Acidosis is a condition that occurs when the levels of acid in the body are very high. This condition is characterized by several symptoms, such as shortness of breath, confusion, or headaches.
Normally, the pH of the blood in the blood is around 7.4. Acidosis occurs when the blood pH is less than 7.35 (acidic). This is in contrast to the alkalosis condition that occurs when the blood pH is more than 7.45 (alkaline). This change in pH will greatly affect the function and work of various organs of the body.
Causes of Acidosis
Acidosis occurs when the acid-base balance in the body is disturbed, resulting in very high acid levels. There are 3 mechanisms that cause acidosis, namely excessive acid production, disturbed acid secretion, and abnormal acid-base balance processes in the body. These things will cause a buildup of acid in the body.
These three mechanisms can be caused by a disturbance in acid metabolism in the body (metabolic acidosis) or a disturbance in the process of exchanging oxygen and carbon dioxide (respiratory acidosis). Here is the explanation:
Metabolic acidosis
This condition occurs when the body produces too much acid or when the kidneys are unable to remove acid from the body. There are several types of acidosis including metabolic acidosis, namely:
- Diabetic acidosisDiabetic acidosis or diabetic ketoacidosis is caused by excess production of ketone bodies (acids). This condition occurs when diabetes is not controlled.
- Lactic acidosisLactic acidosis or lactate acidosis caused by overproduction of lactic acid. This condition occurs when the body performs anaerobic metabolism (low oxygen levels). Lactic acidosis can be caused by cancer, excessive alcohol consumption, liver failure, heart failure, long-term hypoglycemia, sepsis, and genetic disorders, such as MELAS.
- Hyperchloremic acidosisIncreased acid levels in the body in this condition are caused by excessive loss of sodium bicarbonate (base) over a long period of time. This condition usually occurs due to prolonged diarrhea or vomiting.
- Renal tubular acidosisThis condition occurs when the kidneys can't get rid of acid through urine, so acid builds up in the blood. This usually occurs when kidney damage is caused by an autoimmune disease or genetic disorder.
respiratory acidosis
Respiratory acidosis will also increase acid levels in the body, but with a different mechanism. This condition is caused by disorders of the respiratory system that increase levels of carbon dioxide in the blood.
The following are some disorders of the respiratory system that can trigger respiratory acidosis:
- Respiratory disorders, such as asthma and COPD (chronic obstructive pulmonary disease)
- Lung tissue disorders, such as pulmonary fibrosis
- Disorders of the sternum that can affect breathing, such as scoliosis and kyphosis
- Disorders of the nervous system that affect the process of breathing, such as: myasthenia gravis, GBS (Guillain-Barre Syndrome), and ALS (amyotrophic lateral sclerosis)
- Use of drugs that can affect the respiratory system, such as the use of opioids or a combination of benzodiazepine drugs with alcohol
- Other conditions that can affect breathing, such as obesity and sleep apnea
Symptoms of Acidosis
Symptoms of acidosis depend on the cause, whether it is a disorder of acid metabolism (metabolic acidosis) or an impaired exchange of oxygen and carbon dioxide (respiratory acidosis).
Symptoms of metabolic acidosis can include:
- Short and fast breath
- Headache
- daze
- Nausea and vomiting
- Tired or sleepy
- Decreased appetite
- Heart rate increases
- Jaundice
- The smell of breath smells like the smell of fruit
While the symptoms of respiratory acidosis can be:
- Short and fast breath
- Tired or sleepy
- Dizzy
- Headache
- daze
- Nervous
If the patient has respiratory acidosis that develops over a long period of time (chronic), symptoms are not always felt. However, signs such as memory loss, trouble sleeping, and changes in behavior may occur.
When to go to the doctor
Early detection and treatment can help reverse acidosis. Therefore, immediately consult a doctor if you feel the symptoms of acidosis as described above.
Keep in mind that acidosis is a serious condition and can be fatal. Make sure you go to the hospital immediately if you have trouble breathing.
Acidosis can be triggered by diseases and conditions such as diabetes, asthma, COPD. Have regular check-ups and checkups if you have this condition to prevent acidosis.
Diagnosis of Acidosis
To diagnose acidosis, the doctor will ask the patient's symptoms, medications that are being used, as well as the patient's and family's medical history. After that, the doctor will perform a thorough physical examination of the patient.
The doctor will also perform supporting tests to confirm the diagnosis, determine the severity of the acidosis, and determine the underlying cause. Tests that can be done are:
- Blood tests, to comprehensively assess metabolic function including kidney function, sugar levels, and electrolytes.
- Arterial blood gas analysis, to measure the levels of oxygen, carbon dioxide, and PH in the blood.
- Chest X-ray, to detect injury or other disorders in the lungs.
- Pulmonary function tests, to determine the condition and function of the lungs and respiratory tract.
- Urine test, to detect the presence of ketone bodies and the level of acid excreted in the urine.
Acidosis Treatment
Acidosis treatment will be tailored to the type, cause, and severity of acidosis. Here is the explanation:
Metabolic acidosis
Treatment of metabolic acidosis largely depends on the cause. In cases of hyperchloremic acidosis, the doctor will usually give sodium bicabornate, either in tablet form or as a liquid that is injected through a vein.
For renal tubular acidosis, your doctor may prescribe sodium citrate and treat your kidney problems. As for people with diabetic acidosis, insulin will be given along with intravenous fluids to balance acid levels.
For people with lactic acidosis, some medications, such as sodium bicarbonate, antibiotics, intravenous fluids, or oxygen, can be given. If the condition is not too severe, the detoxification process can be carried out, especially for patients who have drug or alcohol poisoning.
respiratory acidosis
Treatment of respiratory acidosis aims to improve lung function. In cases of acute respiratory acidosis, treatment is carried out by treating the cause. Meanwhile, for chronic respiratory acidosis, treatment is usually done to prevent the condition from getting worse.
Generally, the doctor will give antibiotics, diuretics, corticosteroids, or bronchodilators. If the patient's condition is severe enough, the doctor may install a breathing apparatus or ventilator called a continuous positive airway pressure (CPAP).
Complications of Acidosis
If left untreated, acidosis has the potential to cause complications such as:
- Kidney failure
- Osteoporosis
- Muscle disorders
- Endocrine system disorders
- Kidney stones
- Delay in growth
Acidosis Prevention
Not all types of acidosis can be prevented. However, there are several ways that can be done to reduce the risk of this condition, namely:
- Undergo medication and regular control if you have a disease that can cause acidosis, such as diabetes, asthma, and COPD
- Do not smoke
- Do not drink alcoholic beverages
- Maintain ideal body weight
- Drink enough water
- Take medicines as recommended by the doctor