What Does The Fluctuating Lipase Level In A Pancreatitis Patient Indicate?

Posted on Fri, 23 Oct 2015

Question: Hello Doctor,

I was admitted to the hospital a week ago with acute pancreantitis with lipase levels of 6300. The only complaints i had were bloating, loss of appetite, diarrhea and minor discomfort 6 hours after attending a wedding with 6-7 mixed drinks. After receiving IV's and fasting 3 days my lipase went down to 2900. However it jumped back up on the 4th day back to 6300. The doctor tried me on clear liquids for two days and my lipase dropped to 4400 on the 6th day. I tried full liquids however my body couldnt tolerate it and I had watery, foul smelling stool. Tomorrow marks 7 days in the hospital. The gastro has ordered a ct scan because he want to see if any cysts have formed because he believes comolications may be arising with the flucuation in my lipase numbers. However he said not to worry about those number a few weeks ago which is puzzling. My blood sugar has been normal with the exception of one reading today that was 70. I havent had the classic symptoms of extreme pain or nausea. I do have an underlying condition of celiac disease. I'm really concerned about the ct scan tomorrow. Is this a mild case that may just take longer than 7 days for the inflamation to go down?

Answered by Dr. Prashant (1 hour later)

Brief Answer:
ideally we do CT scan after 72 hrs or beyond

Detailed Answer:
Hi,

I went through the details provided with diligence and I understand you are worried about this condition. However it is difficult to predict the severity before we have the scan results.

A CT scan is ideally needed after 72 hrs of insult to pancreas or beyond. Though you seem symptomatically fine, CT report is an important test that will let us decide further management. Do not be worried, CT scan is a very simple test it will get over in few minutes

Usually acute inflammation settles down in 5 to 7 days. Since it's already a week now, it is important to assess the degree of insult to the pancreas now.

I am not sure if my reply satisfactorily answered your question. But with the limited information and without physical finding notes, I don't think I would be able to comment about severity beyond what I said. If you can keep me updated after the scan test, perhaps we could discuss about it better.

Thank you!!

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Prashant (18 hours later)

Had the ct scan. Doctor said the swelling of the pancreas went down mildy. No cysts or fluid filled sacs were found. My lipase went down another 1000 to 3585 today. I did start solid foods today and did just fine however after the doctor saw the lipase he has me back fasting and getting fluids and nutrients through the veins. I feel great, no other real symptoms today. Is it normal in some cases for lipase to still remain high after a week? It seems things are going in the right direction its just a slow process. Can it take up to two weeks for lipase to return to normal in some acutecases?

Answered by Dr. Prashant (5 hours later)

Brief Answer:
yes ,the lipase levels will come down over a period of 2 to 3 weeks

Detailed Answer:
Hi,

When CT scan doesn't show any necrosis or collection then its really good. The lipase levels will take few more days to settle down probably couple more weeks.

I wouldn't be worried about lipase level. It is not important to me. Clinically and symptom wise if there is improvement that's enough. Anyway try go avoid spicy, oily and fatty food. Drink plenty of water.
And yes the doctors seem to be treating you well.
Hope you will recover soon. I will be glad to help you further if needed. Else please close this discussion and review.

Thank you

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Above answer was peer-reviewed by : Dr. Prasad