A Canadian woman from Toronto went to the emergency room seven times complaining of severe fatigue and impaired speech, but doctors diagnosed her with alcohol intoxication. It took physicians two years to believe the 50-year-old when she said she hadn’t touched alcohol.
Turns out, she was suffering from auto-brewery syndrome, an extremely unusual disorder that imparts the impression of intoxication due to the fermentation of alcohol by fungus in the digestive tract.
The metabolic disorder makes people feel and act drunk.
Researchers say appropriate diagnosis and management of this illness depend on public knowledge of it. The illness is typically accompanied by a diet heavy in carbohydrates and sweets.
The woman’s severe daily tiredness and slurred speech led her to frequent visits to the emergency room over two years. She was taking a proton pump inhibitor to lower her stomach acid levels and many rounds of antibiotics for her recurring UTIs.
She had high blood alcohol levels and smelled like she had been drinking even though she hadn’t had any. The woman and her relatives assured physicians time and time again that she abstained from alcohol for religious reasons.
She was discharged from each hospital visit with the diagnosis of drunkenness. Each about of slurring and excessive tiredness required the patient to take up to two weeks off work after being discharged home. Her symptoms would improve after a week or two, but they would flare up again every month or two.
On her seventh visit to the A&E, the woman’s peculiar symptoms were suspected to be caused by auto-brewery syndrome by a savvy emergency physician. Her doctor gave her medicine and sent her to a nutritionist, who discovered that eating a lot of carbohydrates would cause her blood alcohol levels to spike quickly.
The woman’s symptoms disappeared and didn’t return for four months after she followed a low-carb diet and used anti-fungal medicine.
She gradually resumed eating carbs, but a month later, she fell due to a return of slurred speech and lethargy. After her symptoms subsided, her doctor recommended that she return to the low-carbohydrate diet.
There are serious medical, legal, and social ramifications for individuals and their families affected by the rare disorder.
