Suppose you’re told that you look drunk when you haven’t had a drop of liquor.
Your speech may become slurred. You may become dizzy or confused. Your coordination may become impaired. However, you have indeed not had any alcohol.
This strange phenomenon may happen in rare syndrome, commonly referred as auto-brewery syndrome, or gut fermentation syndrome.
In this case, some microorganisms in the gut break down carbohydrates and generate ethanol within the human body. Organisms that have been reported include Saccharomyces species and Candida species, but the microorganism responsible may be different.
Patients may experience symptoms similar to those of an alcoholic, including dizziness, slurred speech, coordination and confusion. In some cases, this has led to serious social and legal repercussions for those who were mistaken for having consumed alcohol.
The diagnosis may be difficult as the disease is very rare and the symptoms are similar to numerous other diseases. A complete history is important, especially when a person has measurable blood alcohol levels, and denies drinking alcohol. For reported cases a controlled carbohydrate challenge has been part of the diagnostic work-up.
Treatment will depend on the individual case, and may include dietary changes and treatment aimed at the microorganisms responsible, plus treatment of any gastrointestinal issues. Much remains to be learned about the condition from the current evidence, which is largely from case reports and small studies.
While the term auto-brewery syndrome may sound like fiction, it illustrates an important reality: The microbes that reside in your body can impact your health in ways we have only come to understand.
Would you ever consider the possibility of auto-brewery syndrome if the patient had a recurrent history of intoxication but denied drinking alcohol?
MBH/PS