03 Jun Rare Auto-Brewery Syndrome Causes Intoxication Without Alcohol Consumption
MedicalResearch.com Interview with:
Dr. Zewude
Rahel Zewude, MD FRCPC
Infectious Diseases and Medical Microbiology, PGY-5
University of Toronto
MedicalResearch.com: What is the background for this study? Would you describe the syndrome of Auto-brewery syndrome?
Response: Auto-brewery syndrome refers to a syndrome where the gut ferments alcohol from carbohydrates leading to high blood alcohol levels and intoxication without any consumption of alcoholic drinks.
MedicalResearch.com: What are the main findings? Is it due to ketosis?
Response: The alcohol fermentation in auto-brewery syndrome is often carried out by fungi such as Candida species that can reside in the gut of even healthy individuals.
However, in auto-brewery syndrome significant disruption of gut microbiome results in marked increase of the population of these fungi over typical gut bacteria. Prolonged antibiotic use and proton pump inhibitor use can lead to such disruption of gut microbiome.
When this overpopulation by fermenting pathogens interacts with other host factors involved in alcohol metabolism and elimination, it can result in auto-brewery syndrome.
Some identified risk factors for this rare syndrome include underlying gastrointestinal diseases such as short gut syndrome and inflammatory bowel diseases as well as liver diseases.
Genetic predispositions that can affect ethanol metabolism may also play a role
MedicalResearch.com: What should readers take away from your report?
Response: Auto-brewery syndrome is a rare syndrome that carries significant medical, social, legal and occupational consequences for patients and their loved ones.
Awareness of this syndrome is essential to prevent delay in diagnosis.
Diagnostic evaluation includes collateral history from household members, ethanol level measurements with an oral glucose challenge, as well as culture and susceptibility testing of gastrointestinal aspirates.
The primary management strategies of this syndrome are low carbohydrate diet and antifungal therapy. Patients should receive longitudinal and multidisciplinary care with specialists in primary care, infectious diseases and gastroenterology, as well as dietitians.
No conflicts of interest or financial disclosures.
Citation: CMAJ
Auto-brewery syndrome in a 50-year-old woman
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Last Updated on June 3, 2024 by Marie Benz MD FAAD