The Auto Brewery Syndrome

Successful Treatment of Auto Brewery Syndrome with Antifungal Drugs and Diet.

CANDIDA AND SACCHAROMYCES YEASTS CAN PRODUCE SIGNIFICANT ALCOHOL FROM FOOD IN THE GUT. Common intestinal/ stomach yeasts such as Candida species (such as C. albicans, C. krusei, and C. parapsilosis) and Saccharomyces (or bread yeast) can produce significant amounts of ethanol (beverage alcohol) by fermenting food in the intestines.  Such unfortunate people can become quite drunk without consuming beverage alcohol at all- with blood alcohol levels reaching as high as 0.20 to 0.35 grams per deciliter of blood (by comparison the legal limit for motor vehicle intoxication is 0.08 grams alcohol/ deciliter in the USA, 0.05 gram deciliter in most of Europe, and 0.03 gram deciliter in Japan) ^1-5 .

CASE STUDIES – SUCCESSFUL TREATMENT OF AUTO-BREWERY SYNDROME WITH ANTIFUNGAL DRUGS AND DIET.  Such auto brewery cases often go unrecognized for a long time which can lead to accidents and legal problems for afflicted people.  Once diagnosed, however treating the Candida or Saccharomyces overgrowth can often lead to rapid resolution of the auto-brewery syndrome. A 25 year old Texas man experienced blood alcohol levels of 0.04-0.30 gram deciliter after heavy growth of Candida albicans and krusei ¹.  He recovered completely following 3 weeks treatment with 100 mg fluconazole and a sugar free diet ¹. A 30 year old Chinese man developed blood alcohol levels as high as 0.31 gram/deciliter following heavy gut growth of Candida parapsilosis ². Three weeks treatment with 150 mg fluconazole or 400 mg Voriconazole plus 200 MU/day Nystatin in addition to a sugar free diet resolved his symptoms in 3 months ². A 13 year old Oklahoma girl experienced severe intoxication, with blood alcohol levels of 0.25 to 0.35 gram/deciliter⁴. Heavy growth of Candida glabrata and Sacchromyces cerevisiae were found in her gut⁴. The girl respondded well to antifungal treatment ⁴.

Another case involved close observation of a patient to make sure they were not surreptitiously ingesting alcohol  A 61 year old Texas man experienced high blood alcohol levels of 0.33 to 0.40 grams/ deciliter without drinking beverage alcohol.  He was hospitalized with a blood alcohol content of 0.37 grams/ deciliter and his physicians could not believe he was not a “closet drinker”. Stool cultures were positive for Saccharomyces cerevisiae. During a second hospitalization he was observed closely for 24 hours and checked to make sure he did not bring in any alcoholic beverages.  His blood alcohol level rose to 120 mg/ deciliter following a meal.  The patient recovered completely in 10 weeks after being treated with fluconazole 100 mg day for 3 weeks, Nystatin 500,000 IU four times daily for 3 weeks, Acidophilus tablets to promote healthy gut bacteria, and a sugar free, low carbohydrate diet.

Research and References

1. Akhavan BJ, Ostrosky-Zeichner L, Thomas EJ. Drunk Without Drinking: A Case of Auto-Brewery Syndrome. ACG case reports journal. 2019;6(9):e00208.

2. Guo X ZW, Hjuang R, Ma J, Liu Z, Hu D, Chen J, Sue Y, Liu W. The case study of one patient with gut fermentation sndrome: case report and review of the literature. Int J Clin Exp Med. 2018;11(4):4324-4329.

3. Kaji H, Asanuma Y, Yahara O, et al. Intragastrointestinal alcohol fermentation syndrome: report of two cases and review of the literature. Journal – Forensic Science Society. 1984;24(5):461-471.

4. Dahshan A, Donovan K. Auto-brewery syndrome in a child with short gut syndrome: case report and review of the literature. Journal of pediatric gastroenterology and nutrition. 2001;33(2):214-215.

5. Cordell B MJ. A case study of gut fermentation syndrome (Auto-Brewdery) with Szacccharmocyes cerevisiae as the Causative Organism. Int J Clin Med. 2013;4:309-312.