Blood, urine and fecal tests in pancreatitis: results of the indicators

Pancreatitis is an extremely common disease. It is caused by numerous features of modern life: nutritional disorders, dry food, consumption of semi-finished products and fast food, smoking and uncontrolled intake of medications. In order to recognize the disease from the very beginning and begin treatment, the patient must undergo an examination - including certain tests for pancreatitis. The results of these tests will determine whether there is a need for treatment and what drugs are required.

How to determine pancreatitis by tests?

Diagnosing pancreatitis is not that easy – especially if the disease has just begun. Therefore, the doctor must use the entire possible arsenal of diagnostic tools, including laboratory tests for pancreatitis.

What tests are taken for pancreatitis?

• General clinical blood test – helps to find signs of an existing inflammatory process (in particular, an increased number of leukocytes, accelerated ESR, etc.).
• Blood biochemistry – allows you to see increased levels of enzymes such as amylase, trypsin, and lipase.
• Blood test for glucose levels – indicates disturbances in the secretion of insulin by the pancreas.
• Urine analysis – allows you to find amylase, which is an indirect sign of acute pancreatitis.
• A coprogram is a study of feces that allows one to detect insufficiently digested food components, which indicates a disrupted process of enzyme production.

Of course, laboratory tests alone are not enough to diagnose pancreatitis. As a rule, it is necessary to obtain the results of instrumental diagnostics. Therefore, the doctor will unconditionally prescribe other diagnostic procedures, such as ultrasound, gastroscopy, retrograde cholangiopancreatography, computed tomography, as well as various functional tests.

Tests for pancreatitis: indications for testing

Diagnosis of the pancreas's functionality should be carried out using a comprehensive approach. After all, the doctor needs to determine both the functionality and the condition of the organ's tissues. The pancreas is a miniature but very complex element in the human body, on which the quality of digestive processes, the quantities of enzymes produced, and the absorption of food by the body depend. Among other things, the glandular organ plays an important role in maintaining general metabolic and hormonal processes.

The pancreas is considered a unique organ. When one area of the gland is damaged, other normal tissues replace the function of the damaged ones and begin to work "for two", so even if there is a problem in the organ, a person may not feel significant digestive disorders. However, the opposite can also happen: a very small area of gland tissue is damaged, and the patient already has serious problems with a full clinical picture of pancreatitis. It is for this reason that it is important to examine the pancreas as thoroughly as possible.

The clinical picture of acute and chronic pancreatitis is not specific. Therefore, it is often difficult for a doctor to establish the correct diagnosis without prescribing additional studies. Therefore, tests sometimes play a fundamental role in establishing a diagnosis.

A medical specialist has a difficult task: not only to determine the presence of pancreatitis, but also to find out the form of the disease - chronic or acute. Signs of acute pancreatitis can coincide with the symptoms that are observed during an exacerbation of the chronic form of the disease, so tests for pancreatitis are prescribed approximately the same in order to carefully study all the changes that have occurred inside the body.

Tests for acute pancreatitis are taken as early as possible to start treatment in a timely manner. It is important to adequately prepare for diagnostics so that the test results are as reliable as possible:

• you should refrain from drinking alcoholic beverages, strong tea and coffee;
• any food intake should be excluded (blood tests are taken on an empty stomach, after an 8-hour break from eating);
• physical activity should be avoided until the moment of donating blood for analysis;
• Before taking a urine test, you must wash yourself thoroughly so that secretions from the genitals do not get into your urine.

It is important to note that the results of many tests can be affected by medications such as vitamin C, paracetamol, and antibiotics.

Tests for chronic pancreatitis must include a blood test. This test will help find out if there are any inflammatory processes in the body at all, even if it is not an inflammatory reaction in the pancreas. In chronic pancreatitis, in addition to standard tests, the doctor may refer the patient for various laboratory tests:

• Immunoreactive trypsin analysis is prescribed relatively rarely, since its effectiveness in pancreatitis is no more than 40%. This type of study is included in the list of diagnostic procedures used for cholecystitis or insufficient renal function.
• Analysis of the level of trypsin inhibitors in the blood helps to determine the scale of destructive processes in the pancreas.
• Urine analysis for trypsinogen content is used less and less due to its high cost, but can 100% indicate the presence of pancreatitis.

The tests for exacerbation of pancreatitis are usually the same as for an acute attack of this disease. In order not to waste time, the doctor first prescribes an analysis of the enzyme level in the blood:

• during the first day – the level of pancreatic amylase;
• next – the level of elastase and lipase.

Tests for pancreatitis and cholecystitis primarily involve determining diastase. The normal value per milliliter of blood is 40-160 units, and in a milliliter of urine - 32-64 units. The test is taken on an empty stomach. In the acute phase of the disease, diastase increases more than 4-5 times. In the chronic course of the disease, anemia in the blood is additionally determined, and bilirubin and α-amylase in the urine.

