A woman from Toronto, Canada made multiple visits to the hospital, complaining of slurred speech and extreme exhaustion. Despite exhibiting all the signs of intoxication, including a foul odour on her breath, the 50-year-old woman said that she hadn’t consumed any alcohol. It wasn’t until her seventh visit that she was correctly diagnosed with auto-brewery syndrome.
Doctors discovered significantly elevated alcohol levels in her system, ranging from 30-62 millimoles per litre, far exceeding the normal limit of 2 millimoles per litre. Auto-brewery syndrome is a rare condition wherein fungi in the gut produce alcohol through fermentation. Symptoms include slurred speech, stumbling, dizziness and excessive burping. It is reported that individuals are not born with this condition but that it can be triggered by factors such as prolonged use of antibiotics or diets high in carbohydrates.
Speaking with CNN, Dr Rahel Zewude, an infectious disease specialist at the University of Toronto said, “She visited her family doctor again and again and went to the emergency room seven times over two years. She told doctors her religion does not allow drinking, and her husband verified she did not drink. 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.”
Explaining the case in the Canadian Medical Association Journal, Zewude wrote, “The patient remained asymptomatic for 6 months, after which we conducted an oral glucose challenge test to evaluate the safety of carbohydrate consumption. Based on the results, we advised her to gradually increase her carbohydrate intake, and she will continue follow-up with our infectious diseases clinic, the gastroenterologist, and the dietitian.”
Meanwhile, Barbara Cordell, president of an advocacy association called Auto-Brewery Syndrome Information and Research, claimed that alcohol levels above 62 millimoles per litre can be life-threatening. While she hasn’t come across anyone with levels as high as the 50-year-old, many can easily function with blood alcohol levels of up to 30 or 40 millimoles per litre. However, Cordell wonders how people with such conditions still perform daily activities.
In 1946, the first known case of auto-brewery syndrome was reported in Africa, involving a 5-year-old boy whose stomach suddenly burst. During an autopsy, doctors discovered his abdomen was filled with a frothy fluid that smelled strongly like alcohol. This unusual condition has since been reported in English medical literature and close to 20 cases were registered since 1974. The syndrome happens when certain types of bacteria and fungi in a person’s gut grow too much, which creates alcohol inside the body and can lead to high blood alcohol levels without the person drinking any alcohol.
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