When pancreatitis is very informative substance for analysis and obtaining the final diagnosis is urine. About disorders of the pancreas indicates a change in color, the chemical composition and its volume. Along with this, in different periods of the course of the disease, there will be a gradual increase in some and a decrease in other substances. In some cases oliguria, proteinuria and cylinduria are noted. Therefore, doctors are not limited to a single urine sample when a patient enters, and repeated ones are performed during treatment or discharge.
In acute pancreatitis, increased destruction of proteins is detected, which, accumulating in the blood in the form of medium molecular peptides. In the first couple of hours of the exacerbation period, the normal content of diastase will exceed 16-64 units in a healthy person. Most often, the number of diastases that can be observed in the urine for the first 48 hours increases. If the stage of exacerbation is delayed, then it can be determined within a month.
For the most part, its color changes with pancreatitis. Thus, an enlarged pancreas head usually becomes a cause of jaundice of a mechanical type which, in addition to the negative effect on the body and changes in the chemical composition of the blood, affects the color of the stool, making it lighter, also changes the color of the urine, staining it in a darker color. In patients with pancreatitis, the disorder of carbohydrate metabolism, which is manifested by sugar in the urine, is often observed as a protective reaction of the body to its high content in the blood.
Especially important in the diagnosis and selection of treatment methods for pancreatitis is the determination of the content of diastase in urine, which in excess is usually detected on the third day after the exacerbation of the disease. Since the enzyme content fluctuates within 24 hours, then to analyze the dynamics of changes, the analysis is collected for analysis every 3 hours after the patient's admission. Even if its level is within normal limits, this does not exclude pancreatitis, since it can quickly disappear after the increase jump. Disappearance can occur spasmodically, alternating the rise and fall of diastase smoothly, gradually or abruptly.
Increased diastase may indicate pleurisy, pneumonia, appendicitis, gastritis, hepatitis, but even so, its presence in the urine is considered a pathognomonic factor, and if its content exceeds 128 units.then this clearly indicates pancreatitis.
Determination of amylase in urine is of colossal diagnostic value in detecting symptoms of pancreatitis and gives better results than an analysis of its content in the patient's blood. The ease of obtaining urine contributes to repeated repetition of the diagnostic study and does not harm the patient. Repeating such an analysis helps to detect even the smallest increases in the diagnostic index, which is an important factor in the appointment of effective treatment to a patient with pancreatitis and prevention of further development of the disease.
The only downside of determining urine amylase in the analysis for pancreatitis is the difficulty in interpreting the results of the study. This enzyme is found in the tissues of many internal organs and therefore can be detected even in an absolutely healthy person. So, for example, amylolytic activity can manifest itself in milk, saliva and sweat. It does not apply to pancreatic enzymes of a strict order, so its nominal level may increase for reasons not depending on the state of the pancreas and the patient's health.