What is this Condition?

Metabolic alkalosis is an acid-base imbalance in the body fluids caused by too little acid or too much of a base compound called bicarbonate. Metabolic acidosis is always brought on by some other illness. This imbalance causes metabolic, respiratory, and kidney effects and, especially, depressed breathing.

With early diagnosis and prompt treatment, the chance of correcting this chemical imbalance is good. However, untreated metabolic alkalosis may lead to coma and death.

What Causes it?

Metabolic alkalosis is caused by loss of acid compounds or retention of base compounds in body fluids due to various disorders or drug actions. The body fluids become more alkaline than acid.

Acid Loss

Causes of critical acid loss include vomiting, excessive suctioning of the stomach with a tube, abnormal openings in the stomach (such as perforation caused by ulcers), and the use of certain drugs, including corticosteroids and diuretics. Diseases that cause acid loss include hyperadrenocorticism, Cushing’s disease, hyperaldosteronism, and Bartter’s syndrome.

Base Retention

Causes of base retention include excessive intake of bicarbonate of soda or other antacids (usually for treatment of gastritis or peptic ulcer), toO much alkali (as in milk-alkali syndrome with peptic ulcers), or too much intravenous fluid containing bicarbonate.

What are its Symptoms?

Symptoms begin when the person’s body tries to correct the acid-base imbalance, primarily through hypoventilation, which causes slow, shallow respirations. The person also may feel irritable, pick at his bedclothes, twitch, act confused, and complain of nausea, vomiting, and diarrhea. Because the heart, circulation, and breathing are all disturbed, the person with uncorrected alkalosis may have seizures and fall into a coma.

How is it Diagnosed?

Because the person is often in the hospital for another disorder, the doctor can observe his or her symptoms and then confirm metabolic alkalosis with blood tests and urine tests. The most important test for detecting metabolic alkalosis is called arterial blood gas analysis. The doctor may also use an electrocardiogram to determine the effects of this imbalance on the heart’s function.

How is it Treated?

The doctor tries to correct the underlying cause of metabolic alkalosis - for example, by discontinuing the use of drugs such as diuretics or stopping stomach suctioning. Fluids and elements such as potassium may need to be replaced. For the person with severe alkalosis, the doctor may prescribe intravenous ammonium chloride or other solutions to restore the person’s chemical balance.