Pancreatic lipase is an enzyme produced by the pancreas that plays a role in digestion. It is one of several digestive enzymes the pancreas releases into the small intestine to break down food.
The Role of Pancreatic Lipase in Digestion
When food enters the small intestine from the stomach, the pancreas releases its digestive enzymes. Pancreatic lipase is secreted in its active form, but it functions most effectively with another pancreatic substance called colipase. Colipase helps the lipase bind to the surface of fat droplets.
The primary job of pancreatic lipase is to break down dietary fats called triglycerides, which are too large for the intestines to absorb. Bile, produced by the liver, first emulsifies large fat globules into smaller droplets to increase their surface area. Pancreatic lipase then acts on these droplets, breaking the triglycerides into two free fatty acids and a monoglyceride.
This enzymatic breakdown is required for fat absorption. The resulting fatty acids and monoglycerides are small enough to be absorbed by the cells lining the small intestine. From there, they enter the lymphatic system for transport throughout the body, preventing dietary fats from passing through undigested.
Pancreatic Lipase Levels and Medical Testing
Healthcare providers may order a lipase blood test to investigate symptoms like severe abdominal pain, nausea, or vomiting that suggest a pancreatic problem. The test measures the concentration of lipase in the bloodstream, which is normally very low. This simple blood draw provides information about the health of the pancreas.
Elevated lipase levels in the blood are most often associated with acute pancreatitis. This condition involves sudden inflammation of the pancreas, causing its digestive enzymes to leak into the surrounding tissue and bloodstream.
A high lipase reading indicates pancreatic stress or injury. Besides acute pancreatitis, other conditions like pancreatic adenocarcinoma can also cause the pancreas to release its enzymes into the blood. The test helps physicians diagnose these conditions by measuring this enzymatic release.
Conditions Associated with Lipase Deficiency
Insufficient lipase activity in the digestive system leads to exocrine pancreatic insufficiency (EPI). This condition occurs when a damaged pancreas cannot produce or secrete enough digestive enzymes to break down food. Unlike the blood test for high lipase, EPI concerns a functional lack of the enzyme within the intestines.
The primary symptoms of lipase deficiency are caused by fat malabsorption. Since fats are not broken down and absorbed, they are excreted in the stool, leading to a condition called steatorrhea. This is characterized by oily, foul-smelling stools that may float, and can also lead to unintended weight loss and nutritional deficits.
Several underlying medical conditions can cause EPI. Chronic pancreatitis, a long-term inflammation, can lead to scarring that impairs enzyme production. Cystic fibrosis is another cause, as the condition leads to thick mucus that blocks the pancreatic ducts. Celiac disease can also be associated with insufficient pancreatic enzyme output.
Managing Lipase-Related Disorders
The standard treatment for lipase deficiency is Pancreatic Enzyme Replacement Therapy (PERT). This therapy involves taking prescription medications containing a mixture of digestive enzymes, including lipase, protease, and amylase. These capsules are taken with meals and snacks to supplement the body’s own enzyme production.
The enzymes in PERT help break down fats, proteins, and carbohydrates from food, allowing for their proper absorption. The dosage is carefully calibrated to the fat content of a meal and the individual’s needs. This reduces symptoms like steatorrhea and improves nutritional status by mimicking the natural digestive process.
Dietary management is also part of the treatment plan. A healthcare provider or dietitian can help develop a diet that supports nutritional health while managing symptoms. This may involve adjusting the amount and type of fat consumed to ensure the PERT prescription is effective.