Renal Tubular Acidosis is a medical condition. When the kidney is unable to acidify urine, it leads to the accumulation of acid in the body. Usually, when blood is filtered by the kidney, it passes through the tubules of the nephrons (the functional unit of the kidney).

Before it flows into the bladder from the kidney, the urine undergoes an exchange of salts, acids and other solutes. Renal tubular acidosis results in the formation of excessive amounts of acid because the kidneys cannot drain them. This may happen because the kidneys cannot reabsorb the alkaline bicarbonate ions from the urine in the early segment of the nephron or because of inadequate production of acidic hydrogen ions in the latter half of the nephron.

Renal Tubular Acidosis is simply associated with abnormal urinary acidification. Other functions of the kidneys remain unimpaired.
There are several different types of renal tubular acidosis-

  Distal Renal Tubular Acidosis (RTA)
This is the most fundamental form of RTA. It is characterized when the hydrogen ions are not secreted into the lumen of the nephron by the alpha-intercalated cells of the medullary collective duct of the distal nephron. When this happens the pH of urine cannot be brought down below 5.3. Renal excretion is inhibited and hydrogen ions are not eliminated which leads to academia. At the same time, Potassium ions cannot be absorbed by the cell which leads to hypokalemia. The end result is protein retention and potassium excretion. Distal RTA can lead to the urinary stone formation, calcium deposits in the kidney, rickets and osteomalacia and Sjogren s syndrome.

  Proximal RTA
When proximal tubular cells reabsorb 85% of filtered bicarbonates and 60% of filtered sodium from the urine, then this again leads to academia. The distal intercalated cells, however, function normally and so the academia is not as severe as in case of Distal RTA. The alpha-intercalated cells can acidify urine to a pH of 5.3 or less because they produce hydrogen ions. Proximal RTA is also associated with Fanconi Syndrome which is characterized by aminoaciduria, uricosuria, glucosuria, and tubular proteinuria.

  Combined distal and proximal RTA
Inherited carbonic anhydrase II deficit leads to combined distal and proximal RTA. This is accompanied by osteopetrosis, cerebral calcification, and renal tubular acidosis. Cases of combined distal and proximal RTA are very rare.

How is RTA understood?
The following steps are applied to analyze Renal Tubular Acidosis-
  Determining the anion gap in acidosis. The normal Anion Gap is 8-12 (4-6 mEq/L)
  Separating the renal from the extrarenal causes of normal anion gap acidosis
  Classifying the types of RTA
  If it is distal RTA, further tests will be necessary to support the diagnosis

How is RTA diagnosed?
Three types of tests can reveal if a person is affected by Renal Tubular Acidosis-
  Urine test
  Acid load test
  Physical examination

Treatment of RTA-
Doctors prescribe either or both of the following two types of therapies-

  Alkali therapy- The pH level of urine is restored and electrolytes are balanced
  Vitamin D supplements- If RTA leads to bone deformities or rickets, your doctor will prescribe vitamin supplements to strengthen your bones.

Timely diagnosis can prevent the effects of Renal tubular Acidosis from becoming compounded. With the right medication, a person can lead a healthy normal life.

What Should You Know About Renal Tubular Acidosis?

The first commandment of healthy living is to eat plenty of fresh fruits. However, did you know that some fruits are healthier than others? Fruits do not have any added sugars but many fruits are rich in natural sugar. However, here are 11 fruits which have lowest sugar content.

Limes and lemons: Limes and lemons are known as sour fruits. While they are rich in vitamin C, they do not contain a lot of sugar. Freshly squeezed lime juice and hot water is the perfect drink to curb your appetite and raise metabolism.
Raspberries: Raspberries are rich in fiber but have only a little more than a teaspoon of sugar per cup. This makes them the perfect fruit to start the day with.
Strawberries: Strawberries may taste sweet but a cup of fresh strawberries has only about 7 grams of sugar. However, a cup of strawberries has enough vitamin C to take care of your daily requirements.
Blackberries: A cup of these berries also has minimal sugar. Along with fiber, these fruits are also rich in antioxidants. These berries also help lower the risk of type 2 diabetes, cardiovascular diseases, and other such conditions.
Kiwi: Did you know that kiwis are technically berries? Each kiwi has less than 6 grams of sugar but is very rich in vitamin C.
Grapefruit: A grapefruit is a perfect breakfast. These citrus fruits are rich in fiber and low in sugar. Half a grapefruit contains only 52 calories and minimal sugar. They are also rich in vitamin A, vitamin C, and potassium.
Avocado: Avocados are naturally low in their sugar content. One raw avocado has less than a gram of sugar. However, they are full of vitamin C, vitamin K, folate, and potassium.
Watermelon: Summer would be incomplete without watermelons. Though they taste sweet, watermelons are very low in sugar. A cup of watermelon has less than 10 grams of sugar.
Cantaloupe: Cantaloupes are rich in vitamin A but a cup of this fruit has only about 14 grams of sugar. They are also rich in vitamin B, magnesium and fiber.
Oranges: Eating an orange is the best way to boost our vitamin C levels and keep infections away. One orange typically contains less than 70 calories and 12 grams of sugar.
Peaches: A medium sized peach has less than 13 grams of sugar. This is an example of how taste can be deceptive when it comes to calories.
Given the sugar content in these fruits, it would be a great idea for the diabetics and weight watchers to include them in their diet and have a healthy and hearty meal. If you wish to discuss about any specific problem, you can consult a General Physician.

