Elevated pancreatic enzymes in inflammatory bowel disease are associated with extensive disease

Am J Gastroenterol. 1999 Apr;94(4):1062-9. doi: 10.1111/j.1572-0241.1999.01015.x.


Objective: Our aim was to perform a cross-sectional study to estimate the prevalence of elevated pancreatic enzymes in patients with inflammatory bowel disease and to correlate the enzyme activities with clinical, endoscopic, and histological findings.

Methods: Two hundred thirty-seven patients diagnosed with inflammatory bowel disease (IBD), including a subgroup with known hepatobiliary disease, were studied crosssectionally. Serum and urinary pancreatic enzymes were prospectively sampled and compared to endoscopic and histological findings obtained previously.

Results: Hyperamylasemia was found in 11% and hyperlipasemia in 7% of the total study group. The corresponding prevalences in patients with Crohn's disease were 17% and 9%, those in ulcerative colitis 9% and 7%, and those in indeterminate colitis 10% and 5%, respectively. High levels of serum amylase and pancreatic isoamylase were associated with extensive colonic disease (p < 0.005) and high histological activity (p < 0.05). Amylase, but not lipase, was significantly elevated in patients with primary sclerosing cholangitis. Smokers showed higher urinary amylase levels than non- and ex-smokers. The use of medication had no influence on the enzyme levels.

Conclusions: Pancreatic enzymes are elevated in a significant proportion of patients with IBD, and the enzyme increase is associated with a more extensive and active disease, and in some cases with primary sclerosing cholangitis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alcohol Drinking / epidemiology
  • Amylases / analysis
  • Cholangitis, Sclerosing / complications
  • Colitis, Ulcerative / complications
  • Colitis, Ulcerative / enzymology*
  • Colitis, Ulcerative / pathology
  • Crohn Disease / complications
  • Crohn Disease / enzymology*
  • Crohn Disease / pathology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Isoamylase / analysis
  • Lipase / analysis
  • Male
  • Pancreas / enzymology*
  • Pancreatitis / complications
  • Prospective Studies
  • Smoking / epidemiology


  • Lipase
  • Amylases
  • Isoamylase