Alkalosis Complicating the Sippy Treatment of Peptic Ulcer

Alkalosis, Renal Insufficiency and Hypercalcemia Secondary to the Excessive Intake of Sippy Powders

“…Many subsequent workers (3)(4)(5) have corroborated the findings of Hardt and Rivers. The underlying mechanism of renal failure in these patients has not been clarified, despite considerable clinical investigation.…”

Studies of Alkalosis. I. Renal Function During and Following Alkalosis Resulting From Pyloric Obstruction 1

“…As usually seen clinically, this syndrome occurs where there has been vomiting, although there may be an accompanying ingestion of alkali (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Hence, there is depletion not only of chloride but also of water, sodium and potassium (16,26).…”

“…Many of the reports in the literature fail to state definitely whether the alkalosis and renal insufficiency were unassociated with vomiting or gastric aspirations. In Kirsner and Palmer's series where they clearly made this differentiation, excessive alkali in the absence of chloride loss through vomiting or aspiration of gastric contents did occasionally cause a fall in previously normal urea clearances if alkalosis occurred; but these returned to normal after the alkalosis was relieved (13). Acute alkalosis resulting from administration of large quantities of alkali caused temporary and inconstant changes in renal function in subjects with previously normal function (20).…”

“…The combination of alkalosis and renal insufficiency has been reported repeatedly (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). The causes of the failure of kidney function, and the nature of the renal lesion have not been defined clearly.…”

Got Calcium? Welcome to the Calcium-Alkali Syndrome

“…1 As the Sippy method gained popularity, some patients developed toxic manifestations including a strong distaste for milk, headache, nausea, vomiting, mental clouding, and renal failure that eventually came to be known as the milk-alkali syndrome from the work of Burnett. [2][3][4] Approximately one third of cases resulted in permanent renal impairment. 5 The incidence of milk-alkali syndrome declined with the arrival of histamine blockers and doxycycline for treatment of peptic ulcer disease; however, the syndrome saw a resurgence beginning in the 1990s in large part as a result of postmenopausal women taking overthe-counter calcium and vitamin D supplements for treatment or prevention of osteoporosis, a chronic disorder affecting more than 10 million individuals in the United States.…”