Displaying all the symptoms of intoxication, such as a foul odor on her breath, the 50-year-old woman from Toronto adamantly denied consuming any alcohol. This persisted for two years of doctor visits, with her husband advocating for her, until someone finally believed her. Her dizziness, disorientation, and weakness even resulted in a fainting episode when she hit her head while preparing lunch for her children.
“She visited her family doctor again and again and went to the emergency room seven times over two years,” Dr Rahel Zewude, an infectious disease specialist at the University of Toronto told CNN.
“I know of over 300 people diagnosed with auto-brewery syndrome and we have over 800 patients and caregivers in our private Facebook support group,” said Cordell, who was not involved in the new case.
“Part of the mystery of this syndrome is how these people can have these extremely high levels and still be walking around and talking.”
Despite the woman’s alarming symptoms, ER physicians remained skeptical of her assertions of sobriety. Three different hospital psychiatrists conducted a thorough examination and ultimately dismissed alcohol dependence (alcohol use disorder) as the underlying cause.
“She told doctors her religion does not allow drinking, and her husband verified she did not drink,” said Zewude, who treated the woman and coauthored a report on the anonymous case that was published Monday in the Canadian Medical Association Journal.
“But it wasn’t until the seventh visit that an emergency room doctor finally said, ‘I think this sounds like auto-brewery syndrome,’ and sent her to a specialist,” Zewude said.
Dr. Fahad Malik, a gastroenterologist who specializes in Auto-Brewery Syndrome, empathizes with the woman’s challenges.
Having 30 patients under his care (although not directly related to this particular case), he has witnessed the widespread skepticism and occasional mockery faced by individuals with this condition.
According to Dr. Malik, many patients have been dismissed as “secret drinkers” or attributed to behavioral issues prior to receiving a proper diagnosis.
Dr. Malik also serves as a clinical assistant instructor at the State University of New York Upstate Medical University.
Auto-brewery Syndrome, also known as gut fermentation syndrome, is an unusual condition where the body converts everyday carbohydrates into alcohol due to the activity of gut bacteria and fungi.
The discovery of this condition dates back to 1946 when an autopsy on a 5-year-old African boy revealed that his ruptured stomach contained a frothy liquid with a distinct alcohol smell.
Although the first documented case of Auto-brewery Syndrome dates back to 1946, it remains a rare condition. A review conducted in April 2021 revealed only 20 diagnosed cases reported in English medical literature since 1974.
Interestingly, Japan has documented additional cases using the terms ‘meitei-sho’ or ‘alcohol auto-intoxication syndrome,’ implying that the condition might be more prevalent than currently recognized.
This syndrome disturbs the intricate equilibrium of our gut microbiome. When specific fungi and bacteria proliferate, they effectively transform the digestive tract into a fermentation vessel akin to a brewing apparatus.
Unlike the healthy gut processes in the large intestine, this internal fermentation results in alcohol production.
Researchers posit that this unusual fermentation predominantly takes place in the small intestine. Although various pathogens may contribute, the most frequent culprits are fungal overgrowths, specifically Saccharomyces and Candida.
Candida, a naturally occurring fungus in the body, tends to exploit situations where beneficial bacteria are diminished, often following antibiotic use.
In a remarkable 2013 case, a 61-year-old man suffered from unexplained intoxication for years. The cause? An excessive presence of Saccharomyces cerevisiae, commonly known as brewer’s yeast—the same yeast used in beer production!
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