Pancreas tests: what laboratory tests are needed to detect diseases?

During the day, the pancreas is able to allocateFrom one and a half to three liters of alkaline juice, which contains about 20 enzymes that help digest protein, fats and carbohydrates that enter the human body.

In addition to enzymes, the secret of the gland also contains electrolytes, in particular sodium, potassium, calcium and chlorine. But the main and leading role is played by bicarbonate, which produces special cells. To digest proteins to a person helps amylase and maltose, lipases, phospholipase A, and cholinesterase work well with fats. There are also proteases that are represented by endoproteases( trypsin and chemotripsin), exopeptidases( carbypeptidases and aminopeptidases, elastases).The activity of all the above pancreatic enzymes is manifested only in an alkaline environment, it is in the duodenum where the gland juice is secreted.

In order to monitor the work of such an important body, check the level of hormones in various biological fluids, in particular blood, urine, contents of duodenum and feces.

These analyzes allow you to determine the level of failure and control the effectiveness of the treatment of the pancreas.

Enzymes play the role of

There are tests that allow to determine the enzymatic activity of the gland. Thus, lipase, amylase, isozymes, which are found in serum or urine, are examined, and less often they can be found in pleural or ascitic( accumulates in the pleural cavity) fluids.

The most informative amylase that is found in the study of blood serum or in urine, this test is used most often. Normally, this enzyme enters the blood from the salivary glands, and its level is not dependent on sex, age, how many people move or eat. But when a violation occurs when it stagnates( due to a stone or a cyst), also due to increased membrane permeability, an inflammatory disease( pancreatitis), the index of this enzyme grows up. Accordingly, its excretion occurs by the kidneys, due to which the increase of this index occurs in the urine. There are options when there is little amylase in the urine, this happens when large proteins circulate in the blood that are unable to penetrate the membrane of the kidneys. It is possible to increase the level of the enzyme in urine with pancreatitis in the acute stage.

In the blood serum, the level of amylase in the exacerbation of pancreatitis begins to rise for 2-12 hours and the maximum concentration is reached by the end of the first day. By this time, the norm is exceeded from 5 to 20 times. After the activity of amylase falls, and the excess is excreted by the kidneys with urine. The serum level is reached after 2 to 4 days, and if it rises again, this indicates a new complication or a poor prognosis. The enzyme index also depends on the obstruction of the pancreatic ducts, as well as the damage to its tissue.

Chronic pancreatitis, in which there are scars of pancreatic tissue, does not give a high rise in the level of amylase, in contrast to the acute form. But with acute pancreatitis, with the presence of extensive necrosis, an increase in amylase may not be observed.

If urinalysis indicates an increase in the enzyme more than twice, then it is also worth thinking about the defeat of the pancreas. Initially, the urine is examined, which, unlike blood, is easier to obtain and can be repeated at any convenient time. Urine, which is collected in a few hours, will give an idea even of minor damage to the gland.

Lipase and its definition

Serum lipase assays are the most sensitive and specific when it comes to pancreatic damage. Lipase in the disease increases about 90%, in contrast to amylase, which increases in 78% of cases of pancreatitis. If the amylase rises and there is no lipase, then it's worth thinking about another disease.

Isoamylase

Isoamylase is tested in blood and urine for the diagnosis of pancreatitis, and the pathology of a non-lesion-associated gland when there is an increase in amylase.

Trypsinogen

Trypsinogen allows you to determine the function of the gland and differentiate the norm and pathology. With acute pancreatitis, this enzyme is raised, with the chronic level not changing.

Tests

There are also tests that allow to determine the activity of the organ, in particular, enzymatic activity in the lumen of the intestine. In total, there are two such tests:

• The first is that the pancreas is stimulated with special medication, followed by taking a fetus of what was released into the lumen of the intestine. Due to this test, it is possible to diagnose the latent form of the disease.
• Stimulation with amino acids, fats and carbohydrates( indirect).After that, the contents of the intestine determine the enzymes.

Fecal analysis

Widely used in pancreatic disease and coprologic tests. Appoint their feast having a liquid or mushy stool. With a formal and firm feces to think about the defeat of the pancreas there is no sense.

Cal is examined by a macroscopic method( odor, consistency, color) and with the help of a microscope, in which the doctor is interested in the index of fats, nitrogen and chymotrypsin. Microscopic examination allows undigested muscle fibers, neutral fat.

The change in the amount of fat, nitrogen and chymotrypsin is important in terms of diagnosis. In normal operation, fat is absorbed by 94%, and less than 6 grams per day is output. Steatorrhea( fat in the feces) begins when the fat release increases to 15 grams throughout the day. The activity of chymotrypsin is reduced in the presence of chronic pancreatitis.

Preparation for

As a rule, preparation for the analysis is not required, urine and feces are collected in clean utensils, preferably disposable. Blood is better to take on an empty stomach, because the level of enzymes can change. Urine, like feces, is collected in whole.

Useful video about pancreatitis