Ketoacidosis

Alcoholic ketoacidosis is a severe metabolic complication due to long-term alcohol consumption. The disease is the accumulation of ketones in the blood. Ketones are the by-product of the body when it breaks down fat for energy.

A person who drinks alcohol every day can often be malnourished. One of the main reasons for getting the disease is the clear effects of alcoholism and starvation. In this condition, starvation means the glucose starvation of metabolism. Ketoacidosis from alcoholism should be a tigger that you need to seek alcohol addiction treatment.

 What causes Alcoholic Ketoacidosis?

 Long-term very heavy alcohol consumption will cause the disease. Prolonged alcohol abuse may cause malnutrition; the combination of these two may lead to Alcoholic Ketoacidosis.

 How does the body metabolize?

 For the body to function properly, the cells need glucose (sugar) and insulin. The body can produce glucose when it digests the food, and the pancreas produces insulin.

 However, when a person drinks alcohol, the pancreas may stop producing insulin for a brief period. Without insulin, the cell cannot produce glucose for the energy that the body needs. To replenish itself with the energy it will start to burn fat.

 Once the body turns fat for energy, it will produce ketones.  Once the body stops producing insulin for long period due to alcohol intake, ketones will start to accumulate in the bloodstream. This buildup will eventually lead to a severe condition called ketoacidosis.

 Here are the important events when a person drinks heavy for a long period of time:

Also, people who drink too much alcohol may not eat properly and regularly. Most often they vomit frequently because of the alcohol intake. Not eating properly and vomiting may result in starvation. Whenever this happens, the body will further reduce the insulin production.

Other causes for general ketoacidosis:

  •  large prescribed amount of aspirin
  • shock
  • kidney related diseases
  • abnormal metabolism

Furthermore, there are specific types of Ketoacidosis, these includes:

  • Diabetic ketoacidosis (DKA), Type 1 diabetic people mostly develop the disease
  • Starvation Ketoacidosis, excessive vomiting of pregnant women in their third trimester can lead to this illness
  • Alcoholic ketoacidosis, excessive heavy alcohol intake can lead to this disease

Each one of these scenario may lead to the excessive acid production in the body. They can dramatically reduce the insulin production, leading to an increase breakdown of fat. This will then result to the increase production of ketones in the bloodstream. Alcoholics need not go through this alone. Hopefully they have someone in their lives like you, who can see the symptoms of alcoholism.

Important facts for Alcoholic Ketoacidosis:

  •  Ketoacidosis happens when the body ingest food which then metabolized it or breaks it down into an acid
  • Excessive heavy alcohol intake and malnutrition can lead to Alcoholic Ketoacidosis
  • Stomach pain, vomiting, fatigue and dehydration are the common signs of the disease

What are the sign and symptoms of Alcoholic Ketoacidosis?

The signs and symptoms of the disease vary depending on the alcohol consumption of the person. Also, it will depend on the amount of ketones present in the bloodstream. Here are the common symptoms of Alcoholic Ketoacidosis:

  • Stomach or abdominal pain
  • Anxiety and confusion
  • Decreased awareness or coma
  • Fatigue
  • Slow movement
  • Erratic, deep, and rapid breathing (known as Kussmaul’s sign)
  • Loss of appetite
  • Nausea and vomiting

Besides these symptoms, Alcoholic Ketoacidosis will include symptoms of dehydration. Examples include dizziness (vertigo), lightheadedness and feeling of thirst. Alcoholic Ketoacidosis is a life-threatening disease. If one or more of these symptoms became clear, contact immediate medical attention. Can functioning alcoholics experience this? Yes, but since they tend to perform well, you may not notice.

A person with Alcoholic Ketoacidosis may also develop other alcohol related illness. These may include:

  •  Kidney Disease
  • Pancreatitis
  • Ulcers
  • Ethylene glycol poisoning

How does Alcoholic Get Ketoacidosis diagnosed?

If the symptoms of the disease became clear, doctors will do physical examination. Doctors will also check for history of alcohol abuse. They need to eliminate other diseases.
When the results are in, they can now confirm the diagnosis.

These examinations may include:

  • Amylase and lipase tests (used to monitor the functions of the pancreas and check for
  • Arterial blood gas test ( to measure the oxygen level in the blood)
  • Blood alcohol test
  • Blood glucose test
  • Urine test for Ketones
  • Serum lactate test (high lactate levels can show signs of lactic acidosis which may indicate the cells and tissue may not getting enough oxygen)
  • Anion gal calculation (to measure sodium and potassium levels)
  • Blood chemistry (CHEM-20) (to check the metabolism function)

If the result shows elevated glucose level, doctors may also request for hemoglobin A1C test. The test will give additional information about the sugar levels to determine the existence of diabetes.

What are treatments available for Alcoholic Ketoacidosis treated?

Treatments for Alcoholic Ketoacidosis are usually given to the person in the emergency room. Doctors will monitor the vital signs such as blood pressure, breathing and heart rate.

Also, doctors may give more fluids intravenously. These fluids may contain vitamins, and nutrients to help treat malnutrition.

These may include the following:

  • Thiamine
  • Potassium
  • Phosphorus
  • Magnesium

For severe conditions that may need on-going care, doctors may admit the person to the intensive care unit (ICU). The length of the admission in the hospital will vary depending on the severity of the disease. It will also depend on the ability of the body to recuperate from the disease. It also depends on how long it takes to get your body out of danger and to regulate the person’s well-being.

What are the complications of Alcoholic Ketoacidosis?

Alcohol withdrawal serves as the major complication of Alcoholic Ketoacidosis. Doctors and other medical practitioner may observe the symptoms of withdrawal. The disease may also lead to gastrointestinal bleeding if it progress severely.

Other complications may include the following:

  • Coma
  • Encephalopathy (a brain disease which cause memory loss)
  • Pancreatitis
  • Pneumonia
  • Psychosis

 

 

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Dr. Vikram Tarugu

Gastroenterologist and medical professional focused on addiction.

Dr. Muhammad Syed

Doctor of internal medicine, C.F.O. He is Instrumental in the success of Detox of South Florida. He is known for his cheerful, ever happy and helpful attitude.

Dr. Shilpa Tarugu

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