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Patrick Guilfoile: Drunk without a drink?

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Many people make their own wine or beer at home. But imagine if you could make beer or wine in your gut. No need to visit the liquor store, the local bar or equip a home brewery. Could this actually happen?

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A recent report by clinicians from Texas suggests it could. They describe the case of a patient who took home brewing to a whole new level. At one point, this 61-year-old man came to a hospital emergency room, claiming intoxication without having drunk anything, a continuation of a problem he had experienced for about five years.

During his hospitalization, he had an alcohol concentration of up to 0.37 (almost five times the legal limit for driving) and was treated for acute alcohol intoxication. His physicians diagnosed him as a “closet drinker” and sent him home.  His challenges with alcohol intoxication continued, and he was hospitalized for observation a little over a year later. His belongings were searched to make sure he didn’t have any alcohol. He was given glucose and carbohydrates, the raw materials for making beer or wine, and his alcohol level went up as high as 0.12 (well above the legal limit), without any alcohol, supporting the idea that he was making his own.

Health care workers determined that his intestines contained brewer’s yeast. Based on that observation, they treated him with antifungal drugs (since yeast is a type of fungus). Subsequently, he was placed on a no sugar, low carbohydrate diet. When tested after treatment, he had no alcohol content in his blood and no evidence of brewer’s yeast in his gut. This result strongly suggested that the gut microbes were responsible for the alcohol in his system.

There have been a few cases of “auto-brewery syndrome” previously reported in the literature, with cases from Japan, the U.S., United Arab Emirates and other countries. In at least some cases, patients have had an underlying treatment or condition, which permitted the brewer’s yeast to colonize the small intestine.  For example, some individuals had taken antibiotics, which depleted competing bacteria from the gut. Other individuals had intestinal conditions that may have favored the colonization of yeast. Once present in the gut, these microbes are capable of fermenting the carbohydrate to alcohol. Although this condition is very rare, one commentator (Michaeleen Doucleff) has suggested that we may need to add a new definition for the phrase “beer belly.”

More information is available in “A Case Study of Gut Fermentation Syndrome (Auto-Brewery) with Saccharomyces cerevisiae as the Causative Organism.” by Barbara Cordell, Justin McCarthy in the International Journal of Clinical Medicine, 2013, 4, 309-312.

PATRICK GUILFOILE has a Ph.D. in bacteriology and is the associate vice president at Bemidji State University.

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