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A description of acidosis as a condition characterized by excessive acid in the body fluids

Journal of the Pancreas Abstract One primary reason for the current epidemic of digestive disorders might be chronic metabolic acidosis, which is extremely common in the modern population. Chronic metabolic acidosis primarily affects two alkaline digestive glands, the liver, and the pancreas, which produce alkaline bile and pancreatic juice with a large amount of bicarbonate.

The pancreatic digestive enzymes require an alkaline milieu for proper function, and lowering the pH disables their activity. It can be the primary cause of indigestion. Acidification of the pancreatic juice decreases its antimicrobial activity, which can lead to intestinal dysbiosis.

  1. Mc Clave, SA believed that while healthy people have a high bicarbonate concentration in the duodenum, patients with chronic pancreatitis have a low bicarbonate concentration.
  2. In this situation, the acidic milieu in duodenum inactivates the pancreatic enzymes.
  3. Even neutral pH 7. The constancy of the blood pH is important for the body's capability to maintain a relatively unchanging internal milieu.
  4. The human body has a complicated, multifunctional mechanism to neutralize these acids or remove them from the body via CO2 carbon dioxide, a gas that is eliminated by the lungs or, by keeping bicarbonate ions HCO3- in the blood by the kidneys.

Lowering the pH of the pancreatic juice can cause premature activation of the proteases inside the pancreas with the potential development of pancreatitis. The acidification of bile causes precipitation of the bile acids, which irritate the entire biliary system and create bile stone formation.

Normal exocrine pancreatic function is the core of proper digestion. Currently, there is no effective and safe treatment for enhancing the exocrine pancreatic function. Restoring normal acid-base homeostasis can be a useful toolfor pathophysiological therapeutic approaches for various gastrointestinal disorders.

There is strong research and practical evidence that restoring the HCO3 - capacity in the blood can improve digestion. This increase cannot be explained solely by genetic factors, so the environmental causes come to the light of scientists and doctors. The Burden of Digestive Diseases in the United States might illustrate the medical statistic [ 1 - 4 ]. Researchers from the Mayo Clinic College of Medicine USA, in the study of more than 21,000 Americans, found that the prevalence of an average of one or more upper GI symptoms during the last 3 months was 44.

There are 60 to 70 million people affected by digestive diseases in the U. This is an official medical statistic of the number of Americans seeking medical care at doctor offices and hospitals, but this number is only the tip of the iceberg.

  1. One of the most prevalent and preventable results is low-grade chronic metabolic acidosis, which when left untreated poses a substantial threat to human health. The importance of plasma bicarbonate was demonstrated by in vivo experiments, in which pancreatic secretion was studied under the conditions of metabolic acidosis.
  2. Many factors support that chronic metabolic acidosis can be a reason for numerous digestive disorders. Select your language of interest to view the total content in your interested language Viewing options.
  3. The importance of Bicarbonate The bicarbonate content is a prime factor of alkalinity in bile and pancreatic juice.
  4. There are 60 to 70 million people affected by digestive diseases in the U.
  5. Tohoku J Exp Med 1991; 163. Ordinary tests cannot reveal the shift to acidity because humans have an enormous buffer capacity.

The food revolution has had a significant impact on preparing, conserving, preserving, and dispensing modern food for the last 60 years. This decreases the amount of essential enzymes, vitamins, minerals, and bicarbonate in the foods.

The modern processed foods have been available for only several generations; therefore, genetic adaptation to these foods in such a short period is highly unlikely. What causes the body to be acidic? The main factors are: The average person generates from 50 to 100 mEq of acid per day from the metabolism of protein, carbohydrates, and fats, and from the loss of alkaline substances in the stools [ 6 ].

To maintain a normal pH, an equivalent amount of acid must be neutralized or excreted. Many body functions are designed to regulate the acid-base balance, including respiration, excretion, circulation, digestion, and cellular metabolism. The human body has a complicated, multifunctional mechanism to neutralize these acids or remove them from the body via CO2 carbon dioxide, a gas that is eliminated by the lungs or, by keeping bicarbonate ions HCO3- in the blood by the kidneys.

