When a man in North Carolina was pulled over on suspicion of drunk driving, police did not believe him when he said he had not consumed alcohol.
The man, in his 40s, refused to take a breath test and was taken to hospital, where his initial blood alcohol level was found to be 0.2% – about 2.5 times higher the legal limit and the equivalent of consuming 10 drinks per hour. Although the man swears up and down that he did not drink anything, the doctors did not believe him either. But researchers at the Richmond University Medical Center in New York eventually discovered that the man was telling the truth. He didn't take beers or cocktails – instead, there was a yeast in his gut that probably turned carbohydrates into the food he ate into alcohol.
In other words, his body was brewing beer.
The results were reported in a study in BMJ Open Gastroenterology. The person whose identity was not disclosed had a rarely diagnosed medical condition called Auto-Brewing Syndrome (ABS), also known as bowel fermentation syndrome.
The intestinal fermentation system occurs when the yeast in the gastrointestinal tract causes the body to convert carbohydrates taken through food into alcohol. The process usually takes place in the upper GI tract, which includes the stomach and the first part of the small intestine.
"These patients have exactly the same effects of alcoholism: odor, breathing, drowsiness, gait is changing," Fahad Malik, lead author of the study and chief internal medicine specialist at the University of Alabama in Birmingham, told CNN. "They will portray themselves as being intoxicated, but the only difference here is that these patients can be treated with antifungal drugs."
Researchers treated him with antifungal drugs
Things are not the same for the man after completing a course of antibiotics to treat a thumb injury. His personality is beginning to change, researchers are writing in the study, and he is experiencing episodes of depression, brain fog, memory loss and aggressive behavior that is not typical of him.
Three years later, after his suspicion of driving an arrest for driving, his aunt's husband bought alcohol to record his alcohol levels. She had heard of a case that had been successfully treated by a doctor in Ohio and convinced her nephew to seek treatment there.
His basic laboratory tests turned out to be normal. But doctors found two strains of yeast in his feces: Saccharomyces cerevisiae yeast, often used in brewing beer, wine making and baking, and other fungus.
The man was successfully treated at an Ohio clinic and told to stick to a strict carbohydrate-free diet, along with some special supplements. But after a few weeks his symptoms started to flare up again. This time, it seems that no treatment is working, despite visits to numerous medical professionals.
At one point, the man became so upset that he fell and experienced bleeding in his brain.
"At this institution, blood alcohol levels range from 50 to 400 mg / dL," the researchers wrote. "Here too, the medical staff refused to believe that he did not drink alcohol despite his constant refusals."
Finally, the man sought help from an online support group and contacted researchers at the University of Richmond Medical Center, who said in the study that they believe that the antibiotics he has taken years ago alter the gut microbiome and allow fungi to grow in his gastrointestinal tract.
The researchers then used antifungal therapies and probiotics to help normalize the bacteria in his gut, treating that he continued. And besides a relapse that happened after he drank pizza and soda without telling the researchers, it seemed to work.
And he can eat pizza again.
The condition is rarely diagnosed
There are only a handful of studies documenting cases of intestinal fermentation and the condition is rarely diagnosed, Malik said, in the past it was even considered a myth. explored in the 1930s and 40s as a fa a group of 20 to 30 cases appeared in Japan in the 1970s and the first cases in the United States were reported about 10 years later.
There have been several reported cases in recent years, a 2013 study that described a 61-year-old man who seemed to be drunk all the time for years before he was diagnosed with bowel fermentation syndrome. In 2015, a woman in upstate New York was fired by a DUI after providing evidence that she had the condition.
The authors of a study at the University of Richmond Medical Center recommend that doctors investigate the condition, especially when the patient shows increased levels of alcohol in the blood despite denying that they have consumed alcohol.
Early signs of bowel fermentation syndrome may include changes in mood, delirium and brain fog, the researchers wrote, even before the patient began to show symptoms of alcohol inbreeding.
The study says more research should "It's a condition that can be treated with dietary modifications, appropriate antifungal therapy, and probably probiotics," the researchers wrote. "The use of probiotics and the transplantation of fecal microbiota may be considered for future research."