Woman Misdiagnosed as Intoxicated Actually Suffered from Uncommon Condition

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Repeatedly misinterpreted as inebriated, a woman who experienced slurred speech and excessive fatigue was eventually diagnosed with the rare auto-brewery syndrome after multiple hospital visits.

The 50-year-old sought medical care seven times, each time being wrongly dismissed for drunkenness despite her assertions of sobriety. It wasn’t until later that she was accurately diagnosed with the condition.

Auto-brewery syndrome arises when fungi in the gastrointestinal tract ferment and produce alcohol.

Previously, in April, a 40-year-old man from Belgium was acquitted of a drink-driving charge once he was diagnosed with this rare disorder.

The syndrome can mimic actual alcohol intoxication, causing symptoms such as slurred speech, stumbling, impaired motor skills, dizziness, and excessive belching.

The condition is not congenital; its onset can be associated with various factors, such as prolonged use of antibiotics or a carbohydrate-rich diet, as posited by scientists.

Recognizing this syndrome is critical due to its wide-ranging social, legal, and medical repercussions, experts emphasize.

UNDERSTANDING AUTO-BREWERY SYNDROME

Known also as gut fermentation syndrome, auto-brewery syndrome is quite rare.

In those affected, their guts ferment carbohydrates into ethanol, significantly elevating blood alcohol concentrations.

The syndrome stems from particular bacterial or fungal species in the gut.

The resultant alcohol from the gut’s fermentation is absorbed in the small intestine, leading to intoxication-like effects.

The impact on individuals can be severe, with symptoms including slurred speech, difficulty walking, motor control loss, dizziness, and excessive belching, along with possible mood changes and neurological complications.

Although rare and often underreported, triggers for the syndrome are variable and may relate to antibiotic usage or diets rich in carbohydrates, scientists note.

Further, according to Lisa Florin, a clinical biologist at Belgium’s AZ Sint-Lucas hospital, auto-brewery syndrome can also emerge in individuals with other intestinal conditions.

Across two years, the woman visited the emergency department due to severe daytime sleepiness and slurred speech.

She had been prescribed multiple antibiotics for recurrent urinary infections as well as proton pump inhibitors to lessen stomach acid.

Her breath and blood tests indicated alcohol presence, though she had not consumed any.

Each visit led to a diagnosis of alcohol intoxication, without addressing her underlying condition.

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She faced a forced two-week leave from work after each episode where her diet would be minimal.

While her condition would stabilize temporarily, it would relapse every one or two months.

On her third hospital visit, she was detained under the Mental Health Act due to concerns for her well-being, as she left prior to a psychiatric evaluation.

Her correct diagnosis only came about during her seventh ER visit. She was prescribed medication and then referred to a specialist.

A dietitian advised a low-carb diet, which, combined with a month-long antifungal treatment, led to a significant improvement in her symptoms for four months.

Upon reintroducing carbohydrates to her diet, she experienced a symptomatic relapse, leading to a fall. Following a return to the low-carbohydrate diet, her symptoms dissipated once more.

Authors Dr Rahel Zewude and her team from the University of Toronto highlighted in the Canadian Medical Association Journal that auto-brewery syndrome significantly affects individuals and their families in many ways.

“This case underscores the importance of increasing awareness about auto-brewery syndrome for timely diagnosis and treatment.

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Frequently Asked Questions about Auto-Brewery Syndrome

What is Auto-Brewery Syndrome?: Auto-Brewery Syndrome (ABS) is a rare medical condition in which intoxicating quantities of ethanol are produced through endogenous fermentation within the digestive system.
What causes Auto-Brewery Syndrome?: The exact cause of ABS is not known, but it has been associated with excessive fungal or bacterial growth in the gut that ferments carbohydrates into alcohol. It can be triggered by factors such as prolonged antibiotic use or a diet high in carbohydrates.
How is Auto-Brewery Syndrome diagnosed?: Diagnosis usually involves documenting high blood alcohol levels in the absence of alcohol consumption, along with gastrointestinal symptoms and history. Specific tests may be conducted to assess gut fermentation.
What are the treatments for Auto-Brewery Syndrome?: Treatment can include antifungal medications, a low-carbohydrate diet, antibiotics, and probiotics to restore normal gut flora. Each treatment plan is tailored to the individual.