Doctors believe one rare gastrointestinal condition might be going undiagnosed among patients.
Auto-brewery syndrome — which causes someone to become drunk without consuming alcohol due to excessive fermentation in the gut — caused trouble in the life of one otherwise-healthy 46-year-old man, the subject of a recent case study.
While it’s normal for the body to break down carbs and sugars into ethanol, the drunkenness is caused by an overproduction of the byproduct, resulting in all the side effects that come with inebriation.
According to the study, which was published in the journal BMJ Open Gastroenterology, the man was arrested for driving under the influence and authorities didn’t believe him when he explained he hadn’t been drinking. His blood alcohol level at the time was 0.2%, nearly double the legal limit.
After his aunt learned of an identical case in Ohio and bought him a breathalyzer to track his blood alcohol levels, the man sought specialized medical attention. His quest for a diagnosis eventually brought him to doctors at New York’s Richmond University Medical Center, the authors of the report.
The condition, which was featured in a 2018 episode of Grey’s Anatomy, presents itself more commonly in patients with liver dysfunctions, diabetes and chronic intestinal obstructions, according to research, though it can also appear in individuals with seemingly normal health.
Research suggests that patients “avoid sugars and carbohydrates and eat a diet higher in proteins during treatment,” and that alcohol dependency can develop in patients who become accustomed to the extra ethanol, the byproduct produced in the fermentation.
“Even after symptoms have resolved, the long-term exposure to endogenous ethanol can result in addiction to and cravings for alcohol with subsequent drinking,” reads one academic analysis of auto-brewery syndrome. “Patients should be educated about the possibility of alcohol addiction after symptoms are resolved and be given referrals for alcohol treatment if needed.”
Following a relapse, the man eventually found a treatment plan involving probiotics, helping him repair his intestinal microbiome. It was later determined that antibiotics he was given after a 2011 thumb injury likely altered his digestive tract and led to his struggle with auto-brewery syndrome.
Since undergoing treatments and temporarily adjusting what he ate, the study says the man “remains asymptomatic and has resumed his previous lifestyle, including eating a normal diet while still checking his breath alcohol levels sporadically.”
If you or someone you know is struggling with addiction, please contact the SAMHSA substance abuse helpline at 1-800-662-HELP.