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These organisms use lactic acid fermentation or mixed acid fermentation pathways to produce an ethanol end product. [3] The ethanol generated from these pathways is absorbed in the small intestine, causing an increase in blood alcohol concentrations that produce the effects of intoxication without the consumption of alcohol. [4]
As a result, they rely on lactic acid fermentation to provide the majority of their energy needs. [23] Adaptations in particular in the turtle's blood composition and shell allow it to tolerate high levels of lactic acid accumulation. In the anoxic conditions where fermentation is dominant, calcium levels in the blood plasma increase. [23]
Characteristic features include developmental delay and a buildup of lactic acid in the blood (lactic acidosis). Increased acidity in the blood can lead to vomiting, abdominal pain, extreme tiredness , muscle weakness, and difficulty breathing. In some cases, episodes of lactic acidosis are triggered by an illness or periods without food.
Lactic acid producing bacteria also act as a protective barrier against possible pathogens such as bacterial vaginosis and vaginitis species, different fungi, and protozoa through the production of hydrogen peroxide, and antibacterial compounds. It is unclear if further use of lactic acid, through fermentation, in the vaginal canal is present [6]
Pyruvate is the terminal electron acceptor in lactic acid fermentation. When sufficient oxygen is not present in the muscle cells for further oxidation of pyruvate and NADH produced in glycolysis, NAD+ is regenerated from NADH by reduction of pyruvate to lactate. [4] Lactate is converted to pyruvate by the enzyme lactate dehydrogenase. [3]
Most people with MELAS have a buildup of lactic acid in their bodies, a condition called lactic acidosis. Increased acidity in the blood can lead to vomiting, abdominal pain, extreme tiredness (fatigue), muscle weakness, loss of bowel control, and difficulty breathing.
Lactic acid fermentation is relatively inefficient. The waste products lactic acid and ethanol have not been fully oxidized and still contain energy, but it requires the addition of oxygen to extract this energy. [8] Generally, lactic acid fermentation occurs only when aerobic cells are lacking oxygen.
The stomach can become bloated when too much air is swallowed during eating and drinking too quickly. As the stomach swells, belching removes the gas and alleviates the pain associated with it. Burping can also be used as a form of relief from abdominal discomfort other than too much gas in the stomach. [citation needed]