Auto-Brewery Syndrome: When Your Body Makes Its Own Alcohol

Sona Soban James
Tuesday, August 23, 2022

A 46-year-old man with good health claimed that from January 2011, he had memory loss, mental problems, and bouts of despair for more than six years. These alterations began to manifest after he underwent antibiotic treatment for a complex traumatic thumb injury. His personality changed, showing signs of sadness, "brain fog," and violent behaviour a week after his antibiotic therapy was over, which was completely out of character for him. He was detained for suspected drunk driving one morning (DWI). He was hospitalized because he declined to have a breathalyser test. He had a 200 mg/dL starting blood alcohol concentration. He consistently denied drinking alcohol to medical staff and police, but they didn't believe him. Following the worsening of his symptoms, he contacted an online support group, who came to know the man was suffering from an underdiagnosed condition called the Auto-Brewery syndrome.

Auto-Brewery Syndrome (ABS) or gut fermentation syndrome is a rare illness where the gastrointestinal (GI) system produces alcohol (ethanol) as a result of endogenous fermentation. This indicates that someone with this disease can get drunk after eating foods high in carbohydrates without really drinking alcohol.

The gut fermentation syndrome was originally mentioned in 1952 in Japan, although it wasn't properly recognized as such until 1990. Even though it has only been recorded in a tiny number of patients since the first occurrence, the syndrome has been utilized as a defence in DUI cases throughout the years.

Despite the widespread reports of the auto-brewery syndrome, little is known about its prevalence or any associated demographic, dietary, medical history, or lifestyle factors. But it is the pathogen, a form of yeast called Saccharomyces cerevisiae, which causes the condition that has been identified through a bacterial culture of affected patients. Elevated blood alcohol levels and signs of alcohol intoxication, such as slurred speech, stumbling, loss of motor skills, dizziness, and belching, are common symptoms of ABS. There have also been reports of neurological issues and changes in mood.

Diets high in protein and low in carbohydrates have been shown to reduce or eliminate its symptoms. In the event that diet alone is unable to relieve the symptoms, antifungal medications may also be suggested. However, due to their potential for negative side effects and the fact that symptoms have been known to go away on their own, antifungal medications should only be administered in rare cases. Theoretically, other therapies could involve surgical or medical care of any GI obstruction or hypomotility that might cause auto-fermentation.

Sona Soban James
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