Alcoholic Ketoacidosis: Etiologies, Evaluation, and Management

One complication of alcoholic ketoacidosis is alcohol withdrawal. Your doctor and other medical professionals will watch you for symptoms of withdrawal. These conditions have to be ruled out before a medical professional can diagnose you with alcoholic ketoacidosis. Alcoholic ketoacidosis can develop when you drink excessive amounts of alcohol for a long period of time.

How is alcoholic ketoacidosis treated?

Not eating enough or vomiting can lead to periods of starvation. Take our free, 5-minute alcohol abuse self-assessment below if you think you or someone you love might be struggling with alcohol abuse. The evaluation consists of 11 yes or no questions that are intended to be used as an informational tool to assess the severity and probability of an alcohol use disorder. The test is free, confidential, and no personal information is needed to receive the result. They provide some energy to your cells, but too much may cause your blood to become too acidic.

How Is Alcoholic Ketoacidosis Treated?

• Fat cells begin breaking down, producing compounds called ketones.
• If you believe you or someone you love may be struggling with addiction, let us hear your story and help you determine a path to treatment.
• We present a 64-year-old female who presented with generalized abdominal pain, nausea, vomiting and shortness of breath.

It should be suspected in any patient who has a history of chronic alcohol dependency, malnutrition or recent episode of binge drinking 1. This case demonstrates the importance of considering AKA in the differential diagnosis of a patient presenting with non-specific symptoms, significant metabolic acidosis and a history of alcohol excess. It is essential to differentiate AKA from DKA to ensure that inappropriate insulin administration does not occur. The key tenants to management of AKA include fluid resuscitation and electrolyte correction. If you chronically abuse alcohol, you probably don’t get as much nutrition as your body needs.

What Are the Symptoms of Alcoholic Ketoacidosis?

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Going on a drinking binge when your body is in a malnourished state may cause abdominal pain, nausea, or vomiting. Infection or other illnesses such as pancreatitis can also trigger alcoholic ketoacidosis in people with alcohol use disorder. The presence of a high anion gap, although not specific, is suggestive of AKA in a patient with an appropriate clinical history 9. Additional measurements that may help determine the diagnosis of AKA include beta-hydroxybutyrate levels (high in AKA, low in DKA) and serum alcohol concentration (typically low or undetectable) 8.

This drop in blood sugar causes your body to decrease the amount of insulin it produces. Your cells need insulin to use the glucose in your blood for energy. If they can’t use glucose because there’s not enough insulin, your body switches to another method to get energy — breaking down fat cells.

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Further biochemical investigation after treatment showed a alcoholic ketoacidosis pathophysiology rapid decline in the level of ketones and normalization of pH. It can be helpful to understand the basic guidelines for alcohol consumption so you can determine whether you are drinking above recommended levels and engaging in potentially harmful alcohol use. Group meetings provide support for people trying to quit drinking. Meetings are widely available at little-to-no cost in most communities. Support groups can be a valuable source of support and can be combined with medication and therapy.

Alcoholic ketoacidosis is a condition that can happen when you’ve had a lot of alcohol and haven’t had much to eat or have been vomiting. When this happens, it can cause ketones, which are acids, to build up in your blood. If not treated quickly, alcoholic ketoacidosis may be life-threatening. Alcoholic ketoacidosis is a complication of alcohol use and starvation that causes excess acid in the bloodstream, resulting in vomiting and abdominal pain. Alcoholic ketoacidosis is a problem caused by drinking a lot of alcohol without eating food. Your doctor may also admit you to the intensive care unit (ICU) if you require ongoing care.

Arterial blood gas analysis showed significant acidaemia with a pH of 7.10, bicarbonate of 2.9 mmol/l and lactate of 11.7 mmol/l. If you have symptoms of alcoholic ketoacidosis, your doctor will perform a physical examination. They will also ask about your health history and alcohol consumption.

Additional information

• If you chronically abuse alcohol, you probably don’t get as much nutrition as your body needs.
• Seeking help as soon as symptoms arise reduces your chances of serious complications.
• Although DKA can also present with a severe metabolic acidosis, with a raised anion gap and the presence of ketones, the history and examination are quite distinct from that of someone presenting with AKA (Table 1).
• Typical patients are usually chronic drinkers who are unable to tolerate oral nutrition for a 1 to 3 day period.
• Following resuscitation, our patient had plasma electrolyte levels corrected, nutritional supplementation provided and completed an alcohol detoxification regimen.

But it can happen after an episode of binge drinking in people who do not chronically abuse alcohol. Alcoholic ketoacidosis doesn’t occur more often in any particular race or sex. We present a 64-year-old female who presented with generalized abdominal pain, nausea, vomiting and shortness of breath.