(1) The pH value of a normal body fluid ranges between pH 7.35 and 7.45. If the pH value of the normal body fluid is less than 7.35, it is a case of acidosis and if the pH value is less than 7.45, it is a case of alkalosis. The pH value of a normal body fluid is lowered when acidic products are formed due to Metabolism. The continuous removal of the acidic products from the body, formed due to metabolism, results in alkalosis whereas when the acidic products cannot be removed, it results in acidosis.
(2) Metabolic Alkalosis: Depending upon the chloride level in urine, cause of metabolic alkalosis can be divided into two groups:
1) Chloride-responsive (<10mEq/L): This includes:
- Fall in the number of hydrogen ions- This mainly happens either due to vomiting or fall of hydrogen ions in the kidneys. There is a loss of hydrochloric acid due to vomiting whereas due to the loss of potassium and sodium in the body there may be severe vomiting. The compensation is done by the kidneys by collecting sodium into the collecting ducts, spending hydrogen ions causing metabolic alkalosis.
- Congenital Chloride Diarrhea: It is rarely seen diarrhea causing alkalosis and not acidosis.
- Contraction alkalosis: The blood pH is raised, as hydrogen ions are mopped up by the increase in the concentration of bicarbonate due to the loss of water in the extracellular space, due to diuretic use.
- Diuretic therapy: Increase in chloride can be initially caused by “thiazides” and “loop diuretic”. If the urine excretion is below 25mEq/L, contraction alkalosis may be caused due to loss of fluid from sodium excretion.
- Cystic Fibrosis.
2) Chloride-resistant (>20mEq/L): This includes:
- Bicarbonate retention
- Shifting of hydrogen ion into intracellular space: A raise in the pH of blood occurs due to the shift of hydrogen ion in the cells for maintaining electrical neutrality.
- Alkalotic agents: Excess administration of antacids, bicarbonate in the blood can cause alkalosis.
- Excess Glycyrrhizin Consumption
- Gitelman and Barters syndrome
- Liddle syndrome
SYMPTOMS: The symptoms of metabolic alkalosis are:
- Mental Confusion
- Spasms in muscles
CONSEQUENCES IF NOT TREATED: If metabolic alkalosis is left untreated, it may lead to all or any one of the following:
2) Cardiac arrest
(3) Metabolic Acidosis: If the body produces much acid or if the kidneys are unable to remove the produced acids, metabolic acidosis occurs.
SYMPTOMS: A person having metabolic acidosis may show the following symptoms:
- Bone pain
- Muscle weakness
CONSEQUENCES IF NOT TREATED: If metabolic acidosis are left untreated, it may cause acidemia. Acidemia happens when the body is incapable to produce bicarbonate. Neurological and Cardiac problems are lead by extreme acidemia. The neurological and cardiac problems may be:
- Neurological: Lethargy, Seizures, Coma, Stupor
- Cardiac: Hypotension may occur by arrhythmias and low response of epinephrine.
Metabolic Alkalosis: Excess use of drugs like diuretics, antacids should be avoided. Patients being fed by tubular method should be monitored carefully for avoiding salt and fluid imbalance.
Metabolic Acidosis: In certain cases, one may be asked to consume sodium bicarbonate which is also known as “baking soda” for the regulation of the acid level in the blood of the body. It is not an acidosis remedy and should not be tried at home. One should visit a doctor for proper treatment.