Endogenous Intoxication- Auto Brewery Syndrome
Auto-brewery syndrome, also called gut fermentation syndrome or drunkenness disease, is characterized be endogenous production of ethanol. Ethanol is fermented from the consumed carbohydrates by the microbiome of the gut. However, in patients with ABS, there is excess colonization of the organisms which leads to high blood alchohol levels, with or without alcohol consumption. Hence, this disease can make one drunk without even drinking! The organisms most commonly involved are yeasts of the genera Candida and Saccharomyces. Over colonization of these organisms can be caused by a diet high in carbohydrates. Many other conditions predispose to the risk of developing ABS like Crohn's disease, irritable bowel syndrome, diabetes, obesity and other liver dysfunction diseases. This condition can also result from frequent overuse of antibiotics which can help in fungal overproduction. Patients present with symptoms similar to those of alcohol intoxication like dizziness, brain fog, slurred speech and belching. Other presentations include loss of coordination and mood changes. ABS can be treated by adapting dietary changes. A diet with low carbohydrates and high protein content can be useful. Medications include antifungals to reduce the fungal colonization. Image via:https://images.app.goo.gl/SZCS4VKAqtQKJT756
