- A 46-year-old man was pulled over for erratic driving and found to have a blood alcohol level more than twice the legal limit. Still, he insisted he hadn’t been drinking.
- Doctors later found out he had a rare condition called a uto-brewery syndrome, which is caused by yeast in the gut that ferments carbs inside the body to produce alcohol.
- In severe cases, the condition can create enough alcohol to put patients more than four times over the legal limit, equivalent to 10 or more drinks.
- Doctors were able to treat the man with antifungal medications to get rid of the yeast and probiotics to restore healthy gut bacteria.
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When a 46-year-old man was pulled over for erratic driving and found to have a blood alcohol level more than twice the legal limit, neither police nor doctors believed him when he said he hadn’t been drinking.
But it turns out he was telling the truth – he was later diagnosed with a rare disorder called auto-brewery syndrome or gut fermentation syndrome, in which yeast inside the gut converts carbs into alcohol, according to the recent case study in BMJ Open Gastroenterology.
The patient’s journey to the diagnosis took about six years, tracing back to 2011, when he took a course of antibiotics for a hand injury. Afterwards, which he started to experience “brain fog,” depression, unusual moodiness, and memory problems. He didn’t see a doctor for treatment of those symptoms until 2014, when he was prescribed antidepressants, which didn’t help.
His symptoms became increasingly dangerous, including a fall that caused bleeding inside his brain, and the apparent drunk driving incident.
The man finally underwent medical testing that revealed his gut was home to a colony of fungi, including Saccharomyces cerevisiae, more commonly known as brewer’s yeast. These microscopic critters consume carbohydrates for energy instead of oxygen, producing ethanol, or the type of alcohol we drink, as a byproduct.
Auto-brewery syndrome is difficult to diagnose, and can be dangerous
Although drunkenness is easy to spot at a bar, symptoms of alcohol intoxication can be much more subtle in people who haven’t been drinking. It can appear as moodiness, confusion, difficulty focusing, lack of physical coordination, and memory problems.
Currently, there are no standard criteria to diagnose or treat auto-brewery syndrome, according to the authors of the case study, making it even harder to tell when patients have the disorder.
But diagnosing it correctly is critical because brushing it off as intoxication via beer, wine, or liquor can can lead to dangerous consequences. For example, people with it can get behind the wheel or put themselves in other hazardous situations, not realising they’re drunk.
The syndrome can also cause a lethal level of drunkenness: When reintroducing carbs to his diet as a part of treatment, the patient in the case study had several recurring episodes of the disorder, including one with a life-threatening blood alcohol level of .40, or more than four times the legal limit. That amount of alcohol in your system can cause vomiting, inability to walk, loss of consciousness, and even death due to respiratory arrest.
“Any patient with an elevated blood alcohol level who denies alcohol ingestion should be treated with empathy and compassion,”one report urged.
iStockIt’s not clear exactly what allows some microbes to take hold inside a healthy digestive system.
It’s not clear how exactly the fungi colonise the gut
Previous cases of auto-brewery syndrome have reportedly been caused by Saccharomyces, as well as a species of Candida fungus and at least two different types of bacteria. But it’s not clear exactly what allows these microbes to take hold inside a healthy digestive system.
Other reports of auto-brewery syndrome have been linked to other illnesses like Crohn’s disease and diabetes.
Researchers believe the cause of the current case study can be traced back to the man’s antibiotic course in 2011. They suspect the drugs somehow interfered with the man’s healthy gut bacteria, allowing an overgrowth of fungus in his gut. The case study also noted he worked in construction, and was potentially exposed to mould while working on water-damaged buildings.
Once diagnosed, the man was treated several times with anti-fungal medication and orders to maintain a strict no-carb diet until the problem resolved. Doctors also administered probiotics to improve his gut bacteria, which worked, further confirming that the body’s microbiome is somehow involved in protecting from fungal invaders.
The disorder finally abated and the man was able to gradually reintroduce carbs into his diet. He has been symptom-free for over a year, the case study reported.
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