Amylase
Introduction
Amylase is a digestive enzyme that catalyzes the hydrolysis of carbohydrates. The process breaks starches into sugars that are readily absorbed and used by the body as energy.
This enzyme comes in two forms: salivary amylase, secreted by salivary glands; and pancreatic amylase, released by the pancreas.
Both enzymes mix to make it easier for them to digest, which starts in the mouth but continues further in the small intestine.
Such amylase blood concentrations are measured to assess pancreatic function in the body as well as diagnose problems such as acute pancreatitis.
The existence of amylase in blood and urine makes it possible for the medical practitioner to understand the status of the pancreas and other digestive organs in the body.
The article is going to analyze the different aspects of amylase, that is, the functions it has in the body, its determination, and how very much critical it is in a wide range of diagnoses.
Role of Amylase in the Body
Salivary Amylase
Salivary amylase or also known as alpha amylase, is produced by the salivary glands. It starts starch digestion in the mouth by breaking down complex carbohydrates to simpler sugars.
At the entrance of food into the mouth, where it mixes with saliva, the action of salivary amylase begins; this breaks up the starches into maltose and dextrin.
The digestion at this level is very critical as it prepares everything for further digestion to occur in the stomach and the small intestine.
Salivary amylase is significantly involved in the digestion process. The addition of this enzyme would contribute to slow and certainly less efficient starch digestion.
Activity of amylase in the mouth remains until the food is swallowed and then reaches the highly acidic stomach that interferes with the activity of the enzyme.
Pancreatic Amylase
Once the food has passed into the small intestine, the work of carbohydrate digestion is over to be taken up by pancreatic amylase.
An enzyme secreted by the pancreas into the small intestine, it breaks up the remaining starches into glucose, which is subsequently absorbed into the bloodstream to provide one of the essential sources of energy to the body.
Pancreatic amylase is very important as it degrades carbohydrates and enables their complete absorption into the bloodstream.
Low concentrations of this enzyme can lead to undigested carbohydrates that collect in the intestines, showing symptoms such as bloating gas, and diarrhea.
Amylase and Its Diagnostic Importance
Amylase in Diagnosing Acute Pancreatitis
Acute pancreatitis is an acute inflammation of the pancreas and can cause severe complications quickly unless this condition is dealt with early.
Measuring serum amylase activity is the most common diagnostic test for this condition, and increased serum amylase levels are most commonly related to the cause of acute pancreatitis and can be elevated hours after the onset of symptoms.
When the pancreas inflames, pancreatic amylase is released into the blood and thus causes an increased level of serum amylase.
Although increased levels of serum amylase do not apply exclusively to acute pancreatitis , they remain one of the main indicators of the disease.
High amylase levels caused by other conditions, including chronic pancreatitis, pancreatic cancer, and gallstones.
Serum Amylase, Salivary Amylase
To identify pancreatic disorders accurately, a distinction needs to be made between pancreatic amylase and salivary amylase. Diseases of either the pancreas or the salivary glands can be connected to increased serum amylase.
For example, inflammation of the salivary glands-such as in mumps results in increased levels of salivary amylase in the blood; diseases of the pancreas result in increased levels of pancreatic amylase in the blood.
Sometimes, doctors employ specific tests that may determine the amount of serum amylase and salivary amylase, thus establishing exactly where the problem originates.
If the amylase levels come primarily from the pancreas, this is an indication of some form of acute pancreatitis or even other pancreatic diseases.
If the increased levels come from the salivary glands, then the causative problem may relate to a salivary gland disease.
Normal and Abnormal Amylase Levels
Normal Range of Amylase
Normal Range for Serum Amylase A normal range is noticed when there are slight variations among the laboratories conducting the test.
However, it is primarily around 30 and 110 units per liter of serum. The amylase levels vary according to age, gender, and personal condition of the individual.
A minimal deviation from the normal value does not have any clinical significance, but an elevated or low increase in the level significantly points towards an underlying disorder.
Increased Amylase Levels
Increased amylase levels are generally caused by diseases of the pancreas and salivary glands, acute pancreatitis, chronic pancreatitis, and salivary gland infections, among other causes.
A level of amylase higher than three times the upper limit of normal range is generally reflective of acute pancreatitis.
Other common causes of increased amylase levels include:
-Gallstones: Obstruction of bile ducts lead to a digested enzyme backup with amylase - elevated in the bloodstream.
