She Doesn't Drink, But Has All the Symptoms: Doctors Didn't Believe Her Until This Rare Diagnosis
A 50-year-old woman from Toronto never touched a drop of alcohol, yet she had all the telltale signs of a heavy drinker¡ªthrobbing headaches, disorientation, and a weariness that seeped into her bones. She went from doctor to doctor, but none would believe her when she insisted she didn¡¯t drink. It took two years for a diagnosis of an extremely rare condition.
Doctors wouldn't believe she didn't drink
"She visited her family doctor repeatedly and went to the emergency room seven times over two years," Dr. Rahel Zewude, an infectious disease specialist at the University of Toronto, told CNN.
"She told doctors her religion forbids drinking, and her husband confirmed she did not drink," said Zewude.
Doctors were baffled by her fluctuating alcohol levels, ranging from a dangerously high 30 to 62 millimoles per litre, while normal levels are below 2 millimoles per litre.?
Further scrutiny from three separate hospital psychiatrists ruled out alcohol dependence as a cause.
"But it wasn't until the seventh visit that an emergency room doctor finally said, 'I think this sounds like auto-brewery syndrome,' and sent her to a specialist," Zewude said.
What is Auto-Brewery Syndrome (ABS)?
Auto-Brewery Syndrome (ABS) is a rare medical condition where the body produces alcohol internally through fermentation within the digestive system. This happens when certain types of yeast or bacteria in the gut convert carbohydrates into ethanol. Individuals with ABS can experience symptoms of intoxication, such as dizziness, fatigue, and confusion, even without consuming any alcoholic beverages.?
This condition is so rare that, since 1974, only 20 diagnosed cases of auto-brewery syndrome have been reported in English medical literature, according to an April 2021 review.
Who is at risk for Auto-Brewery Syndrome (ABS) and how is it treated?
Risk factors for auto-brewery syndrome include diabetes, liver disease, and gastrointestinal diseases such as inflammatory bowel disease and short gut syndrome, where the small intestine is damaged or shortened, Zewude said.?
There may also be a genetic predisposition related to how well a person metabolises alcohol.
Treatment for auto-brewery syndrome starts with a course of fungicides prescribed after a biopsy or colonoscopy identifies the specific pathogens in the gut.?
In addition to eliminating the yeast, patients need to follow a very restricted low-carb diet.?
Probiotics to rebuild beneficial bacteria can also help, she said.
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