Drunk Without Drinking: What It’s Like to Live With Auto-Brewery Syndrome

How it’s possible to get drunk without ever taking a sip of alcohol.

Imagine this: It’s 8 p.m. on a warm summer night. You’ve just had a pizza dinner with your friends and are driving home for the evening. You roll your windows down to enjoy the soft breeze when, all of a sudden, your vision becomes hazy. You start to feel nauseous as the road blurs in front of you. Then, you’re drifting into oncoming traffic, but your body is too slow to respond and correct it. Red and blue lights flash in your rearview mirror and you pull over. Suddenly you’re charged with a DUI, and you haven’t even had a sip of alcohol.

While this may sound like the plot of a bad episode of CSI, it’s actually a real possibility, and the result of a life changing condition called auto-brewery syndrome.

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So what is auto-brewery syndrome?

Auto-brewery syndrome, also known as gut fermentation syndrome, is a medical condition generally caused by a disturbance in your gut’s microbiome — aka the healthy bacteria that live in your gut. Everyone’s intestines have naturally-occurring bacteria that aids in food digestion. For most people, a small amount of ethanol (or alcohol) can occur in the gut when these bacteria break down food, especially carbohydrates. However, people with auto-brewery syndrome overproduce or have different strains of this bacteria, which can cause an abnormally high amount of alcohol to be produced in the gut. This can result in extreme blood alcohol levels.

This disturbance of the microbiome, and subsequent creation of alcohol, in a person with auto-brewery syndrome can be caused by a number of different factors. A diet high in carbohydrates and refined foods, the overuse of antibiotic drugs, and poor overall health can all contribute. In addition, a number of medical conditions including short bowel syndrome, diabetes, intestinal pseudoobstruction, or SIBO (small intestine bacterial overgrowth) have been seen in patients with auto-brewery syndrome.

The first mention of this syndrome was recorded in Japan in 1952. Since then, it has only been reported in a small number of patients, with only a few cases being reported in the past three decades. Since this condition is very rare, not everyone with the lifestyle factors or medical conditions mentioned will develop the disease. There are some who think auto-brewery syndrome may have a genetic component, but this has not been studied enough to say definitively.

How do I know if I have it?

There is no formula for those who develop this rare disease. More likely, it is how a mix of the conditions described above affects a person’s gut individually.

People with this condition may experience symptoms often associated with the over consumption of alcohol including vomiting, belching, chronic fatigue syndrome, dizziness, loss of coordination, disorientation, and irritable bowel symptoms. If you develop these symptoms without consuming alcohol, you should make an appointment to see your doctor to discuss.

For the rare group that has it, auto-brewery syndrome can have significant effects on their lives. On Dec. 20, 2019 The Dr. Oz Show invited Nick Hess, a man who has been struggling with this condition for almost a decade, to share his experience. “I got into a car accident and ended up blowing a .298 on a breathalyzer test, recounts Hess. The legal limit is .08; he hadn’t had anything to drink.

As you can imagine, before knowing he had a auto-brewery syndrome, Hess started to have significant legal (even social) difficulties. Hess told Dr. Oz that in the beginning, his wife accused him of hiding and stashing alcohol bottles in the house and secretly drinking when she was out. She would even search the house for his stash. People with auto-brewery syndrome often face this skepticism from their loved ones and it can be hard to regain that trust, all while battling a real medical issue.

Can it be treated?

Being diagnosed with auto-brewery syndrome does not mean your life is over. There are a number of treatment options that can help patients return to their normal lives. Firstly, just like any other situation, if a person has extremely high blood alcohol content, they should be treated for acute alcohol poisoning.

In addition, if someone thinks they may have auto-brewery syndrome, the first step would be going to a physician. Doctors may recommend a change in the diet for a more long-term treatment. Because the bacteria in the gut that produces alcohol mainly feeds off carbohydrates, reducing or avoiding carbohydrates should reduce the amount of alcohol formed in the gut, and therefore reduce symptoms.Hess says he’s found some relief by taking supplements and trying different holistic methods of healing, like acupuncture. He has fully eliminated alcohol from his diet. There are also a number of medications, such as antibiotics or supplements, that can reduce the bacteria in the gut that ferment the alcohol.

Ongoing research has allowed not only for new treatment options, but an overall better understanding that this disease is possible, which is the first step to helping those who suffer from it.


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