What is auto brewery syndrome? Auto brewery syndrome is also known as gut fermentation syndrome and endogenous ethanol fermentation. It’s sometimes called “drunkenness disease.” This rare condition makes you intoxicated — drunk — without drinking alcohol. This happens when your body turns sugary and starchy foods (carbohydrates) into alcohol. Auto brewery syndrome can be difficult to diagnose. It may also be mistaken for other conditions. Only a few cases of auto brewery syndrome have been reported in the last several decades. However, this medical condition has been mentioned in the news several times. Most of these stories involve people who were arrested for drinking and driving. For example, one woman was found to have the condition after she was arrested for drunk driving in New York. Her blood alcohol level was four times the legal limit. She wasn’t charged because medical tests showed that auto brewery syndrome raised her blood alcohol levels. It’s the type of story that the media loves, but it’s not likely to repeat itself very often. Nevertheless, this is a very real condition. It’s important to be diagnosed if you feel you may have it. Let’s take a closer look.

What are the symptoms? Auto brewery syndrome can make you: drunk without drinking any alcohol

very drunk after only drinking a small amount of alcohol (such as two beers) Symptoms and side effects are similar to when you are slightly drunk or when you have a hangover from drinking too much: red or flushed skin

dizziness

disorientation

headache pain

nausea and vomiting

dehydration

dry mouth

burping or belching

fatigue

memory and concentration problems

mood changes Auto brewery syndrome can also lead to or worsen other health conditions such as: chronic fatigue syndrome

irritable bowel syndrome

depression and anxiety

What are the causes? In auto brewery syndrome, your body makes — “brews” — alcohol (ethanol) out of the carbohydrates you eat. This happens inside the gut or intestines. It may be caused by too much yeast in the gut. Yeast is a type of fungus. Some kinds of yeast that might cause auto brewery syndrome are: Candida albicans

Candida glabrata

Torulopsis glabrata

Candida krusei

Candida kefyr

Saccharomyces cerevisiae (brewer’s yeast) Who can get it? Adults and children can have auto brewery syndrome. Signs and symptoms are similar in both. Auto brewery syndrome is usually a complication of another disease, imbalance, or infection in the body. You can’t be born with this rare syndrome. However, you may be born with or get another condition that triggers auto brewery syndrome. For example, in adults, too much yeast in the gut may be caused by Crohn’s disease. This can set off auto brewery syndrome. In some people liver problems may cause auto brewery syndrome. In these cases, the liver isn’t able to clear out alcohol fast enough. Even a small amount of alcohol made by gut yeast leads to symptoms. Toddlers and children with a condition called short bowel syndrome have a higher chance of getting auto brewery syndrome. A medical case reported that a 3-year-old girl with short bowel syndrome would get “drunk” after drinking fruit juice, which is naturally high in carbohydrates. Other reasons you may have too much yeast in your body include: poor nutrition

antibiotics

inflammatory bowel disease

diabetes

low immune system

How is it diagnosed? There are no specific tests to diagnose auto brewery syndrome. This condition is still newly discovered and more research is needed. Symptoms alone are typically not enough for a diagnosis. Your doctor will likely do a stool test to find out if you have too much yeast in your gut. This involves sending a tiny sample of a bowel movement to a lab to be tested. Another test that might be used by some doctors is the glucose challenge. In the glucose challenge test, you’ll be given a glucose (sugar) capsule. You won’t be allowed to eat or drink anything else for a few hours before and after the test. After about an hour, your doctor will check your blood alcohol level. If you don’t have auto brewery syndrome your blood alcohol level will be zero. If you have auto brewery disease your blood alcohol level may range from 1.0 to 7.0 milligrams per deciliter. If you suspect you have this auto brewery syndrome, you might try a similar test at home, though you shouldn’t use it to self-diagnose. Eat something sugary, like a cookie, on an empty stomach. After an hour use an at-home breathalyzer to see if your blood alcohol level has risen. Write down any symptoms. This home test may not work because you may not have noticeable symptoms. At-home breathalyzers may also not be as accurate as the ones used by doctors and law enforcement. Regardless of what you observe, see a doctor for a diagnosis.

What are the treatment options? Auto brewery syndrome can be treated. Your doctor may recommend reducing carbohydrates in your diet. Treating an underlying condition like Crohn’s disease may help balance fungus in your gut. Your doctor may prescribe antifungal medications. These drugs work to get rid of fungus infections that may be causing the problem in your gut. You might have to take the medications for three weeks or longer. Antifungal drugs and other medications to help treat auto brewery syndrome include: fluconazole

nystatin

oral antifungal chemotherapy

acidophilus tablets You’ll need to make nutritional changes to help treat auto brewery syndrome. While you’re taking antifungal medications, follow a strict diet: no sugar

no carbohydrates

no alcohol Change your daily diet to help prevent auto brewery syndrome. A low-carbohydrate diet may help to balance fungus in your gut. Avoid sugary foods and simple carbs like: corn syrup

high fructose corn syrup

white bread and pasta

white rice

white flour

potato chips

crackers

sugary drinks

fruit juices Also avoid table sugar and added sugars to foods: glucose

fructose

dextrose

maltose

levulose Eat plenty of complex carbohydrates that are higher in fiber: whole grain bread and pastas

brown rice

fresh and cooked vegetables

fresh, frozen, and dried fruit

fresh and dried herbs

oats

barley

bran

lentils

quinoa

couscous