to the bottom and I am severely constipated. I did most of your tests execpt the colonoscopy. And thankfully they were all normal. It's been two years of having this burning pain that does not go away. When the constupation gets worse the pain gets worse as well. Everything hapoened suddenly two years ago.

    I don't know what to do either.

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  • Posted

    IBS had be hard to diagnose.  It's mainly based on symptoms.  Some of your loose stools can be explained by the use of antibiotics.  It not only kills the germs you don't want, but also the good bacteria.  A good probiotic may help.  You need to replace the good bacteria. 

    I have chronic pancreatitis and IBS.  The GI doctor gave me Levsin for the spasms and diarrhea.  It does not stop the attack, but makes it much less painful and much shorter.  It's like you go once and are done.  You can get in the cycle of diarrhea, constipation, diarrhea, constipation, etc.  Go on a bland diet with plenty of fiber for at least a week and see if that helps. 

    What you are describing does not sound to me like pancreatitis and your tests look great.  Hope this helps a little.

    Good luck.

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    • Posted

      Thanks for you reply. That's the point. Almost all of my reports came back as normal. I have also recently drawn blood tests for ESR, CRP, LFTs and CBC and guess what they are again well normal. I have been to almost 3 to 4 GI doctors and all of them diagnosed me with classical IBS-D and they say that you have to live with it. Recently i saw a GI specialist he gave an example of himself that see i myself have been suffering from IBS-D and i have been taking imodium for a long time so he said it's not a big deal ( it's safe) to take imodium to control IBS-D. He prescribed me one imodium every day along with mebeverine twice a day and he also prescribed me psyllium husk. In simple if you don't have a blood in your stool/diarrhea and you are not loosing your weight then it's classical IBS and he further that just get over with IBS-D and also that you are not suffering from some chronic disease or cancer.. 
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  • Posted

    Dear 2Tazz1985,

    I have had the EXACT same thing happen to me that you have had with the abdominal pain and the Normal Amylase and slightly elevated Lipase example it's similar to yours where the range is from 0 to 60 and mine is 66 or another time it was 72. I too have been diagnosed with IBS for the last 18 years. My 1st visit was in my home town and my husband home I had just started dating went with me to my first G.I. appointment complaining of left upper quadrant pain. The doctor diagnosed me with having the classical symptoms of IBS. I had the CT scan I had the lab work just like you. I then became a travel nurse and started traveling, first coming to Houston TX. With working as a traveler I worked at many different hospitals where my insurance. So with the insurance I had to find a doctor with the network I kind of liked the idea because I wanted a second opinion. I had 4 plus the one back home. ALL tested and said the same thing. IBS! Until recently I went back to the G.I. doctor requesting to see another one in the same office. They told me the nurse practitioner was available so I chose to see her. She said all my symptoms sounded like it was my pancreas and she ordered and EUS aka Endoscopic Ultra Sound and the pancreatic enzyme labs of course and a fecal elastase test. I did have the EUS went showed that I had Chronic pancreatitis I was not only totally devastated but I'm totally very angry that after all these years I've been told that I have IBS. And was also given the anti-spasmodic. I never had diarrhea I never had any symptoms except for the left upper quadrant abdominal pain. I have an appointment to see a specialist now I'm not sure how much damage I have but I'm terrified. Go get yourself an EUS insist on it. Keep me informed I am a nurse and I'm an advocate for helping other people. Prayers for you and me.

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    • Posted

      Thanks alot Pattypill for your detailed reply. Well i would look into your advice of having EUS. I also recently tested for LFTs, ESR,CRP ,CBC, Serum calcium, vitamin D and Uric Acid. All came back normal except vitamin D which showed that i am deficient of vitamin D i.e my value is 13.3ng/mL when it states that <20ng/mL is vitD deficient. So what do you suggest now?
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    • Posted

      The LFTs (Liver Function Test) were all normal on me as well,ESR (Erythrocyte Sedimentation Rate- showing if there is some type of inflamation) was also normal on me,,CRP (C-Reactive Protein- also shows inflamation) was also normal on me.,CBC (Complete Blood count - Self explanatory) also normal on me and Serum calcium (self explanatory) normal too, vitamin D (Normal on me , and Uric Acid (also normal), but even after all of this it turns out I have Chronic Pancreatitis, not Acute, but Chronic. That's pretty severe.  Just please insist on no letting this pass.  EUS-Endoscopic Ultra Sound or ERCP to check the Gallbladder too.  Have they checked that?

