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Acid-Base Balance

Acid-Base Balance

This article is an expose on the mechanism of acid-base balance in your body.

Your body needs both acidic and alkaline compounds in their balanced proportion to bring about the right functioning in the systems of the body. And two important organs of the body ensure that this balance is achieved. They are the lungs and the kidneys. Any minute variation in their blood concentration can result in abnormal health states.

This concentration can be assessed using a pH scale. A low pH signifies a state of acidity while a rise in it points to a state of alkalinity. Their extreme cases are referred to as acidosis and alkalosis, in that order. Acidosis is characterized by excess acid in the blood; alkalosis is a state of excess alkaline in the blood.

Acidosis and alkalosis are classified into two, based on their cause – respiratory and metabolic. When the problem is from the lungs, it will be termed respiratory acidosis or alkalosis. When the source of the problem is the kidney, it will be caused by metabolic acidosis or alkalosis.
Let’s look at them one after the other.

Respiratory acidosis

Respiratory acidosis

It is a state of too much acid in the blood because of the lungs being unable to remove excess carbon dioxide from the blood.

Types of respiratory acidosis
  1. Chronic – In chronic respiratory acidosis, symptoms are not noticeable. This can be attributed to the fact that your blood progressively turns acidic and your kidneys keep adjusting to compensate for it by returning your blood pH to the normal. 
  2. Acute – Acute respiratory acidosis occurs spontaneously with no reasonable time for the kidney to engage its restorative mechanism. This form of acidosis can as well be experienced by those having its chronic variant due to a worsening hidden medical anomaly.
Diagnosis
  1. Complete physical examination
  2. An arterial blood test to assess its gas content
  3. Metabolic panel test
  4. Pulmonary function test to assess the state of the lung apparatus
  5. Chest X-ray to medically view the lungs for any abnormality
Treatment

A prompt visit to your doctor should be your first line of action in cases of acute respiratory acidosis. Any of the following treatment options will be carried out on you as determined by the underlying cause.

Bronchodilator medications: it is for dilating your airways. It helps with the management of airway obstruction.

Oxygen therapy: This will be required if and only if you have a very low blood oxygen level. A breathing apparatus or positive pressure ventilation can be used. These are noninvasive. In treating chronic respiratory acidosis, the subtle cause must first be discovered. That discovery informs the next line of action to take.

The three most likely causes of chronic respiratory alkalosis are infections, inflammation, and deformity in organs. Antibiotics will handle inflammations. Oxygen therapy might also be needed.

Complications

Complications are inevitable when the condition is not treated. Some of the common ones are; shock, respiratory and organ failure.

Prevention
  • Watch against excessive weight gain
  • Quit smoking if you are a smoker
  • Use drugs, especially sedatives under close supervision by your doctor. Plus, don’t take sedatives with alcoholic drinks

Metabolic acidosis

Metabolic acidosis is a state of the body characterized by too much acid production in your body. It can also be due to the kidneys’ failure in ridding the body of excess acid.

Symptoms of metabolic acidosis
  1. Rapid breathing
  2. Fatigued body
  3. Mental confusion
Causes of metabolic acidosis
  1. Hyperchloremic acidosis: It is a diarrhea-induced excess sodium bicarbonate loss.
  2. Diabetic acidosis: You can also call it diabetic ketoacidosis. It is ketone bodies-induced acidosis due to type 1 diabetes.
  3. Lactic acidosis: It is acidosis due to excess accumulation of lactic acid in the body. Prolonged exercise, cancer, alcohol, serious dehydration, oxygen deficiency, medications, hypoglycemia, seizures, kidney malfunctioning, liver dysfunction, aspirin poisoning, ethylene glycol poisoning, and methanol poisoning, etc. can cause lactic acidosis.
Diagnosis

Serum electrolyte test: Your bicarbonate value will be tested for. The normal value is 24mEq/L. Its value will be far more than this if you have acidosis.

Urine pH test: The normal value is 7.4. Since acidosis is associated with a fall in pH, you can reason what the result should look like – value lower than 7.4.

Arterial blood gases assessment: In this test, your blood carbon dioxide pressure will be assessed. Its normal value is 40mmHg. Acidosis will bring about a rise in this pressure. N/B: These tests are confirmatory. Further tests will be needed to diagnose the exact underlying cause.

Treatment

The underlying condition defines the treatment options. Sodium bicarbonate will in most cases be given to returning blood pH to normal.

Complications

Shock: It is usually experienced in severe cases. It is a state of your body where you have very low blood pressure.

Alkalosis

Alkalosis is defined by a state of the body characterized by more than normal alkaline levels. It is as a result of low carbon dioxide or high bicarbonate concentrations.

Alkalosis causes your body to produce more bicarbonate due to a very low carbon dioxide level. This is a compensatory approach to restoring blood pH and it is termed compensated alkalosis.

If your blood pH is tested for, it will show a normal value because your kidneys are busy releasing more bicarbonate ions to compensate for the low carbon dioxide concentration. An excess of bicarbonate ions in your blood is a pointer to metabolic alkalosis.

Prolonged vomiting will cause your body to lose too much chloride ions. This condition is called hypochloremic alkalosis. It is also very possible to develop what is called hypokalemic alkalosis. In hypokalemic alkalosis, your body loses high amounts of potassium ions because of diuretics.

Diagnosis

Physical examination: Its physical signs are not specific and besides, they depend on its severity. Seizures, body weakness, etc. can occur. Your doctor will be in a better position to help you know more about this.

Metabolic panel: it assesses your body’s metabolic and chemical balance state. It comprises a set of tests carried out on your blood plasma. It can tell the doctor the state of your heart, muscles, liver, and kidneys.

Blood gas analysis: In this test, your blood carbon dioxide pressure will be assessed. Its normal value is 40mmHg. Alkalosis will bring about a fall in this pressure.

Urinalysis: The normal value is 7.4. Since alkalosis is associated with a rise in pH, you can reason what the result should look like – value greater than 7.4.

Treatment

The underlying factor for the condition will be diagnosed for proper medical intervention. pH variations can be properly corrected when your vital signs have been taken. Chemical losses can be corrected with medications containing chloride and potassium.

Complications of alkalosis

In very serious cases, alkalosis can cause abnormal rhythms of the heart – arrhythmias. It could as well lead to a coma. A coma is a state of unconsciousness.

Outlook

You never can tell how serious acidosis and alkalosis can be. When you begin experiencing any of the symptoms associated with any of them, please do not hesitate to see your doctor for help.

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