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

OBJECTIVE: Our aim was to perform a cross-sectional study to estimate the p revalence of elevated pancreatic enzymes in patients with inflammatory bowe l disease and to correlate the enzyme activities with clinical, endoscopic, and histological findings. METHODS: Two hundred thirty-seven patients diagnosed with inflammatory bowe l disease (IBD), including a subgroup with known hepatobiliary disease, wer e studied cross-sectionally. Serum and urinary pancreatic enzymes were pros pectively sampled and compared to endoscopic and histological findings obta ined previously. RESULTS: Hyperamylasemia was found in 11% and hyperlipasemia in 7% of the t otal study group. The corresponding prevalences in patients with Crohn's di sease were 17% and 9%. those in ulcerative colitis 9% and 7%, and those in indeterminate colitis 10% and 5%, respectively. High levels of serum amylas e and pancreatic isoamylase were associated with extensive colonic disease (p < 0.005) and high histological activity (p < 0.05). Amylase, but not lip ase, was significantly elevated in patients with primary sclerosing cholang itis. 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 exten sive and active disease, and in some cases with primary sclerosing cholangi tis. (C) 1999 by Am. Cell. of Gastroenterology.