The kidneys and lungs are the principal organs that help manage the blood concentrations of CO2 and the bicarbonate ion HCO3-helping to control the pH of the blood. The blood is normally slightly alkaline with a pH range of 7. The constancy of the blood pH is important for the body's capability to maintain a relatively unchanging internal milieu.

The pH of the blood is constant, and the organism struggles to keep it constant to protect the brain, lungs, and the heart, which completely stop functioning if the pH in the blood falls even slightly. In the bloodstream, there are substances identified as buffers, which act chemically to resist changes in the pH. It is the most powerful blood buffer for metabolic acids. It works in the following manner: The bicarbonate buffering system is essential in many different processes including: The pancreatic juice has a pH of 8.

When acidity depletes the alkaline reserve in the body, this process destroys the function of the liver, gallbladder, and pancreas.

Chronic Metabolic Acidosis Destroys Pancreas

The liver and the pancreas take the minerals and bicarbonates from the blood to create alkaline pancreatic juice and bile. The liver, gallbladder, and pancreas are the organs that suffer the most from over acidity in the body.

In this situation, their capability to take minerals and bicarbonates from the blood becomes low, and the pH of their secretions drops acidic pancreas and bile. The biochemistry, composition, and function of these organs change in a harmful way. The importance of Bicarbonate The bicarbonate content is a prime factor of alkalinity in bile and pancreatic juice.

It is obvious that in bile and pancreatic juice, there is more bicarbonate than in the blood plasma. Scientists found that the pancreas and liver take bicarbonate ions primary from the a description of acidosis as a condition characterized by excessive acid in the body fluids.

Intravenously injected bicarbonate labeled with the 11C radioisotope appears promptly in the pancreatic juice. The concentration of bicarbonate in pancreatic juice depends on the concentration of bicarbonate ions in the plasma [ 9 ]. When the acidic chyme travels from the stomach into the duodenum, the secretion of bicarbonate increases and then decreases, possibly because of the lowering of the amount of bicarbonate capacity inside the pancreas.

Infusing bicarbonate into the blood throughout the digestive process promotes the increase of bicarbonate in the pancreatic juice. There is considerable evidence that there is a decrease in the amount of bicarbonate in the pancreatic juice and bile in patients with pancreatic diseases [ 12 - 13 ]. Duodenal acidity mostly depends on a lower amount of bicarbonate in the pancreatic juice and bile.

In chronic pancreatitis patients who often suffer from pancreatic exocrine insufficiency, the duodenal pH is persistently low [ 1315 ]. A low pH in the duodenum is one of the essential factors known to influence the activity of all the pancreatic enzymes [ 17 ].

Mc Clave, SA believed that while healthy people have a high bicarbonate concentration in the duodenum, patients with chronic pancreatitis have a low bicarbonate concentration. In this situation, the acidic milieu in duodenum inactivates the pancreatic enzymes.

He wrote that chronic pancreatitis patients often present with pancreatic exocrine insufficiency combined with a steadily low duodenal pH in the postprandial period. The duodenal acidity might increase the risk of pancreatic cancer in the course of chronic pancreatitis Table 1 [ 15 ]. A proportional, opposed correlation was found between HCO3- secretion and an acidic shift in the plasma pH [ 10 ]. Different relationships were found between pancreatic HCO3- secretion and plasma HCO3- concentration in metabolic acidosis.

Studies show a direct association between bicarbonate concentration and pancreatic juice flow. There is a positive correlation between the elimination of enzymes and bicarbonate concentrations [ 21 ]. The importance of plasma bicarbonate was demonstrated by in vivo experiments, in which pancreatic secretion was studied under the conditions of metabolic acidosis. Extremely low pH values result in the complete loss of activity for most pancreatic digestive enzymes.