11 Best Fruits That Are Low In Sugar Content!

Do you know not all foods can be consumed on an empty stomach? So, it is imperative that you should be aware of such foods and restructure your breakfast menu accordingly. Here is a list of foods to avoid on an empty stomach. 

Stay away from the following foods when you eat after a considerable gap

Citrus fruits: Citrus fruits contain fruit acids. When these acids enter an empty stomach, they can lead to heartburn. Hence, if eaten after a prolonged period post meal, a person is at risk of gastritis and stomach ulcers.
Soda: Consuming cold soda drinks on an empty stomach may cause damage to the mucosal membrane while reducing blood flow to the stomach. This may lead to a slow digestive process and difficulty in the abdomen.
Spicy foods: Spicy foods are known to cause irritation and damage to the digestive tract, and are especially not recommended for people who suffer from acid reflux issues since very spicy food leads to consequences such as acid reflux in the food pipe.
Cucumber and other green vegetables: Green vegetables and cucumber are rich in amino acids. If consumed on an empty stomach it may very well lead to pain and bitterness in the upper abdomen.
Tomato: Tomato is a fruit containing high levels of tannin. Tannin causes acidity in an empty stomach and leads to consequences and appearance of gastritis if frequently consumed in such a manner.
Fermented milk products: Fermented milk products such as yogurt typically come with loads of health benefits being full of probiotics. But if consumed on an empty stomach it can interfere with the balance of healthy bacteria as the hydrochloric acid produced tends to be destructive.
Sweets: Items such as candy or sweetmeats contain high levels of sugar and cause a sudden and sharp surge of insulin levels in the blood. Over a long period, this has a bad effect on the pancreas.
Products containing yeast: Edible items such as biscuits, puff pastry, vinegar and beverages such as beer and wine contain yeast which can significantly irritate the stomach and cause bloating.
So, be a little conscious and avoid consuming these items on an empty stomach since a little effort goes a long way. In case you have a concern or query you can always consult an expert & get answers to your questions!

Empty Stomach - 8 Food Types That You Must Avoid!

The most common dietary problem that every vegetarian comes across is protein deficiency. It was a widely acknowledged fact that animal products are the best protein sources. However, it is no longer so, and vegetarians everywhere can now rejoice!

Here are the 13 best sources of protein for vegetarians:

Green peas: Green peas are legumes, which are a very good protein source. They contain 7.9 grams of protein per serving.

Quinoa: Grains usually contain very little protein, but quinoa is unique. It contains 8 grams of protein per serving, and contains all nine important amino acids that your body needs for repair and growth.

Nuts and nut butter: Nuts are a good source of proteins and healthy fats. However, eat them with caution, as they do contain 160 calories per serving. Butter made from nuts like peanut butter and almond butter is also a good source of protein.

Beans: Beans are available in a variety of colours and shapes, but all of them have one thing in common that is the high level of protein.

Chickpeas: Chickpeas are also from the legume family, so they also contain high amounts of protein; 7.3 grams of protein in only half of a serving.

Tofu and tempeh: Tempeh and tofu are both soy products and they have the highest amount of vegetarian proteins, about 15-20 grams per serving.

Edamame or soybean: Edamame or soybean is excellent for snacking. They contain 8.4 grams of protein in just half a cup.

Leafy greens: Vegetables usually do not contain much protein, but eating green vegetables will significantly add to your protein consumption. For example, you can eat one cup of cooked broccoli as that contains 8.1 grams of protein.

Hemp: Blend hemp seeds in smoothies or baked goods to get your daily dose of protein. Hemp contains 10 grams of protein per tablespoon.

Chia seeds: Chia seeds contain 4.7 grams of protein per two tablespoons, making them excellent sources of protein.

Seitan: This is a meat substitute made from wheat gluten and it contains 36 grams of protein per serving (about half a cup).

