Colin - high amylase and lipase explanation

[Guest guest]

Hi Colin,

Amylase and lipase elevate rapidly when the pancreas gets

irritated as a sign that the cells that produce these enzymes have

released them all at once because of cell death. Instead of a

controlled release due to hormonal stimulation (like when we

are eating for example) the cells contents are expelled

chaotically and all at once. What this means is that they get into

circulation where they overwhelm the system in place to

neutralize them (again like with normal eating) and they start to

digest normal tissue in the body (organs, joints, etc). If the

pancreas is obstructed because of inflammation or scarring or

stones, these activated enzymes will not enter the system like

normal and will start to auto-disgest the pancreas. Which is the

big danger of the acute phase. A never ending cycle of damage,

release of enzymes, more damage, more release etc.

In chronic pancreatitis, enzyme levels do not correlate with pain

levels or damage. Kinda like with certain hepatitis - you can have

low levels or normal levels of enzymes and have a lot of damage

being done or has been done. Unlike the liver though, the

pancreas is very painful when it is damaged. Again, in chronic

pancreatitis, enzyme levels and pain levels do not always

correlate. Many people are in constant severe pain with normal

levels of enzymes and some with very high levels are pain free.

That is why the diagnosis of CP without any documented cases

of AP is almost impossible to do. And then you add in the fact

that certain types of pancreas abnormalities (like pancreas

divisum) may only have slight rises in pancreas enzymes even

when having an acute attack.

Many / most people who have only one attack of AP recover fine

with no lasting damage to the organ. However, there are a

subset of people, for whatever reason (alcoholic, hereditary,

congenital, idiopathic, etc) that have several or many AP attacks

which is theorized will lead to CP.

Hope this helps explain this very confusing malady.

Laurie