Pancreatic Cancer: The formation of a tumor within the pancreas will disrupt the function of enzymes released by the organ and result in abnormal amylase levels.
Kidney Disease: Because the function of kidneys involves filtering amylase from the bloodstream, this will cause it to rise within the bloodstream as well.
Low Amylase Levels
Low amylase levels are an uncommon occurrence and can be associated with several conditions, such as pancreatic insufficiency, in which the pancreas fails to produce adequate amounts of digestive enzymes.
Therefore, the patient lacks adequate intake of nutrients absorbed by the body and has chronic problems with digestion.
Amylase Levels Test
Blood Test for Serum Amylase
The most common diagnostic test for the evaluation of the pancreas is the serum amylase blood test, which is conducted by taking a minuscule amount of the blood from the patient and testing it in order to find the amount of amylase being produced.
Elevated serum amylase can be a sign of acute pancreatitis, but these patients are required to do more tests before diagnosis.
Urine Amylase Test
Amylase levels can sometimes be measured with a urine test. Both the blood test and the urine test are usually carried out in combination to gain a better appreciation of the level of amylase activity in the body.
An elevated level of the enzyme in the urine could indicate pancreatitis or damage to the pancreas where the organ is releasing excessive quantities of the enzyme.
Preparation for Amylase Tests
The patient preparing for an amylase blood test or urine test usually does not require observing any form of dietary restrictions.
However, there exist drugs that may interfere with amylase levels; hence, the patient should be informed to the healthcare provider in time before the actual test about drugs or supplements being taken at the time.
Some of these include aspirin and birth control pills, which have the effect of interfering with amylase activity.
Conditions Associated with Amylase
Acute Pancreatitis
As previously mentioned, acute pancreatitis is one of the primary conditions diagnosed with high serum amylase results. It occurs in inflammation of the pancreas, often brought about by gallstones, alcohol intake, and infections.
Since the inflammation leads to the release of pancreatic enzymes into the blood, a rise in serum amylase levels often occurs.
Symptoms of acute pancreatitis include, among many, sharp abdominal pain, nausea, vomiting, and fever.
If this condition is not treated promptly, it may eventually lead to other dangerous complications like infections, kidney failure, and respiratory disease.
The treatment usually prescribes hospitalization, pain management, and intravenous fluid as the pancreas self-heals.
Chronic Pancreatitis
Unlike the acute pancreatitis, which occurs suddenly, chronic pancreatitis is an inflammation of the pancreas that lasts for a long time.
Chronic inflammation of the pancreas gradually leads to fibrosis and destruction of pancreatic tissue with eventual loss of secretion of enzymes, among which are amylase, resulting in malnutrition and faulty absorption of fats and proteins.
Interestingly, in chronic pancreatitis, amylase levels are not always increased.
After prolonged damage to the pancreas, it may lose its enzymatic machinery, and low serum amylase levels in a patient presenting with symptoms of pancreatic dysfunction can, therefore, be an indicator of chronic disease as well.
Salivary Gland Disorders
Disorders of the salivary glands, for instance mumps and infections in the salivary glands, lead to amylopectin at increased levels.
Such patients may have their levels elevated in the serum amylase test, and later studies may reveal that their salivary glands are causing this and not the pancreas. Most treatment is based on the infection being treated.
The treatment of abnormal amylase levels depends on the cause of the abnormality in question. For example, those suffering from acute pancreatitis need to be hospitalized, while for those with chronic pancreatitis, dietary management and enzyme supplementation ensures proper digestion.
If the diagnosis relates to disorders of the salivary glands, it is essential to treat the infection or inflammation.
A patient diagnosed with a known condition, such as a disease based on pancreatic cancer, is often treated with surgery and chemotherapy or radiation therapy.
Conclusion
Amylase is one of the important enzymes that are involved in the metabolism of carbohydrates. It is useful in the diagnosis of diseases concerning both salivary glands and pancreas.
Either increase or decrease in serum amylase levels will help account for a lot of diseases, like acute pancreatitis and infections of salivary glands.
Serum amylase tests are used in association with other diagnostic aids while identifying and managing these diseases.
In that regard, understanding the role of amylase in the body calls for better diagnosis and management among patients, thus improving the treatment and outcome in patients.
* * Medical Disclaimer - The following information is for educational purposes only. No information provided on this website, including text, graphic, and images, are intended as substitutes for professional medical advice. Please consult with your doctor about specific medical advice pertaining to your condition(s).
