Auto-Brewery Syndrome: How a Rare Disease Caused a Woman to Urinate Alcohol

A woman from Pittsburgh has been the first person to be diagnosed with an unusual condition that causes alcohol to ferment in the bladder due to yeast and sugar fermentation.

The 61-year-old patient had diabetes and liver cirrhosis and was looking for a liver transplant donor. She was, however, removed from the registry and directed to a substance dependency treatment center instead.

Doctors suspected she had an alcohol problem, but the patient denied ever consuming alcohol.

"Initially, our encounters were similar, leading our clinicians to believe that she was hiding an alcohol use disorder," her doctors explain in a case report.

Furthermore, despite her urine containing elevated levels of ethanol, the woman did not appear to be intoxicated during visits to the clinic, despite her consistent denial of having consumed alcohol.

Another mystery was the discovery of high levels of glucose in her urine (hyperglycosuria) and high levels of budding yeast in urine samples.

The doctors were understandably suspicious, given the positive results of repeated alcohol samples in the urine. The doctors then performed a blood test, which revealed that she had no alcohol in her system.

Experts published the report, titled "Urinary Auto-brewery Syndrome: A Case Report," in February last year.

How They Discovered The Syndrome

Kenichi Tamama of the University of Pittsburgh Medical Center in Pennsylvania performed some simple experiments to solve the mystery and discovered that the woman's urine contained yeast.

It is not uncommon for yeast to be found in the urine. Diabetes, on the other hand, is believed to induce a high level of sugar in the urine. Tamama tested her urine to see how these two components worked and found that the yeast was fermenting sugar in her bladder.

The disorder was dubbed "urinary auto-brewery syndrome" by physicians. Candida glabrata is a yeast usually found in the body and is linked to the yeast used in breweries.

Science Alert explained auto-brewery syndrome occurs when a person may become inebriated simply by eating carbohydrates without drinking any alcohol.

"These findings led us to test whether yeast colonizing in the bladder could ferment sugar to produce ethanol," the researchers wrote.

The doctors said that the experience of two liver transplant teams at separate institutions shows how likely it is to miss signs that urinary auto-brewery syndrome is present.

Clinicians must pay careful attention to medical record reports and test findings, researchers claim. They added that specialists must always examine if there are any discrepancies.

Overall, it seems that peeing alcohol isn't such a big deal. Tamama says that it has no impact on the patient's health. Experts made efforts to eradicate the yeast.

However, they were unsuccessful due to the patient's diabetes. Hence, experts reconsidered the patient's candidacy for liver transplantation. Experts, however, did not disclose further details about the patient.

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