Auto-Brewery Syndrome: When Intoxication Happens Without Alcohol Consumption

Gut fermentation syndrome, or auto-brewery syndrome, is a rare condition that involves gut fungi rapidly turning carbohydrates into alcohol.

What Is Auto-Brewery Syndrome?

Symptoms of auto-brewery syndrome include fatigue, brain fog, dizziness, mood changes, delirium, and slurred speech. The syndrome itself can also lead to other symptoms, such as belching, headaches, nausea, vomiting, memory problems, concentration difficulties, and loss of coordination.

Auto-brewery syndrome can be diagnosed by a doctor through the use of a mix of lab and observational tests. Given the rarity of the condition, a person may need to go through testing for other common illnesses first.

The condition is quite rare and was first reported back in the 1950s. Since it was initially discovered, auto-brewery syndrome has been diagnosed in both children and adults. However, a 2019 case report shows that the syndrome may actually be underdiagnosed.

What Causes Auto-Brewery Syndrome?

There are several microorganisms in the gastrointestinal tract. Bacteria account for the majority of such organisms, while fungi make up less than 0.1% of the microbes present in the typical human gut.

The gut's most common species of fungi is known as candida, which is a specific type of yeast.

While low fungal concentrations rarely lead to health issues, overgrowth could significantly affect a person's quality of life and general health. Yeast and other types of fungi consume starches and sugar in food. They convert these into energy. Such a process leads to waste in the form of CO2 and ethanol, which is a specific type of ethanol.

The ethanol produced from the process of fungal fermentation may enter the bloodstream and move through the body.

For individuals with auto-brewery syndrome, they may have high levels of blood alcohol after taking just a small amount of alcohol or even when they did not take any alcohol at all. The syndrome is capable of causing the same psychological and physical symptoms that surface when a person is in a state of intoxication or hangover.

Auto-brewery syndrome typically surfaces as a result of other conditions, such as a microbiome imbalance or gastrointestinal disease. There are some factors and medical conditions that could boost one's risk of getting auto-brewery syndrome.

These conditions and factors include irritable bowel syndrome, Crohn's disease, diabetes, short bowel syndrome, small intestinal bacterial overgrowth, a weakened immune system, and obesity.

Moreover, long-term or frequent use of antibiotics could lead to changes in the gut microbiome. This could result in the overgrowth of fungi.

Having a diet consisting of processed and high-carbohydrate foods could also lead to gastrointestinal issues. According to research, individuals with the syndrome usually report having a high-carbohydrate and high-sugar diet.

Treating Auto-Brewery Syndrome

As for treatment options, those with auto-brewery syndrome can follow dietary changes and take medication.

When it comes to diet, the avoidance of professed foods and carbohydrates could help with relieving symptoms. People with this condition should avoid consuming simple carbohydrates and refined foods that have additional sugar, such as pasta and white bread.

As for medications, the condition can be treated with antifungals. This could help reduce fungus count within the gut.

Other ways to manage the condition include weight loss, treating underlying conditions, choosing complex carbohydrates, and avoiding or limiting foods and drinks with added sugar.