A MAN discovered he had a rare condition in which his stomach brews beer – after cops pulled him over for drink-driving.
The 46-year-old, from North Carolina, denied having alcohol but refused to take a breathalyser test and was taken to hospital under arrest.
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Tests showed the construction worker’s blood alcohol level was 200mg/dL – which is the equivalent to drinking 10 alcoholic beverages.
He told staff he had been experiencing uncharacteristic personality changes, including depression, “brain fog”, memory loss and aggressive behaviour for the past three years.
The unidentified patient said the problems started a week after completing a course of antibiotics for a thumb injury in 2011.
Researchers from Richmond University Medical Centre in New York, who shared his case in BMJ Open Gastroenterology, said: “The hospital personnel and police refused to believe him when he repeatedly denied alcohol ingestion.”
It’s unclear where the man was charged with driving under the influence, however the case report notes that he fully recovered and was discharged.
Seeking answers
Afterwards, his aunt said she had heard about another similar case in Ohio and she persuaded him to visit the clinic there for treatment.
Most of his tests came back normal, however, his stool sample which showed the presence of Saccharomyces cerevisiae – also known as brewer’s yeast.
The fungus is well-known in the drinks industry as it helps ferment carbohydrates and produces alcohol.
Doctors began to suspect he may gave a bizarre condition known as auto-brewery syndrome (ABS), also known as gut fermentation syndrome.
The rarely diagnosed condition is caused when ingested carbohydrates are converted to alcohol by fungi in the gastrointestinal tract.
“Patients with this condition become inebriated and suffer all the medical and social implications of alcoholism,” the researchers noted.
Rare diagnosis
To confirm the diagnosis, doctors gave the man a 50g carbohydrate meal while monitoring his blood alcohol levels and after eight hours, they had elevated to 57mg/dL.
He was subsequently put on a carb-free diet along with supplements and while his mental status slightly improve, the brain fog returned with a few weeks.
The patient ended up in hospital again when he fell over while inebriated and suffered intracranial bleeding.
While in hospital, his blood alcohol levels ranged from 50mg to 400mg/dL – twice the concentration recorded when he was first pulled over.
Researchers noted: “Here too, the medical staff refused to believe that he did not drink alcohol despite his persistent denials.”
Treating ABS
Due to his worsening symptoms, he searched for help in an online support group and put in touch with the Richmond University specialists.
The patient explained that prior to his thumb injury in 2011, he had been a light social drinker and had completely abstained from alcohol since.
Dr Fahad Malik, a gastroenterologist at Richmond University who treated the man, said that it’s thought his ABS was triggered by a course of antibiotics he was prescribed at the time.
His symptoms were repeatedly misdiagnosed as depression, which had forced him to give up his job.
Dr Malik said the drugs may have disrupted the balance of his natural microbes.
It’s thought to be the first case of the condition – which is so rare there have only been five cases in the last 30 years – as a result of antibiotic use.
What is auto-brewery syndrome (ABS)?
Auto-brewery syndrome (ABS), also known as gut fermentation syndrome, is a very rare and somewhat controversial condition.
It is caused by an overgrowth of yeast in the gut that turns excess carbs from food into booze.
The booze in then absorbed into the blood stream and sufferers become drunk.
As the condition is so rare very little is known about it and it is not widely recognised.
Because of the nature of the condition people are mistaken for closet alcoholics.
Those who have the condition may appear drunk, sweaty, confused and have less coordination after eating a meal that triggers an episode.
As the condition is so rare a cure is not yet known, but antifungal medications to control the growth of yeast in the stomach are thought to help.
Writing in the case report, he said: “His construction company was involved in restoring hurricane-damaged houses, many of which had mould contamination.
“To investigate this patient’s condition further, we collected gastrointestinal secretions using upper and lower endoscopy to detect fungi.”
They decided to treat his gut microflora with a combination of anti-fungal therapies and probiotics.
Aside from one pizza and soda binge, his fungal growths have been successfully treated and he’s been symptom free for almost two years.
Dr Fahad Malik, who treated the man, said: “Approximately 1.5 years later, he remains asymptomatic and has resumed his previous lifestyle, including eating a normal diet while still checking his breath alcohol levels sporadically.”
He told the New Scientist: “He was extremely happy when he started to recover, because for years, no one believed him.
“The police, doctors, nurses and even his family told him he wasn’t telling the truth, that he must be a closet-drinker.
“Now he is off antidepressants, he’s back at work and he’s finally getting on with his life.”
