Alcoholic Ketoacidosis Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Alcoholic ketoacidosis, also known as alcoholic ketosis or alcoholic acidosis, is malnutrition caused by excessive alcohol consumption.
Consumption of large amounts of alcohol can make a person vomiting, dehydrated, and even malnourished.
In conditions of malnutrition because you can’t eat and or vomit, the body will start producing ketones as a response to maintain energy.
Alcoholic Ketoacidosis
| Medical specialist | Internal medicine specialist |
| Symptom | Fast heart rate, fast breathing, ketone-smelling mouth |
| risk factor | People who often consume large amounts of alcohol |
| How to diagnose | Medical interview and laboratory examination (blood alcohol test, urine ketone test) |
| Treatment | Treatment in hospital, drug therapy |
| Drug | Intravenous thiamine and intravenous dextrose |
| Complications | Renal failure, cardiac arrest, pulmonary edema, hypovolemic shock |
| When to see a doctor? | If you have symptoms of alcoholic ketoacidosis |
Symptom
The symptoms of alcoholic ketoacidosis are similar to those of other conditions. Some of these symptoms include:
- rapid heartbeat
- Quick breath
- Nauseous
- Vomit
- Stomach ache
- An unpleasant ketone (may have a fruity) odor on the breath, also known as alcohol breath
- Dry mouth
- Agitation or confusion
Reason
Alcoholic ketoacidosis is triggered by excessive alcohol consumption. This can cause a person to vomit and stop eating.
If a person cannot eat for a day or so, the liver will use up the stored glucose.
When the liver uses stored glucose but you don’t eat anything else, blood sugar levels drop.
This decrease in blood sugar will cause the body to reduce the amount of insulin it produces.
In fact, the body’s cells need insulin to convert glucose in the blood into energy.
If it can’t use glucose because there isn’t enough insulin, the body turns to “another method” for energy, namely breaking down fat cells. And, ketones are produced.
Ketones are acidic chemicals, such as acetone, acetoacetate, and beta-hydroxybutyrate, that the body metabolizes from fatty acids.
This compound is used by the body as energy when there is not enough glucose coming from food sources.
However, very high ketone counts can be a problem because they create a very acidic environment in the body.
Too high a level of acidity in the body can cause severe metabolic acidosis. This condition can be fatal, even life-threatening.
Additionally, alcohol inhibits the body’s ability to produce glucose leading to significant production of ketones once alcohol levels drop.
A person who does not eat properly and gets the required nutrients from food due to drinking large amounts of alcohol starts to get an excessive buildup of ketones in the body.
Apart from that, individuals can also suffer from increased acidity due to the accumulation of lactic acid which is caused by dehydration due to drinking too much.
Other causes stem from the buildup of other metabolic products caused by the breakdown of alcohol, such as acetate.
Risk Factors
People who drink large amounts of alcohol frequently are at risk of developing alcoholic ketoacidosis.
The American National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines problematic alcohol intake by the following criteria:
- Called excessive alcohol consumption, when the concentration of alcohol in the blood (BAC) increases to 0.08 percent or more.
For men, this means consuming about 5 glasses or more in 2 hours.
For women, that means drinking 4 or more glasses in a 2-hour period.
- Called heavy alcohol consumption, for men it means consuming 4 or more drinks a day or more than 14 alcoholic drinks a week.
For women, heavy alcohol use was defined as 3 or more drinks a day or 7 or more drinks a week.
Note that people with alcoholic ketoacidosis often have a low or no BAC.
Why is that? This condition usually develops after stopping drinking.
Diagnosis
The doctor will interview you about your symptoms and medical history, especially regarding alcohol use.
Because the symptoms of alcoholic ketoacidosis are similar to those of other conditions, your doctor may order laboratory tests that include:
- Blood alcohol test
- Blood sugar test
- Kidney function test
- Amylase and lipase tests to see if you have pancreatitis
- Urine test for ketones
- Blood chemistry panel
- Sodium and potassium levels
- Arterial blood gas test to check for acidity and oxygen
Treatment
Treatment for alcoholic ketoacidosis will depend on the severity and other accompanying problems.
In general, this condition is handled by specialists in internal medicine. However, it is not impossible for you to be treated by other specialist doctors according to the conditions.
Meanwhile, some common alcohol ketoacidosis treatment options include:
- Intravenous thiamine, i.e. vitamin B1
- Intravenous dextrose, an intravenous solution containing sugar
- Infusion fluids
- Replacement of potassium, phosphorus, and magnesium, according to the patient’s condition
- Treatment of other conditions you may also have, such as pancreatitis
- Medicines to help with alcohol withdrawal
- Medication to help with nausea
Prevention
You can prevent alcoholic ketoacidosis by limiting or stopping your alcohol use.
If you do have a problem with alcohol addiction, seek treatment to help kick the habit.
There are a variety of treatment options to choose from, including:
1. Drugs
There are currently three drugs approved to help a person quit drinking and reduce the likelihood of relapse. Namely, naltrexone, acamprosate, and disulfiram. The use of these drugs must be under the supervision of a doctor.
2. Behavioral therapy or counseling
Behavioral therapy and counseling teach skills to overcome and change alcohol addiction behavior. Therapy must be carried out by a certified counselor.
3. Support Group
Group meetings will provide support for people trying to quit drinking. This method can be combined with medication and therapy so that the results are maximized.
Complications
Alcoholic ketoacidosis that is treated late or even not completely treated can lead to complications, such as:
- Hypovolemic shock
- Heart attack
- seizures
- Delirium tremens (DTs), which is confusion, shaking, chills, sweating, and irregular heartbeat
- Pulmonary oedema
- Kidney failure
- Death
When to See a Doctor?
If you or someone else around you has the symptoms of alcoholic ketoacidosis above, seek emergency medical help immediately.