Non-dairy milk: Milk made from soy (best non-dairy protein source), almond, rice and hemp are good dairy substitutes.

Unsweetened cocoa powder: This will surprise you, but bitter cocoa contains nearly 1 gram of protein per serving (1 tablespoon)! 
All the above-mentioned food items are the best source of proteins for vegetarians. So, enjoy them with no worry.

Know Excellent Sources Of Protein For Vegetarians!

A Gastroenterologist is a physician with dedicated training and unique experience in the management of diseases of the gastrointestinal tract and liver. If you are planning to visit one, you most likely have a problem in one or many organs like esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. 

Visit your doctor to understand the severity of your condition and the course of treatment, as it is obvious that during this time you must be suffering from anxiety and you may not ask the questions arising in your mind. That is why you need to prepare in advance for your first visit with a gastroenterologist. Being an active partner in the doctor patient relationship is bound to have its benefits. Here are some handy tips:

1. Come mentally prepared: Don't let the anxiety get to you. If you need some extra help calming down, try yoga or meditation. You can simply go out on a walk alone to help you focus your thoughts. This is just like any other doctor visit. The good part is that you are taking the first step in easing your discomfort and starting treatment, so go with a positive mind.

2. Maintain a diary of symptoms: It is likely that you are experiencing discomfort from past few days or weeks before you finally realize the need to seek out a specialist. Try to remember as much as possible about the symptoms you experienced in a chronological order. Write down any over the counter medicines you've tried or anything unusual that you may have consumed in the past week. 

3. Take stock of your medical history: It is likely that your doctor may want to know about any historic conditions you've suffered that may or may not relate to your present condition. Many ask you to fill out forms during your first time patient registration which includes many minor details about your medical past. List down any allergies, especially food allergies you have. 

4. Take stock of your recent medical tests: Bring your latest blood tests and imaging tests (X-rays, ultrasounds, MRIs, and CT scans) with you for the doctor's visit. If you have a pre-existing condition like diabetes, thyroid or you suffer from other chronic conditions like increased uric acid, carry your most recent medical reports with you. 

5. Make a list of questions for the doctor: In most cases, the first visit is a crucial factor in determining whether you want to continue the course of treatment with a particular doctor. This comes out of your ability to trust the doctor, his knowledge and diagnosis and an overall comfort level that comes with how well he handles your questions. Start by making a list of questions you want to ask about your specific condition and course of treatment and see if you get satisfactory answers. 

6. Brace yourself: If you want to suggest a treatment option, make sure you read up all about it before you tell the doctor.

6 Tips For Your First Visit With A Gastroenterologist

In this health-conscious era, more and more people want to stay fit. They constantly look for ways to maintain good health. Many have even developed a good habit of starting the day with a glass of lukewarm water as soon as they wake up in the morning. Yes, drinking water on an empty stomach offers the maximum health benefits. It not only stimulates the removal of toxins from the body but also benefits the overall digestive system. 

Although warm water isn t the most palatable, there are many reasons to start drinking it this way, either alone or with lemon. Below given are 6 reasons to start drinking lukewarm water on an empty stomach:

Digestive system: The food pipe, after having digested a variety of foods the previous day, would still be left with remnants. Starting the day with a glass of warm water acts as a good flush, which removes all these remnants. The warm or hot water also helps in removing greasiness, which is very helpful in people who eat a lot of junk food.
Helps in Weight loss: Drinking warm water on an empty stomach is perfect for those who are trying to lose weight as warm water raises body temperature and the metabolism. This, eventually, helps in burning more fat and boosting the weight loss efforts through diet and exercise changes. Ideally, you should add some drops of lemon in it. 
Strengthens Immune system: When a glass of hot water along with some lime is consumed early in the morning, it gives the required dose of vitamin C and potassium to the body, which strengthens your immunity system. Also, as the stomach is empty, the absorption is faster. 
Maintains body s pH balance: The body s pH turns alkaline as the ascorbic acid and the citric acid is easily digested and removed from the system. Drinking warm water helps in maintaining the required pH in the body.
Keeps you positive throughout the day: A nice juicy lime smells great, and this can be one of the best mood enhancers to begin your day with.
Skin and hair: For anybody with good skin, the key success factor is hydration, and a glass of warm water in the morning works like a cherry on the cake. When our body accumulates toxins, it becomes prone to illness and aging. A glass of hot water in the morning stimulates detoxification and helps in repairing skin cells and elasticity.
So, start your day with a glass of warm water and feel the difference. In case you have a concern or query you can always consult an expert & get answers to your questions!

Benefits of Drinking Lukewarm Water in Morning - Start Your Day With It?

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