Beer potomania

WikiDoc Resources for Beer potomania
Articles
Most recent articles on Beer potomania Most cited articles on Beer potomania Review articles on Beer potomania Articles on Beer potomania in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Beer potomania Images of Beer potomania Photos of Beer potomania Podcasts & MP3s on Beer potomania Videos on Beer potomania
Evidence Based Medicine
Cochrane Collaboration on Beer potomania Bandolier on Beer potomania TRIP on Beer potomania
Clinical Trials
Ongoing Trials on Beer potomania at Clinical Trials.gov Trial results on Beer potomania Clinical Trials on Beer potomania at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Beer potomania NICE Guidance on Beer potomania NHS PRODIGY Guidance FDA on Beer potomania CDC on Beer potomania
Books
Books on Beer potomania
News
Beer potomania in the news Be alerted to news on Beer potomania News trends on Beer potomania
Commentary
Blogs on Beer potomania
Definitions
Definitions of Beer potomania
Patient Resources / Community
Patient resources on Beer potomania Discussion groups on Beer potomania Patient Handouts on Beer potomania Directions to Hospitals Treating Beer potomania Risk calculators and risk factors for Beer potomania
Healthcare Provider Resources
Symptoms of Beer potomania Causes & Risk Factors for Beer potomania Diagnostic studies for Beer potomania Treatment of Beer potomania
Continuing Medical Education (CME)
CME Programs on Beer potomania
International
Beer potomania en Espanol Beer potomania en Francais
Business
Beer potomania in the Marketplace Patents on Beer potomania
Experimental / Informatics
List of terms related to Beer potomania

Editor-in-Chief: Suresh Samson, M.D., Yale Bridgeport Hospital

Overview

Beer potomania is defined as the development of hyponatremia or low levels of salt in the bloodstream, as a result of excess beer intake coupled with poor nutritional intake. This is a syndrome of binge drinking, poor nutritional intake, and profound hyponatremia.

Pathophysiology & Etiology

Hyponatremia is due to a large consumption of beer (which has a poor salt content) together with a minimal intake of ordinary food. Three facts contribute to beer potomania:

1. Beer contains a lot of free water with very little salt and protein (one liter of beer contains only 30 mg of sodium).
2. The amount of free water we excrete depends upon number of osmoles that need to be excreted.
3. The kidneys can dilute urine to a maximum of 50 mosm/L

The pathophysiologic mechanism of beer potomania can be understood through an example. Imagine someone who binged on 4 liters of beer (which essentially means 4 liters of water) with ingestion of roughly 200 mosm that day. To place this in context, a normal American diet contains 750 mosm/day, and all of it is excreted in urine to maintain a steady state. As a result of the ingestion of this large amount of beer (i.e.free water), the patient's anti diuretic hormone(ADH) (the hormone that causes the kidney to reabsorb free water) secretion is at its minimum to allow the kidneys to excrete maximally dilute urine. Since the maximal dilution that can be attained is 50mosm/L, the kidneys will excrete all the 200 mosm in the diet in 4 litres of urine (50mosm/L X 4L = 200 mosm). This will indeed maintain his sodium level.If this person in our example drinks his 5th litre of beer without taking any further osmoles, then he will become hyponatremic. This is beer potomania

Differential Diagnosis

See the differential of hyponatremia

Electrolyte and Biomarker Studies

A value of Uosm < 100 mOsm/kg is indicative of a complete and appropriate suppression of antidiuretic hormone (ADH) secretion, a finding seen with either primary polydipsia (including ‘beer potomania’) or reset osmostat. Criteria used to diagnose the ‘beer potomania’ syndrome include

1. A history of binge beer drinking
2. Poor dietary intake
3. Decreased serum sodium levels
4. Low serum and urine osmolality
5. Absence of other known causes of hyponatremia