• Mon. Jan 18th, 2021

Drunk without Drinking?

ByMuthoni Githire

Oct 1, 2020

Many of us only experience drunkenness, and the subsequent “rough morning” after having had a few stiff drinks. While the alcohol may give us a pleasurable “high” at first, the hangover is an unforgiving reminder that our bodies do not appreciate heavy partying all that much. Nevertheless, there are people who experience intoxication and hangovers without drinking a significant amount of alcohol, or even without consuming alcohol at all. These people have a condition called Auto-brewery syndrome.

Auto-brewery syndrome (ABS) is also known as gut fermentation syndrome, endogenous ethanol fermentation or drunkenness disease. It is a rare medical condition in which intoxicating quantities of ethanol are produced through endogenous fermentation within the digestive fermentation, and bacteria and yeast are responsible for this process. These organisms use lactic acid fermentation or mixed acid fermentation pathways to produce an ethanol end product. The ethanol generated from these pathways is absorbed in the small intestine, causing an increase in blood alcohol concentrations that produce the effects of intoxication without the consumption of alcohol.

Symptoms of alcohol intoxication such as slurred speech, stumbling, loss of motor functions, dizziness, and belching, are manifested in ABS, and mood fluctuations and other neurological problems have also been reported.

Initially, patients diagnosed with ABS are treated for the immediate symptoms of alcohol intoxication. Next, patients can take medications if they test positive for the types of fungi or bacteria that cause gut fermentation. For example, antifungals such as fluconazole or micafungin can be prescribed by a physician. Often, probiotics are given concurrently to ensure that the proper bacteria recolonize the gut, and to prevent recolonization by the microorganisms that caused the syndrome. Patients also typically undergo a diet therapy where they are placed on a high protein, low carbohydrate diet to avoid the symptoms of ABS. The treatments listed above can be used individually or in combination to reduce the effects of the syndrome.

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