      Pattypillrn

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    • Posted

      Well i Had CT Scan abdomen and pelvis with Contrast and everything on it, i.e, Liver, spleen, gallbladder,pancreas and kidneys appeared normal on it and also had ultrasound abdomen and pelvis which also came as normal. But i haven't had EUS or ERCP done yet
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    • Posted

      I have had repeated CT scans (approximately 5 with different physicians) that describe the Liver and Pancreas as Unremarkable and of normal size.  This last doctor said that a CT Scan wont show the damage, it can show size. The EUS goes down the esophagus with a camera and looks at it directly.  I do the TEE's at work where we go down the throat with a camera and see the back of the heart and the Valves much much better,with sedation of course.  Just ask. please.  Im not only a nurse and know the medical field, but I hear too many stories of, " Ive been complaining of this for years," and it has been missed. We have to be advocates for ourselves sometimes or assist and insist.  Just make sure.  
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    • Posted

      So I visited the rheumatologist because of my low vitamin D levels and he said mine levels are alarmingly low. He gave me an injection shot for vitamin D and further advices me to get my self injected once a week for four weeks. And secondly he took my blood samples for RA factor and ANA. Which came back NORMAL.
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    • Posted

      Hi pattypill, I hope that you are doing well and was hoping to get an update on your situation. I have been experiencing the same upper left, under my rib, sometimes to the left side kind of stitch feeling that came out of no where and hasn't completely gone away. It's been 2 months now. I've had an endoscopy-normal, a colonoscopy-normal, AST at 19-normal, ALT at 34-normal, Amylase at 46-normal, Lipase at 23-normal... all blood work was done within 7 days of the initial symptoms. Also had abdominal ultrasound which showed gall bladder unremarkable with no evidence of gall stones, spleen unremarkable, pancreas unremarkable, no fluid present... my stools are either somewhat hard and have to strain a bit or somewhat loose, it varies each week, but color is normal.... I am scared that this may be pancreatic but I don't have any elevated test results to point that way .... any suggestions would be appreciated...

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    • Posted

      Hi Patty

      My situation sounds a lot like yours only I have slightly high amylase normal lipase. A lot of abdominal pain especially in the upper right quadrant. Ct Scan with contrast and ultrasound all normal. Endoscopy showed gastric polyps and moderate gastritis. Today makes 7 months of this. Numerous trips to DOCTORS and emergency room. It got so bad I am now out sick from work.i have been told ibs, gastritis. I am thinking it's pancreatitis of some form.

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    • Posted

      Hi Lotus. Funny thing is I've had my pain for over 20 years and have been told for years that it's IBS And have been on medication for IBS for many years. I finally stopped taking the medication and thought I would just do vitamins. The pain is so severe I went back again to a new doctor and he's the one that did the EUS which stands for Indo scopic ultrasound I was put under sedation and the tube with step down my throat but it went to the pancreas and he said that I have mild chronic pancreatitis I told him I've been treated for IBS for many years and he said that's not it. But my pain is on the left side It's funny how if I've had pancreatitis for 20 years I'm surprised it's just mild. That's what mind boggles me You have your pain on the right I don't know if pancreatitis hurts on the right

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    • Posted

      Pattypill.... may I ask you please how long ago did you first find that your lipase was slightly elevated ? Was that 20 years ago when this all started for you ?
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    • Posted

      Pattypill.... may I ask you please how long ago did you first find that your lipase was slightly elevated ? Was that 20 years ago when this all started for you ?
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    • Posted

      Hi Patty: I have similar symptoms as you: pain on left side just above hip, amylase and lipase levels a bit high. I had an MRI done and they said my pancreas is unremarkable. Colonoscopy showed nothing too. Is EUS better than MRI? Isn't MRI supposed to show everything? Thank you for your advice!

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