The pH is a factor in enzyme stability. As with activity, there is a range of pH for the optimal stability for each enzyme. Normally, digestive enzymes have a pH optimal for maximum activity. Changes in the pH in the small intestine can alter the activity of the pancreatic enzymes. A decrease in the activity of the pancreatic enzymes due to metabolic acidosis is critical for proper understanding of many symptoms of indigestion and functional gastrointestinal disorders.

Bacteria and yeast ferment undigested foods by producing large quantities of gas hydrogen, methane and other toxic substances. The organism tends to eliminate this irritated and poisonous matter. There are only two directions for moving this undigested mass: Moving the mass upwards can cause fullness, nausea, vomiting, heartburn, gas, bloating, cramps, and upper abdominal pain. If the undigested mass moves down, it can cause flatulence, diarrhoea, constipation, inferior abdominal pain.

In his view, pancreatic function and pancreatic diseases are connected to different gastrointestinal diseases duodenal ulcer, malabsorption syndromes, inflammatory bowel diseases, subtotal and total gastrectomy and to some extent in patients with hepatobiliary diseases [ 24 ].

Okada R et al. Some researchers agree that the distinction between functional dyspepsia and the early stages of chronic pancreatitis is difficult [ 27 ]. The early stages of chronic pancreatitis and decreasing exocrine pancreatic function are commonly misdiagnosed. Reported data on the incidence and prevalence of chronic pancreatitis are unreliable and extremely variable.

The diagnosis of the beginning of the pancreatic disorders might be missed in clinical practice because the symptoms of severe exocrine pancreatic deficiency malabsorption syndrome and maldigestion are not specific in the beginning of chronic pancreatitis.

About 80,000 cases of pancreatitis annually occur in the USA. This is only the tip of the iceberg of digestive pancreatic diseases. Acute and chronic pancreatitis are diseases on the rise. The diagnosis of chronic pancreatitis can be challenging since laboratory studies and imaging procedures may be normal, especially in the beginning of this process.

Most attacks of pancreatitis are mild and go undiagnosed. The authors completely agree with John Alfred Lott, who wrote in his book Clinical Pathology of Pancreatic Disorders that generally, pancreatic insufficiency is graded as mild when only bicarbonate output is decreased, moderate when enzyme output is also decreased and severe when fecal fat output is increased steatorrhea [ 29 ].

The suggestion that acidifying the pancreatic juice triggers the premature activation of trypsinogen to trypsin in the pancreatic ducts is not new. The more alkaline the pancreatic juice, the higher the possibility of keeping trypsin inactive within the pancreas. Even neutral pH 7. Niederau C and Grendellin JH 1988 proposed that acidifying the pancreatic juice might play a role in the progression of acute pancreatitis [ 32 ].

Bhoomagoud M et al. They proved experimentally in vivo and in vitro that decreasing the pH acidifying raises the sensitivity of the acinar cells to zymogen activation [ 33 ]. Both clinical and experimental observations suggest that acidosis may increase the risk of developing acute pancreatitis. Peter Hegyi at al. Flushing inactive pancreatic enzymes prevents their premature activation An additional protective mechanism for preventing the premature activation of trypsinogen to trypsin within the pancreatic duct is quickly sweeping zymogens out of the pancreas.

Flushing and draining pancreatic juice that contains inactive enzymes, zymogens trypsinogento the duodenum as soon as possible to prevent the premature activation of digestive enzymes inside the pancreas is extremely important for protecting the pancreas from the development of acute and chronic pancreatitis. The pancreatic duct cells are responsible for fluid and bicarbonate secretion.

Water flushes the contents of the pancreatic duct lumen, including the zymogens, out of the pancreas into the duodenum. Low bicarbonate production can reduce the amount of water a description of acidosis as a condition characterized by excessive acid in the body fluids the pancreatic ducts. This increases the viscosity of pancreatic juice and slows its elimination [ 30 ].

According to Matsuno S et al. They found that bicarbonate secretion and bicarbonate output are decreased, and the viscosity of pancreatic juice was substantially increased in pancreatitis. They believed that concentrated pancreatic juice could cause the progression of chronic pancreatitis [ 35 ].