People With This Rare Condition May Feel Drunk Without Drinking Alcohol
Dry January is a great opportunity for people to watch their alcohol intake after an indulgent festive season and start the New Year more health conscious. Unfortunately, for some people with the rare condition known as auto-brewery syndrome (ABS), skipping booze doesn’t prevent intoxication.
A specific composition of the gut microbiome causes ABS, as it ferments ingested carbohydrates into alcohol in significant amounts, creating an internal distillery, so to speak.
For the first time, researchers from Mass General Brigham and the University of California San Diego have identified key bacteria and metabolic pathways involved in the condition, with the goal of improving diagnosis and treatment. They also uncovered an unconventional method that may help relieve symptoms.
“Auto-brewery syndrome is a misunderstood condition with few tests and treatments,” said co-senior author Elizabeth Hohmann, physician at the Infectious Disease Division in the Mass General Brigham Department of Medicine, in a press release.
What Is Auto-Brewery Syndrome?
Ever left a half-emptied juice box in the car, only to find it smells like alcohol a week later? Congratulations, you made your own alcoholic beverage. When conditions are right, meaning the right mix of microorganisms meets enough sugar at a cozy temperature, foods can ferment into alcohol without spoiling. Observations like this, made thousands of years ago, eventually led to the industrialized alcohol production we know today.
Interestingly, some people’s microbiomes pull off this same trick inside their bodies — free of charge. However, they can spend years facing social, medical, and even legal challenges without knowing the underlying cause. Diagnosing ABS requires monitored blood alcohol testing under strict conditions, and when combined with a lack of awareness, the disorder is rarely identified.
To find better ways of diagnosing and treating ABS, the research team conducted an observational study involving 22 individuals with ABS, 21 healthy household members, and 22 control participants, taking a closer look at their gut microbial composition.
Read More: What to Do — and Not Do — to Keep Your Gut Microbiome Healthy
Measuring Alcohol in Stool Samples
In the study, published in Nature Microbiology, researchers measured elevated levels of alcohol in stool samples from ABS patients during flare-ups compared to household members and healthy controls. This suggests stool samples could offer another diagnostic tool.
Scientists also identified key microbial species (including Escherichia coli and Klebsiella pneumoniae) along with increased activity of alcohol-producing enzymes and genes involved in fermentation processes.
While antibiotics successfully reduced alcohol production, the team also observed improvement through another approach: fecal transplantation. After two rounds of transplanting donor microbiota, combined with antibiotic pretreatment, one patient remained symptom-free for more than a year, according to the press release.
Improving Diagnostics and Treatment for a Rare Condition
These discoveries represent a meaningful step forward in understanding the microbiological profiles of patients with this unusual metabolic condition. Pinpointing causative microbes is tedious work, as gut microbiomes are highly complex, requiring delicate living conditions difficult to recreate in laboratory settings. Still, researchers remain optimistic.
“By determining the specific bacteria and microbial pathways responsible, our findings may lead the way toward easier diagnosis, better treatments, and an improved quality of life for individuals living with this rare condition,” said Hohmann.
Her team is now investigating the potential of fecal transplantation for ABS in a small patient group, continuing to build on these promising findings.
This article is not offering medical advice and should be used for informational purposes only.
Read More: Want to Do Dry January? One Month Without Alcohol Can Benefit Sleep, Mood, and Health
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