Auto-Brewery Syndrome

Auto-brewery syndrome or gut fermentation syndrome is a condition in which ethanol is produced through endogenous fermentation by fungi or bacteria in the gastrointestinal system, oral cavity, or urinary system. Patients with auto-brewery syndrome present with many of the signs and symptoms of alcohol intoxication while denying an intake of alcohol and often report a high-sugar, high-carbohydrate diet.

The production of endogenous ethanol occurs in minute quantities as part of normal digestion, but when fermenting yeast or bacteria become pathogenic, extreme blood alcohol levels may result. Auto-brewery syndrome is more prevalent in patients with co-morbidities such as diabetes, obesity, and Crohn disease but can occur in otherwise healthy individuals. Several strains of fermenting yeasts and rare bacteria are identified as pathogens. While auto-brewery syndrome is rarely diagnosed, it is probably underdiagnosed. Even rarer are two cases of auto-brewery syndrome identified, one in the oral cavity and one in the urinary bladder.