In Canada, a woman in her 50s suffered from auto-brewery syndrome, a rare phenomenon that doctors in Toronto explained in a recent study.
- A Canadian woman who had been abstaining from alcohol was diagnosed with auto-brewery syndrome after presenting to the emergency room for the seventh time with slurred speech, the smell of alcohol and an elevated ethanol level of 62 mmol/L.
- This rare disease involves endogenous alcoholic fermentation by fungi in the intestine.
- The main treatment for this alcohol poisoning is antifungal medications and low-carbohydrate diets.
In a Toronto hospital, a 50-year-old woman had presented to the emergency room several times because she had recurring urinary tract infections, “who required frequent treatments with ciprofloxacin and nitrofurantoin”as well as gastrointestinal reflux, “treated with dexlansoprazole”. Then she began to have excessive sleepiness and episodes of falling asleep suddenly while she was getting ready for work or cooking.
Auto-brewery syndrome: slurred speech, smell of alcohol and high ethanol levels
“After each visit, the patient required one to two weeks off work because of persistent lethargy and drowsiness. During this time at home, she ate little, as her appetite was reduced by drowsiness. Her lethargy then resolved within one to two weeks, with subsequent improvement in appetite. Her lethargy and drowsiness recurred episodically every one to two months thereafter,” doctors said in a case report, published in the Canadian Medical Association Journal.
On her seventh visit to the emergency department, the mother presented with slurred speech, an odor of alcohol on her breath, and an elevated ethanol level of 62 mmol/L. It was at this time that a diagnosis of auto-brewery syndrome was suggested by the emergency physician who prescribed oral fluconazole before her transfer to a specialized gastroenterology clinic for alcohol poisoning. “Despite her statements that she had not consumed alcohol, corroborated by her family,” The 50-year-old underwent a battery of tests and dietary tests, including a low-carb diet.
The digestive system produces ethanol as a result of the fermentation of carbohydrate-rich foods.
The verdict is in: she does indeed have auto-brewery syndrome. This is a rare disease in which intestinal fungi produce ethanol by fermenting carbohydrate-rich foods. This pathology “can have significant social, professional and medical consequences for patients and their loved ones. Knowledge of this syndrome is therefore essential for its diagnosis and clinical management”, according to professionals. Its management involves multidisciplinary care, that is to say with general practitioners, gastroenterologists, infectiologists, psychologists, as well as dieticians, “with an antifungal treatment strategy and a low-carbohydrate diet.”
