Auto-Brewery Syndrome

A 61-year-old man came to Barbara Cordell, a registered nurse at Panola College, complaining of “dizzy spells” that would make him pass out.

His family saw something else. The man had alcohol on his breath. He stumbled around as if he were drunk. And then there was the breathalyzer test, which showed he had a blood alcohol level of .33, nearly five times the legal limit in most states.

The only problem: the man hadn't had a single alcoholic drink.

These “episodes” happened every two or three months in the beginning and lasted three to four hours each, Cordell told Healthline. Then they increased in frequency and severity. They began to happen almost weekly, and the man looked more wasted each time, Cordell said.

“On the breathalyzer, it was too high to read,” Cordell said. “It was .33. I was thinking that’s approaching the lethal level of alcohol in the blood."

It would take 15 drinks in an hour for a 200 lb. man’s blood alcohol levels to reach the same reading, according to researchers.

“I’m sure it was frightening. I can’t imagine being in that situation where you are acting drunk, but you haven’t drunk anything,” she added.

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Solving the Mystery

Cordell hadn’t seen anything like it. She believed what most doctors did not: that he wasn’t a closet alcoholic. So she sought help from a college.

Together, they discovered that the man had an extremely rare virus that leads to something known as Gut Fermentation Syndrome, or Auto-Brewery Syndrome, according to a study co-authored by Cordell and Justin McCarthy, who helped treat Cordell’s patient.

In their review, the two found as many as five confirmed cases, including two in children and one in an adult in China.

The condition occurs when someone eats heavy carbohydrates and they ferment in an overabundance of brewer’s yeast in the intestines. It’s as if the person’s intestines are home brewing by the gallon. It takes three to four hours—the same as in someone who has been drinking—for the alcohol to leave the bloodstream, Cordell said.

It’s hard to tell how many cases of this rare disease have occurred, since many doctors pass these patients off as alcoholics, according to Cordell. Therefore, it’s difficult to study its intricacies and determine the best way to care for the affected  patient.

“When I first found out about it I was pretty blown away,” Cordell said. “I read the literature, where I was like, ‘Wow this is amazing.’ It was the first time I’d heard of anything like it.”

This patient’s case, however, was different from the others found in research literature. Others infected with the virus typically had an underlying condition, and some were already in an intensive care unit.

The man they treated was healthy.

Cordell and McCarthy treated their patient by giving him an antifungal medication and putting him a low-carb diet. Within 10 weeks, his symptoms dissipated and his blood alcohol level reached zero and stayed there, according to the study.

“Since this has come out I’ve been contacted by several people who think they have it,” Cordell said. “My heart goes out to them. One woman said everyone tells her husband that he must be a chronic drinker.”

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