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Metabolic acidosis occurs when the body develops excessive acidity because of increased acid production, reduced acid removal, or loss of bicarbonate. It can develop suddenly or progress gradually, depending on the underlying cause. Common causes include diabetic ketoacidosis, advanced kidney disease, severe diarrhoea, lactic acidosis, certain medications, and prolonged dehydration.

Symptoms vary according to severity and may include rapid or deep breathing, fatigue, weakness, nausea, vomiting, abdominal discomfort, confusion, and reduced alertness. Severe acidosis can affect heart function, blood pressure, and consciousness, making prompt medical assessment important.

Diagnosis generally involves blood tests, including arterial or venous blood gas analysis and measurements of electrolytes and bicarbonate. Additional investigations may be performed to identify the underlying condition and determine the anion gap.

Treatment focuses primarily on correcting the cause. This may involve intravenous fluids, insulin for diabetic ketoacidosis, treatment of kidney dysfunction, or management of severe infections and circulation problems. In selected severe cases, bicarbonate therapy or dialysis may be considered.

Early recognition and appropriate treatment can help restore normal acid-base balance and prevent complications. People with persistent symptoms or conditions that increase the risk of acidosis should receive timely medical evaluation.