Elevated Serum Lipase Levels in Patients with Dyspepsia of Unknown Cause in General Practice

Abstract

Objective: To study the cause(s) of chronic dyspepsia among patients with no findings on general practice screening tests. Materials and Methods: A total of 272 consecutive patients at a general practice in Japan (125 males and 147 females, aged 14–89 years) who underwent abdominal ultrasound (US) and who had serum pancreatic enzyme (lipase or p-amylase) levels measured, were included in a 1-year study. Serum pancreatic enzyme levels were compared according to the duration of the symptoms and causes of dyspepsia, and then compared between two groups: a ‘known-cause group’ of 38 patients in whom the cause of the chronic (over 1 month) dyspepsia was determined by US or other diagnostic procedures; and an ‘unknown-cause group’ of 112 patients in whom no cause was found. Results: The mean lipase level in the unknown-cause group was significantly higher than that in the known-cause group (40.6 vs. 35.3 U/l, p = 0.008 after adjustment for age, sex, and serum creatinine). No difference between these groups was found for p-amylase. The proportion of patients with high lipase levels (above reference range) was higher in the unknown-cause group compared to the known-cause group, although this was not significant (21.4 vs. 10.5%). Conclusion: Our data showed that serum lipase levels were higher in patients with chronic dyspepsia of unknown than in those with a known cause. We therefore speculate that mild functional pancreatic disorder may underlie some cases with unexplainable chronic dyspepsia.

Camostat Mesilate, Pancrelipase, and Rabeprazole Combination Therapy Improves Epigastric Pain in Early Chronic Pancreatitis and Functional Dyspepsia with Pancreatic Enzyme Abnormalities

“…Then, in this study, we tried to determine whether 5 pancreatic enzyme abnormalities can distinguish ECP patients from FD-P patients. Okada et al [37] have reported that an increase in pancreatic enzymes has been reported in FD patients. Schmidt and Schmidt [38] have also reported that serum lipase elevation had been reported to be 97% specific for diagnosing exocrine pancreatic insufficiency.…”

Elevated Serum Lipase Levels as a Marker of Intraductal Papillary Mucinous Neoplasm of the Pancreas: A Cross-Sectional Study

“…alcohol, gallstones) [28,29]. We formerly demonstrated that patients with unknown cause of dyspepsia had hyperlipasemia, which indicates that patients with unknown cause of dyspepsia may suffer from mild functional pancreatic disorders [15]. Associated symptoms of IPMN were epigastric discomfort (50-70%) and weight loss (20-40%) in the previous reviews [1,10].…”

“…Serum lipase values were checked for patients with unknown cause of dyspepsia to check the underlying pancreatic disorder as described elsewhere [15]. Some patients with clinical symptoms such as epigastric discomfort, back pain, and weight loss, or patients with worsened or newly diagnosed diabetes mellitus were also checked for their serum lipase values [6].…”

Evaluation of the Safety and Efficacy of a Multienzyme Complex in Patients with Functional Dyspepsia: A Randomized, Double-Blind, Placebo-Controlled Study

“…In recent years, several well-designed clinical studies have shown that pancreatic or digestive enzyme supplements could be promising alternative approaches in managing FD syndrome. 10 , 22 , 53 Postmarketing surveillance studies of the multienzyme formulation to evaluate the efficacy and tolerability revealed that treatment was able to decrease frequency and severity of various dyspeptic symptoms in FD patients. 23 In another multicenter, randomized, placebo-controlled, crossover study, treatment with an enzyme preparation containing Aspergillus oryzae extract (cellulase, protease, and amylase) and pancreatin (lipase, proteinase, and amylase) in patients diagnosed with chronic digestive disorders, including FD, showed a significant reduction in the severity index of dyspeptic symptoms compared with placebo treatment.…”