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What Is Hypochloremic Alkalosis?

By Jacquelyn Gilchrist
Updated May 17, 2024
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Hypochloremic alkalosis is a medical condition in which the patient's body has abnormally low levels of chloride. This condition usually results from an extremely high loss of chloride, rather than a low intake of it. Patients who may be at risk for hypochloremic alkalosis should monitor themselves for the warning signs and seek medical attention promptly when needed.

Chloride is a type of electrolyte that the body needs to function properly. This electrolyte plays a key role in maintaining blood pressure, blood volume, and the pH of the fluids in the body. It also works to regulate the amounts of fluid in the body's cells.

There are different types of alkalosis, such as respiratory alkalosis and metabolic alkalosis. This general condition indicates that the bodily fluids have too much base, or alkali, as opposed to being too acidic. Normally, the kidneys and lungs regulate these chemicals. A patient with hypochloremic alkalosis may have an underlying medical condition.

Some people develop this type of alkalosis due to persistent vomiting, which causes an extreme loss of fluids. Hospitalized children who are undergoing diuretic therapy may also develop hypochloremic alkalosis. Gastroesophageal reflux, which refers to the upwards flow of the stomach contents into the esophagus, may also be the underlying cause. Children who present with frequent, forceful vomiting may have a condition called pyloric stenosis, which may cause excessive loss of chloride from the body.

Patients who have hypochloremic alkalosis may notice that their muscles twitch or that they have persistent muscle spasms. They may also experience trembling in the hands, and numbness in the extremities and facial region. Other symptoms can include lightheadedness, nausea, and vomiting. Confusion is also a common symptom, and patients may eventually fall into a stupor or a coma.

Complications such as brain damage may develop if patients are not treated promptly. Those who exhibit symptoms of hypochloremic alkalosis will likely be examined for signs of dehydration. The doctor will typically take urine and blood samples to analyze before beginning treatment.

Generally, those with chronic, rather than acute, hypochloremic alkalosis will be treated more slowly, or over the course of about 24 hours. An isotonic sodium chloride solution will be administered and intravenous fluids will be used to correct the patient's dehydration. Over the following 72 hours, the doctor will administer maintenance doses of fluids and electrolytes. When the patient's condition has been sufficiently corrected, he may be prescribed subsequent maintenance doses of potassium salts and chloride.

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