Reports of a case of a woman in her 50s from Canada, who hasn’t consumed alcohol, being repeatedly rushed to the emergency room for alcohol intoxication.
According to CNN and Live Science on the 3rd, a team led by Dr. Rahel Zewude from the University of Toronto in Canada published a report in the Canadian Medical Association Journal (CMAJ) detailing the case of a woman in her 50s with a rare disease called Auto-Brewery Syndrome (ABS).
According to the medical team, the patient began experiencing severe drowsiness and symptoms of narcolepsy two years ago. She displayed drunk-like behaviors, such as speaking in a depressed tone and emitting a smell of alcohol from her breath. Furthermore, the woman was rushed to the emergency room seven times due to falls from sudden sleepiness.
During her seventh visit to the emergency room, her blood ethanol level was extremely high at 62mmol per liter (L). This exceeds the average level of 2mmol/L by over 30 times. Even when drunk, the typical range is around 30-40mmol/L. Attaining a level of 62mmol/L from drinking alcohol alone is rare and life-threatening.
The hospital had once diagnosed the patient with alcohol addiction despite her having been sober for years due to religious reasons. Psychiatrists also determined that, apart from her ethanol level, she did not meet the criteria for alcohol use disorder.
Eventually, it was only after the seventh trip to the emergency room the doctor at the hospital diagnosed her with suspected Auto-Brewery Syndrome and was referred to a specialist.
Auto-brewery syndrome, or gut fermentation syndrome, is a sporadic disease in which bacteria and fungi in the gastrointestinal tract convert carbohydrates from daily dietary intake into ethanol. Certain bacteria and fungi turn the gastrointestinal tract into an alcohol distillery by fermenting carbohydrates.
The first documented case involved a 5-year-old boy in Africa in 1946. The boy tragically succumbed to an unexplained rupture in his stomach, and postmortem examinations revealed his stomach contained a ‘foamy’ liquid that smelled of alcohol.
It is estimated about 300 individuals suffer from ABS. Some become aware of their disease after being apprehended for drunk driving. For instance, a man in his 40s in North Carolina, USA, was arrested by the police with a blood alcohol concentration of 0.2% (a license cancellation level in Korea) due to ABS.
Scientists believe this disease begins in the small intestine. It manifests when two types of fungi, Saccharomyces and Candida, grow excessively. These fungi fill in the space of beneficial fungi killed by antibiotics. The patient also took antibiotics for a urinary tract infection in her mid-40s.
Dr. Zewude advised that consuming fewer carbohydrates can significantly reduce the appearance of symptoms and subsequently prescribed the patient a strict low-carb diet.
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