- Auto-brewery syndrome occurs when carbohydrates in the gut ferment, creating alcohol
- In some people, this can cause episodes of inebriation, even when they had no alcohol
- In a serious case, when nothing else worked, doctors resorted to a faecal transplant
Imagine having to explain being inebriated, even when you didn’t have a drop to drink. This does happen to some people, even though it is rare.
Auto-brewery syndrome (ABS) is a condition where the microorganisms in the gut “eat” any carbohydrates. As a result, alcohol is brewed, which can cause a person to feel and appear intoxicated.
All our guts have small quantities of fermenting microbes, which can cause gas and some digestive issues, but in the case of ABS, the fermentation is out of control. This condition may occur after a course of antibiotics which disturbs the gut balance.
Unexplained moments of inebriation
A 47-year old Belgian man was brought to hospital because of unexplained drunk episodes after completing a course of antibiotics.
He explained to the doctors that, despite not having had any alcohol, his blood ethanol levels were more than 17 times the normal level.
He was diagnosed with ABS, and doctors prescribed oral anti-fungal medication and a low-carb diet – which, however, didn’t help much.
The last straw
After sticking to the treatment for four weeks, his wife could still smell alcohol on his breath, and he kept on experiencing episodes of inebriation. After being ticketed for drunk driving at a random police check, the doctors realised they had to resort to more drastic measures – and decided on a faecal transplant to help re-balance his gut microbiota.
As medical experts got to know more about gut microbiota, they started researching faecal transplants as a method to re-balance the gut flora in cases of digestive issues such as ulcerative colitis. This is, however, a drastic method which only works for certain infections, and poses life-threatening risks.
The patient, however, was willing to try anything and received a transplant from a sample donated by his 22-year old daughter.
The case study was published in the Annals of Internal Medicine.
This drastic step seems to have done the trick, as nearly three years later, he remains free from drunken episodes and hasn't had any embarrassing incidents since. "On the basis of our experience with this patient, we advise other clinicians who have patients with gut fermentation syndrome to consider treatment with faecal microbiota transplantation, especially if more traditional therapy has failed," the team stated in the case study.
"Moreover, we can imagine a future point – after additional research to evaluate the safety of faecal microbiota transplantation – at which this approach might become standard therapy for gut fermentation syndrome."
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