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Alcoholic Ketoacidosis Prognosis

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Severe Metabolic Acidosis In The Alcoholic: Differential Diagnosis And Management

1 A chronic alcoholic with severe metabolic acidosis presents a difficult diagnostic problem. The most common cause is alcoholic ketoacidosis, a syndrome with a typical history but often misleading laboratory findings. This paper will focus on this important and probably underdiagnosed syndrome. 2 The disorder occurs in alcoholics who have had a heavy drinking-bout culminating in severe vomiting, with resulting dehydration, starvation, and then a β- hydroxybutyrate dominated ketoacidosis. 3 Awareness of this syndrome, thorough history-taking, physical examination and routine laboratory analyses will usually lead to a correct diagnosis. 4 The treatment is simply replacement of fluid, glucose, electrolytes and thiamine. Insulin or alkali should be avoided. 5 The most important differential diagnoses are diabetic ketoacidosis, lactic acidosis and salicylate, methanol or ethylene glycol poisoning, conditions which require quite different treatment. 6 The diagnostic management of unclear cases should always include toxicological tests, urine microscopy for calcium oxalate crystals and calculation of the serum anion and osmolal gaps. 7 It is suggested here, however, that the value of th Continue reading >>

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Popular Questions

  1. tarek

    So, for the past few nights, I've had quite a bit of trouble falling asleep. My body is very tired, but I've just been unable to sleep as soundly as I normally do. At first, I thought it might have been the dairy I was including in my diet, so I cut that out. The sleeping troubles persisted. I just realized that I've been eating fewer carbohydrates than ever (I don't really keep count, but I believe it's been around 100 grams or less each day for the past two weeks or so), so I think my body might have entered ketosis. I do have some of the other "symptoms" -- I have a funny taste in the back of my mouth, I'm thirsty more often than usual (I still drink plenty of water), I feel fatigued often, etc.
    I won't mind dealing with this as long as it eventually subsides, but I would like to know how long it will last, given that I continue to eat the same amount of carbohydrates. If you think I need to eat more or less, go for it; any advice will help. As a side note, I do some form of exercise every day, usually in the form of a light bike ride or a walk, and I do some heavy lifting two to three times per week.
    Any help is appreciated! Thanks.

  2. lmyers04

    if youre lifting you need more carbs thats why you feel tired. experiment with eating more of them.

  3. Canarygirl

    From what I gather, some people get over the sleep issues when they get fully acclimated to burning fatty acids for fuel. However, not everyone goes back to their former sleep habits...as long as they are on a low carb diet. You can try taking a tryptophan supplement before bedtime. It helps me. Also, magnesium (chelated for easy absorption).

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