why is alkaline antidote given in acid poisoning
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Introduction
Alkali toxicity, though rare, can lead to significant medical problems. In developed nations, alkaline ingestions are more predominant when compared to acidic ingestions.[1] Worldwide caustic ingestions occurring amongst children are usually accidental and therefore benign given the small amounts ingested. In contrast, adult caustic ingestions are usually intentional, involving larger amounts, and have more significant sequelae. Patients with intentional ingestions require more involved medical management and long term treatment.
management, including dilations, stenting, and sometimes surgery. Poor prognosis is associated with grade 3 esophageal injury, systemic complications, or age greater than 65.[14]
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Complications
Alkali ingestions may lead to stricture formation. Esophageal strictures can cause odynophagia and dysphagia with subsequent malnutrition. Squamous cell carcinoma of the esophagus is a complication of grade 3 esophageal caustic injuries.[15] Cancer can present decades after the initial exposure. Hence total removal of the esophagus is recommended if reconstructive surgery for strictures is necessary.[10]
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Consultations
A gastroenterologist should be consulted for esophagogastroduodenoscopy within 12 to 24 hours of ingestion to assess the extent of the damage. A regional poison control center should render consultation to guide clinicians on treatment options and the duration of observation. If the ingested substance has several known ingredients, then poison control can also advise in the management of the additional ingredients.
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Deterrence and Patient Education
It is crucial that household cleaning products are stored in a safe childproof location to prevent accidental ingestions. If caustic ingestion is suspected, it is contraindicated to induce vomiting as this re-exposes the gastrointestinal tract to the substance. Milk or water are options within a few minutes of accidental
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