What is auto-brewery syndrome? Woman misdiagnosed as drunk discovers rare condition

A woman who was told she was drunk after visiting the hospital seven times with slurred speech and extreme tiredness has been diagnosed with auto-brewery syndrome.

Sky News reported that the 50-year-old woman, from Canada, visited the emergency department over two years. She had been on several antibiotic courses for recurrent urinary tract infections and a proton pump inhibitor to reduce the amount of acid in her stomach.

She also had elevated blood alcohol levels and alcohol on her breath — despite not drinking any.

The woman needed up to two weeks off work each time and ate very little.

Though her symptoms would improve after one to two weeks, they would return every one to two months.

Writing in the Canadian Medical Association Journal, Dr Rahel Zewude, University of Toronto, and her co-authors, said: “Auto-brewery syndrome carries substantial social, legal, and medical consequences for patients and their loved ones.

“Our patient had several (emergency department) visits, was assessed by internists and psychiatrists, and was certified under the Mental Health Act before receiving a diagnosis of auto-brewery syndrome, reinforcing how awareness of this syndrome is essential for clinical diagnosis and management.”

What is auto-brewery syndrome?

Auto-brewery syndrome, also known as gut fermentation syndrome, is a rare medical condition in which a person’s digestive system produces ethanol (alcohol) through the fermentation of ingested carbohydrates.

What are the symptoms of auto-brewery syndrome?

Auto-brewery syndrome causes symptoms similar to alcohol intoxication without alcohol consumption. These symptoms include dizziness, disorientation, slurred speech, and impaired coordination.

People with the condition may also experience chronic fatigue, mood swings, memory problems, and digestive issues. The severity of these symptoms can vary based on the amount of carbohydrates consumed, as these are fermented into ethanol by the yeast or bacteria in the gut. ]

In some cases, people might face legal and social challenges due to the appearance of being intoxicated.

What causes auto-brewery syndrome?

Researchers believe the underlying causes of auto-brewery syndrome are related to prolonged antibiotic use, poor nutrition and/or diets high in carbohydrates.

They are also thought to be linked to pre-existing conditions such as diabetes and genetic variations that result in improper liver enzyme activity.

Can you drive if you have auto-brewery syndrome?

Driving with auto-brewery syndrome can be risky and is generally not advisable.

The condition causes elevated blood alcohol levels without alcohol consumption, leading to symptoms of intoxication such as impaired coordination, dizziness, and slurred speech. These symptoms can significantly affect driving ability, making it unsafe.

Additionally, if the police pull you over, you might fail a breathalyser test, leading to legal complications. Management of the syndrome, including dietary changes and medical treatment, is crucial to minimise symptoms and ensure safety.

If you have auto-brewery syndrome, consult a healthcare provider about driving and other activities that require full cognitive and motor function.

Can it be auto-brewery syndrome be cured?

Auto-brewery syndrome can often be effectively managed, though whether it can be fully cured depends on the underlying causes and the person’s response to treatment. Management strategies typically include:

• Dietary changes: Reducing carbohydrate intake to limit the substrate available for fermentation by yeast or bacteria.

• Antifungal or antibacterial medications: Prescribed to reduce or eliminate the overgrowth of fermenting organisms in the gut.

• Probiotics: To restore a healthy balance of gut flora.

• Addressing underlying health conditions: Managing conditions such as diabetes or gastrointestinal disorders that may contribute to the syndrome.

With proper treatment, many sufferers can achieve significant relief from symptoms and maintain normal blood alcohol levels.

However, ongoing management may be necessary to prevent recurrence.

In some cases, especially if there is a persistent imbalance in gut flora or chronic health issues, the condition may not be completely curable but can be controlled effectively.

Regular follow-ups with healthcare providers are essential for monitoring and adjusting treatment as needed.