A 50-Year-Old Woman Visits the Emergency Room Seven Times a Year Due to Inebriation Symptoms Without Drinking Alcohol
This unusual case was reported by Dr. Rahel Zewude, an infectious disease specialist at the University of Toronto, in the Canadian Medical Association Journal. The patient’s blood alcohol concentration typically ranges from 30 millimoles to 62 millimoles per liter of breath, while a normal person’s level is below 2 millimoles per liter of breath.
According to Dr. Zewude, the unnamed woman suffers from Auto Brewery Syndrome (ABS), a rare but serious condition that occurs when gastrointestinal yeast and bacteria overgrow, converting carbohydrates from food into alcohol through fermentation. The patient can become intoxicated at any time and endures multiple symptoms such as vomiting, fatigue, and tingling in the limbs.
The woman frequently experiences excessive sleepiness. She can suddenly doze off while preparing for work or cooking. The patient has consulted doctors multiple times regarding her sleep issues. Emergency room physicians have also noted that she has collapsed due to drowsiness, exhibited slurred speech, and had a strong smell of alcohol on her breath. Eventually, she was referred to a gastroenterology clinic.
At the clinic, doctors observed that the patient’s symptoms would not be severe if she avoided carbohydrates. However, just after consuming a slice of bread or a meal containing carbohydrates, her alcohol levels would rise rapidly, coinciding with her drowsiness.
The woman with Auto Brewery Syndrome shows high alcohol levels in her breath. (Photo: Stock Image).
Since her mid-40s, she has suffered from urinary tract infections and has been treated with antibiotics. She has also taken antacids to manage gastroesophageal reflux disease. Dr. Zewude noted that the patient’s gut flora began to weaken, allowing yeast to flourish, leading to her diagnosis of ABS.
ABS was first reported in medical literature in 1940. The patient was a Belgian man who frequently violated alcohol levels while driving. Another case involved a former athlete from Long Island, who lost his job at a school due to regular inebriation.
According to reports, individuals with diabetes, liver disease, and inflammatory bowel disease are at higher risk of developing ABS. The syndrome can also occur in healthy individuals taking antibiotics.
Dr. Zewude states that patients with ABS may be prescribed antifungal medications before starting long-term probiotic treatments to improve their beneficial gut bacteria. They should also consider purchasing a breathalyzer to use in the morning, evening, or whenever symptoms arise. The 50-year-old patient recently completed antifungal therapy and is currently following a low-carb diet to prevent recurrence of the condition.
