Which enzymes are typically elevated in pancreatitis?

• A. Elevated amylase and lipase
• B. Elevated AST/ALT
• C. Elevated bilirubin
• D. Elevated creatinine

Answer: (A)

Pancreatic inflammation causes leakage of digestive enzymes into the bloodstream, so the classic finding is elevated pancreatic enzymes, especially amylase and lipase. Amylase rises relatively quickly—within about 6–12 hours of onset, peaks around 24 hours, and usually returns to normal in a few days. Lipase is more specific to the pancreas and tends to stay elevated longer, often detectable for 8–14 days, making it a very reliable marker for pancreatitis. Because of its greater specificity and longer window, elevated lipase (often alongside amylase) is the best indicator of pancreatitis.

AST and ALT are liver enzymes and can be elevated with liver or biliary disease, not pancreatitis specifically. Bilirubin rises with bile duct obstruction or liver dysfunction, which can occur with gallstone pancreatitis but isn’t a primary marker of pancreatitis itself. Creatinine reflects kidney function and dehydration, not pancreatitis.