Bowel obstruction occurs when you have a complete or partial blockage of your bowel, stopping liquids, solids and gas passing through your small or large intestine. This can cause severe abdominal pain, bloating, nausea and vomiting. Bowel obstruction requires prompt medical assessment.…
- Lactic acidosis is a build-up of lactic acid in your blood.
- It can be the result of intense exercise, severe dehydration, an underlying medical condition, or as a reaction to some substances and medications.
- Symptoms of lactic acidosis can initially include weakness and nausea. More severe symptoms, such as chest pain, a fast heartbeat or breathing difficulties, require immediate medical attention.
- You can reduce your risk of lactic acidosis by not abusing alcohol and by properly managing diabetes if you have it.
What is lactic acidosis?
Lactic acidosis is a build-up of lactic acid in your blood. It makes the blood too acidic.
Inside the cells of your body, there are structures called mitochondria. Their role is to supply energy to the cells. Mitochondria break down glucose for energy using oxygen, a process known as aerobic respiration.
In situations when your body is starved for oxygen, or needs a lot of energy very quickly (such as during intense exercise), your mitochondria can switch to an alternative process known as anaerobic respiration. It is much less efficient, but it does not require oxygen and can, for a brief period, produce energy more quickly.
Anaerobic respiration produces lactic acid (also known as lactate), making the blood more acidic. In most cases this is not a problem, because your liver and kidneys handle the excess lactic acid once your body starts to recover from oxygen starvation and returns to normal. However, when your body produces lactic acid faster than it can be removed, lactic acid builds up in your blood.
Causes and risk factors
Causes and risk factors of lactic acidosis include:
- Intense exercise;
- Severe dehydration;
- Low blood sugar, and;
- Some substances and medications - such as alcohol, cocaine, epinephrine, isoniazid, salicylates, and the diabetes medication metformin - can raise the level of lactate in the body.
Lactic acidosis is often the result of another medical condition, such as:
- Liver failure.
- Kidney problems.
- Mitochondrial diseases.
- HIV/AIDS - people with AIDS are more prone to infection, which can result in lactic acidosis when the bloodstream is infected. Lactic acidosis can also result from medications used to treat HIV.
- Cancer - in rare cases, lactic acidosis can occur in people with leukemia, lymphoma, or solid tumors. It is not clear why this happens.
- Short bowel syndrome can lead to bacteria in the gut producing too much lactate, which can sometimes enter the bloodstream.
- Diabetes increases the risk of heart and kidney problems, leading to increased risk of lactic acidosis.
Signs and symptoms
Mild symptoms of lactic acidosis include:
- Weakness and lethargy, and;
- Nausea and sometimes vomiting.
The following severe symptoms may indicate a life-threating condition. Seek immediate medical attention if you have:
- Chest pain, tightness or pressure;
- High fever;
- Bluish lips or fingernails;
- Short breath and rapid breathing, and;
- An abnormally fast heart rate or an irregular heartbeat.
Methods for diagnosis
Lactic acidosis is diagnosed with a blood test. Further tests can identify the underlying cause of the lactic acidosis.
Types of treatment
Treatment for lactic acidosis starts by identifying the underlying medical condition, or by removing the drug or toxin that is causing it.
Treatment generally includes:
Lactic acidosis is itself a complication, often arising as a result of another medical condition or as a side effect of certain medications.
Left untreated, lactic acidosis can result in the following complications:
The prognosis for lactic acidosis depends on its cause. In many people, lactic acidosis is a temporary condition that can be treated effectively. In others, lactic acidosis is only one aspect of an existing medical condition, and their prognosis would depend on all aspects of their condition.
You can reduce your risk of lactic acidosis by not abusing alcohol and by properly managing diabetes if you have it.
- Fall PJ, Szerlip HM. (2005) Lactic acidosis: from sour milk to septic shock. J Intensive Care Med. Sep-Oct, 20(5):255-71.
- Acidosis - National Library of Medicine - PubMed Health. Accessed 9 October 2014 from link here
- Bakker J. Nijsten M.W. & Jansen T.C. (2013). Clinical use of lactate monitoring in critically ill patients. Annals of Intensive Care 3: 12.
- Causes of lactic acidosis. Accessed 9 October 2014 from link here
- Lactic Acidosis. Accessed 9 October 2014 from link here
- Lactic acidosis | University of Maryland Medical Center. Accessed 9 October 2014 from link here
- Lactic acidosis and liver disease. [Arch Intern Med. 1979] - PubMed - NCBI. Accessed 9 October 2014 from link here
- Lactic acidosis: from sour milk... [J Intensive Care Med. 2005 Sep-Oct] - PubMed - NCBI. Accessed 12 October 2014 from link here
- Lactic acidosis in patients with diabetes | POLSKIE ARCHIWUM MEDYCYNY WEWNĘTRZNEJ. Accessed 10 October 2014 from link here
- Lactic acidosis - National Library of Medicine - PubMed Health. Accessed 9 October 2014 from link here
- PLOS ONE: A Risk-Factor Guided Approach to Reducing Lactic Acidosis and Hyperlactatemia in Patients on Antiretroviral Therapy. Accessed 10 October 2014 from link here
- Renda F. Mura P. Finco G. et al. (2013). Metformin-associated lactic acidosis requiring hospitalization. A national 10 year survey and a systematic literature review. European Review for Medical and Pharmacological Sciences 17 Suppl 1: 45–49.
- Tissue hypoxia results in lactic acidosis: EBSCOhost. Accessed 10 October 2014 from link here
FAQ Frequently asked questions
What is lactic acidosis?
Lactic acidosis is when lactic acid builds up in your blood, making it too acidic. If left untreated, it can result in an irregular heartbeat, shock, coma and even death.
What are the symptoms of lactic acidosis?
Mild symptoms of lactic acidosis include weakness, nausea and vomiting, while severe symptoms include rapid breathing, a rapid and irregular heartbeat, chest pain and fever.
What causes lactic acidosis?
Lactic acidosis occurs when there is too much lactic acid in the blood, which can be due to a number of causes, such as dehydration, excessive alcohol use, or certain medications, including some used to treat HIV and diabetes.
How is lactic acidosis treated?
How lactic acidosis is treated depends on the cause, but treatment usually includes oxygen therapy and intravenous fluids to improve the supply of oxygen to tissues and flush out lactic acid from the body, respectively.
What HIV medications can cause lactic acidosis?
Nucleoside reverse transcriptase inhibitors (NRTIs) such as zidovudine, labovudine and abacavir can increase your risk of lactic acidosis by damaging the energy-producing parts of cells (mitochondria) and blocking their reproduction.
What is the outlook for lactic acidosis?
The outlook for lactic acidosis depends on how severe the lactic acidosis is. In general, outcomes are poor when lactate in the blood is higher than 5 mmol/L and is not cleared in 48 hours.