What causes elevated base excess in extracellular fluid, and what should be done about it?

In general, an elevated base excess in extracellular fluid may be caused by dietary factors, intense physical exercise, respiratory alkalosis, metabolic alkalosis, or renal tubular acidosis. If discomfort occurs, it is recommended to seek medical attention promptly. Specific analyses are as follows:

1. Dietary Influence

Consuming excessive alkaline foods or insufficient acidic foods in the diet may increase the body's alkaline load, leading to elevated base excess in extracellular fluid. It is recommended to adjust the dietary structure, maintain a balanced diet, and consume acidic and alkaline foods in appropriate proportions.

2. Intense Physical Exercise

After intense exercise, increased production of acidic metabolic byproducts such as lactic acid may prompt the kidneys to excrete more bicarbonate to maintain acid-base balance, resulting in a temporary elevation of base excess in extracellular fluid. It is recommended to rest appropriately and replenish fluids and electrolytes to promote the metabolism of acidic substances like lactic acid.

3. Respiratory Alkalosis

Excessive ventilation leading to over-elimination of carbon dioxide may cause respiratory alkalosis, reducing arterial partial pressure of carbon dioxide (PaCO₂), which in turn may elevate base excess in extracellular fluid. Symptoms may include hand and foot spasms and dizziness. Under medical supervision, treatment may include medications such as calcium gluconate and zinc oral solution, potassium citrate granules, or glutathione tablets.

4. Metabolic Alkalosis

Metabolic alkalosis may result from excessive loss of gastric acid or impaired renal acid excretion, leading to elevated bicarbonate concentration in body fluids and consequently increased base excess in extracellular fluid. Symptoms may include paresthesia and arrhythmias. Under medical guidance, treatment may include medications such as hydrochlorothiazide tablets, torasemide tablets, or bumetanide tablets.

5. Renal Tubular Acidosis

Congenital functional defects may lead to renal tubular acidosis, impairing the kidney's ability to excrete hydrogen ions and reabsorb electrolytes such as calcium and phosphorus. This can result in accumulation of bicarbonate in the body, ultimately causing elevated base excess in extracellular fluid. Symptoms may include osteoporosis and urinary tract stones. Treatment should follow medical advice and may include sodium bicarbonate tablets, potassium citrate sustained-release tablets, or amiloride hydrochloride tablets.

In daily diet, it is advisable to avoid spicy and raw-cold foods to prevent bodily discomfort.