[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Biochemistry](https://durgical.com/en/biochemistry/) › Amylase as a lab test

[Biochemistry](https://durgical.com/en/biochemistry/) · Topic

# 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.

## In detail

- 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.

**Also called**
Serum amylase, α-amylase, Pancreatic and salivary amylase

## Clinical notes

- 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.

## Related conditions

- [Acute pancreatitis](https://durgical.com/en/conditions/acute-pancreatitis/)
- [Chronic pancreatitis](https://durgical.com/en/conditions/chronic-pancreatitis/)
- [Mumps](https://durgical.com/en/conditions/mumps/)
- [Small bowel obstruction](https://durgical.com/en/conditions/small-bowel-obstruction/)
- [Ectopic pregnancy](https://durgical.com/en/conditions/ectopic-pregnancy/)

## Related

- [Lipase as a lab test](https://durgical.com/en/biochemistry/topics/lipase-as-a-lab-test/)
- [Glycogen](https://durgical.com/en/biochemistry/molecules/glycogen/)
- [Glucose](https://durgical.com/en/biochemistry/molecules/glucose/)

## Test yourself

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.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/biochemistry/topics/amylase-as-a-lab-test/)

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

Sources: [Amylase Test: MedlinePlus Medical Test](https://medlineplus.gov/lab-tests/amylase-test/) (MedlinePlus, US National Library of Medicine, 2026); [Amylase - blood: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/003464.htm) (MedlinePlus, US National Library of Medicine, 2026); [Macroamylasemia: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/001216.htm) (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).

[← All of biochemistry](https://durgical.com/en/biochemistry/)

## **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.

---
Source: https://durgical.com/en/biochemistry/topics/amylase-as-a-lab-test/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/biochemistry/topics/amylase-as-a-lab-test/