Amylase as a lab test !

Amylase rises in acute pancreatitis but also from the salivary glands and other causes; lipase is now preferred.

Updated 2026-11-01

Key facts

It breaks α-1,4 bonds in starch and glycogen; it has pancreatic (P) and salivary (S) isoforms.
In acute pancreatitis it rises within 6–12 hours and returns to normal in 3–5 days, sooner than lipase.
Pancreatitis criterion: amylase or lipase above 3 times the laboratory's upper limit, with typical pain or imaging.
It is not specific: mumps, non-pancreatic acute abdomen, ruptured ectopic pregnancy, renal failure and macroamylasaemia raise it.
Its level does not show the severity of pancreatitis.

What it measures: α-amylase activity in serum (it is also measured in urine and in fluids such as peritoneal or pleural fluid).
Where it comes from: exocrine pancreas and salivary glands; to a lesser degree fallopian tubes, ovaries and some tumours.
Why it rises: acute pancreatitis, pancreatic duct obstruction, mumps, bowel perforation or ischaemia, ruptured ectopic pregnancy, diabetic ketoacidosis, renal failure (lower clearance).
Pitfalls: in macroamylasaemia amylase binds immunoglobulins, is not filtered and stays high in blood with low urine amylase; severe hypertriglyceridaemia can make it falsely normal; in alcoholic or late pancreatitis it may be normal.
A very high amylase in fluid from a collection or effusion suggests a pseudocyst or pancreatic fistula.

With epigastric pain and a mildly raised amylase, lipase and the clinical picture decide; imaging is kept for doubt or complications.
In children with mumps a high amylase is salivary and does not mean pancreatitis.
Urine amylase stays high longer and helps when patients present late.

Think of the answer, then tap the question to see it.

Which bonds does amylase break?

The α-1,4 glycosidic bonds of starch and glycogen.

Why has lipase replaced amylase in pancreatitis?

It is more pancreas-specific and stays high for more days, while amylase also rises from salivary glands and other abdominal causes.

What is macroamylasaemia?

Amylase bound to immunoglobulins that is not filtered: high serum amylase with low urine amylase, without pancreatic disease.

Does the amylase level show the severity of pancreatitis?

No; severity is judged by the clinical picture, organ failure and scores, not by the enzyme level.

Educational information, not medical advice. For any symptom, see a health professional.

Sources: Amylase Test: MedlinePlus Medical Test (MedlinePlus, US National Library of Medicine, 2026); Amylase - blood: MedlinePlus Medical Encyclopedia (MedlinePlus, US National Library of Medicine, 2026); Macroamylasemia: MedlinePlus Medical Encyclopedia (MedlinePlus, US National Library of Medicine, 2026); Textbook of Biochemistry for Medical Students, 6th ed. (Jaypee Brothers Medical Publishers (Vasudevan DM, Sreekumari S, Vaidyanathan K), 2011).

Spotted a mistake?We are always improving for the community. Tell us what is wrong and our team will review it.Report a mistake

Representative model, for educational purposes only.