In the acute period or during exacerbation of chronic cholecystopancreatitis, leukocytosis (shift of the formula to the left), accelerated ESR are detected. Urine analysis demonstrates the presence of bilirubin and bile pigments, an increase in urobilin. Biochemical analysis indicates a high content of bilirubin, fibrinogen and haproglobin.

The chronic process is accompanied by a sharp decrease in the number of B and T lymphocytes and a decrease in the content of immunoglobulin A.

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Blood test for pancreatitis

A general clinical blood test for pancreatitis is only of auxiliary importance, helping the doctor confirm that there is an inflammatory process inside the body. In addition to inflammation, a blood test can detect anemia.

Blood test results for pancreatitis are characterized by corresponding changes:

• The content of hemoglobin and red blood cells decreases - for example, in the case of long-term chronic pancreatitis, as well as in the case of complications associated with bleeding from the inflammatory focus.
• The leukocyte level increases, and significantly, as a result of severe inflammation.
• The sedimentation rate of erythrocytes increases, which is considered an additional sign of inflammation.
• Hematocrit increases if there is a disorder in the balance of water and electrolytes.

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Normal test results for pancreatitis

Indicator	Norm of tests	In the presence of pancreatitis
Leukocytes	4-8.5×10 9	Above normal values
Erythrocyte sedimentation rate	2-15 mm per hour	Above normal values
Antigen of pancreas	Not detectable	In acute cases – detected, in chronic cases – not detected
Sugar	3.5-5.9 mmol/liter	Above normal
Cholesterol level	3.0-6.0 mmol/liter	Below normal
Globulin content	From 7 to 13%	Below normal values
Amylase in blood	From 28 to 100 U/liter	Above normal
Pancreatic α-amylase in urine	Up to 5.83 mcat/liter	Above normal
Cal		The shade is grayish, the consistency is uneven, with undigested particles
Physiological norm of amylase in urine	From 1 to 17 units/hour	Above normal values

Biochemical analysis for pancreatitis

Blood biochemistry is perhaps the main blood test for pancreatitis. This type of research helps to determine the degree of organ functionality.

What does a biochemical analysis show if a patient has pancreatitis?

• The content of amylase, a glandular enzyme that breaks down starch, increases.
• The content of other enzymes, such as lipase, elastase, trypsin, and phospholipase, increases.
• Blood sugar increases as a result of insulin hyposecretion.
• The bilirubin content increases - this happens if the gland, enlarged due to inflammation, interferes with the functioning of the biliary organs.
• The total protein content decreases as a result of protein-energy deficiency.
• The level of transaminases increases (not in all cases).

Biochemistry for pancreatitis is done first, before other tests and studies, as soon as the patient is admitted to hospital for treatment.

In destructive processes in the pancreas, the most important thing is to determine the serum elastase content. The level of this enzyme increases against the background of increasing organ damage. In case of extensive necrotic foci, the elastase level is especially high.

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Urine analysis for pancreatitis

Urine analysis for pancreatitis may be more informative than it seems at first glance. Urine fluid for analysis is collected in the morning, and also during the day (if necessary). In this case, not a general urine analysis is done (which is not particularly informative for pancreatitis), but an analysis of diastase of urine fluid.

Diastase is produced in the pancreas and is responsible for the breakdown of complex carbohydrate foods. The normal value is 64 units or less, but with pancreatitis, the diastase level can increase to several thousand units. If pancreatitis is chronic, diastase can decrease, indicating insufficient organ function.

Urine diastase should be determined immediately after collecting the fluid, since the enzymatic composition of urine changes rapidly.

Stool analysis for pancreatitis

A stool test can help determine if the pancreas is underactive.

Since pancreatitis can be observed to be associated with insufficient enzyme secretion, the process of digesting food masses in the intestines becomes problematic. This applies to a greater extent to the digestion of fatty foods.

Firstly, it is already possible to distinguish feces with digestive disorders from feces with a healthy gastrointestinal tract by appearance. For example, pancreatitis is characterized by the following fecal mass features:

• mushy consistency;
• presence of fat particles;
• presence of undigested food;
• a sharp unpleasant smell;
• light color, closer to a gray shade.

The above-mentioned features are a consequence of putrefactive processes that primarily affect protein food particles. In addition, patients themselves note that bowel movements have become more frequent, up to the point of diarrhea. This becomes especially noticeable after eating hard-to-digest foods: fried and fatty foods, sweets, smoked foods.

Tests for pancreatitis do not always include stool testing, but such diagnostics are prescribed if the doctor needs additional information about the state of the digestive system.

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