The significance of alkalosis in the treatment of peptic ulcer

Milk-Alkali Syndrome

“…Throughout the years, several contributing factors have been proposed, including loss of gastric juice, preexisting renal disease, insufficient chloride intake, hemorrhage, anemia, impaired liver function, and warm weather. 16,[26][27][28][29][30][31] Ingestion of excessive quantities of calcium and absorbable alkali is a prerequisite for establishing the diagnosis. What constitutes "excessive" is unclear but generally indicates at least 4 to 5 g of calcium carbonate daily.…”

“…Subsequent reports confirmed that preexisting renal disease seemed to be a predisposing factor. 20,26,27,36 However, it is widely recognized that MAS can develop without renal impairment. 37 Furthermore, even in patients with impaired renal function, large amounts of absorbable alkali do not lead to alkalosis in most individuals.…”

Síndrome calcio-alcalinos: actualización de un antiguo problema clínico

“…La toma continuada de cantidades altas junto a una limitació n en su eliminació n renal conduce a una situació n de hipercalcemia. La existencia de una enfermedad renal subyacente no es un prerrequisito, pero sí un factor que contribuye a su desarrollo [30][31][32][33] . Ademá s de la elevació n de la calcemia, en el SCA «moderno» es característico que las concentraciones sé ricas de fó sforo se encuentren dentro de los límites normales o incluso por debajo de é stos, porque la ingesta de leche no es en la actualidad un factor precipitante, y por el efecto quelante del carbonato cá lcico 7,12,28,34,35 .…”

Milk-Alkali Syndrome

“…; carbon-dioxide-combining power, 23 mEq. per liter ; calcium, 10 carbon-dioxide-combining power, 21 mEq. per liter, and inorganic phosphate, 2.5 mg. per 100 cc.…”

“…In 1936, Cope5 reported four cases of alkalosis with hypercalcemia complicating the treatment of gastric ulcers with alkaline powders. Despite the very high blood levels of calcium, there was prompt return of the blood calcium to normal within 10 days following removal of the absorbable alkalis from the diet. Cope's patients were ingesting large amounts of calcium carbonate.…”