auto-brewery syndrome

Auto-brewery syndrome, also known as gut fermentation syndrome or drunkenness disease, is a rare medical condition characterized by the fermentation of ingested carbohydrates in the gastrointestinal tract of the body caused by bacteria or fungi.

Key Features:

• The body produces intoxicating quantities of ethanol through endogenous fermentation [1]
• Symptoms similar to those of being drunk, such as dizziness, confusion, and loss of coordination [2]
• Can occur even if no alcohol is consumed, but rather from the consumption of high-carbohydrate foods [3]
• Caused by an overgrowth of yeast or bacteria in the gut, which ferments carbohydrates into ethanol [4]

Important Notes:

• Auto-brewery syndrome is a rare condition and can be misdiagnosed as alcohol intoxication [5]
• A multidisciplinary team, including a primary care doctor, gastroenterologist, and infectious disease specialist, may be necessary to manage the condition [6]
• Treatment options are available, but more research is needed to fully understand this complex condition [7]

References:

[1] - Search result 2 [2] - Search result 3 [3] - Search result 4 [4] - Search result 5 [5] - Search result 10 [6] - Search result 1 [7] - Search result 8

Auto-Brewery Syndrome (ABS) is a rare condition in which the body converts sugary and starchy foods into alcohol, leading to various symptoms.

Common Symptoms:

• Neurological symptoms:
  • Seizures [2]
  • Slurring of speech [4]
  • Incoordination leading to falls [2]
  • Blurred vision [2]
  • Faintness [2]
• Gastrointestinal symptoms:
  • Diarrhea
  • Abdominal pain
• Respiratory symptoms:
  • Shortness of breath
• Psychological symptoms:
  • Memory loss [4]
  • Mental changes [4]

Other Symptoms:

• Recurrent seizures [4]
• Comatose states [4]
• Fruity breath odor [7]
• Elevated Blood Alcohol Concentration (BAC) [8]

It's essential to note that ABS symptoms can vary from person to person and may be similar to those experienced by someone who has been drinking alcohol. If you suspect you or someone else might have ABS, it's crucial to consult a healthcare professional for proper diagnosis and treatment.

References: [1] - Symptoms of auto-brewery syndrome can be neurological, gastrointestinal, respiratory, and psychological. [2] - The neurologic symptoms mentioned in the literature include seizures, slurring of speech, incoordination leading to falls, blurring of vision, faintness, and ... [4] - The symptoms of ABS include memory loss, mental changes, recurrent seizures, slurred speech, and comatose states. [7] - Symptoms and diagnosis of ABS. A systematic review reported the most common signs observed in patients to be slurred speech, fruity breath ... [8] - The diagnoses of the syndrome is based on a host of factors such as an elevated BAC, symptoms of inebriation, GI cultures showing an elevated ...

Auto-brewery syndrome, also known as gut fermentation syndrome, can be challenging to diagnose due to its rarity and nonspecific symptoms. However, several diagnostic tests can help confirm the condition.

• Blood alcohol test: This test measures the level of alcohol in the blood, showing elevated levels in people with ABS [12][15]. Elevated blood or breath ethanol after a glucose challenge test is considered the confirmatory test for this syndrome [4][13].
• Stool tests: To identify the presence of yeast overgrowth, which can contribute to the fermentation process [13].
• Blood Tests: To measure blood alcohol levels and rule out other potential causes [13].
• Glucose challenge test: This involves providing nonspecific carbohydrate meals to the suspected patient and analyzing blood and breath alcohol level [2][22].
• Endoscopy: A thorough evaluation, including medical history, laboratory tests, and endoscopy is required for diagnosis [8].

It's worth noting that there are no specific tests to diagnose auto-brewery syndrome, and more research is needed in this area. Symptoms alone are typically not enough for a diagnosis [10].

Auto-brewery syndrome, also known as gut fermentation syndrome, is a rare condition where the body ferments and produces alcohol from undigested carbohydrates in the gut.

Treatment Options

The primary treatment for auto-brewery syndrome involves medication to control the symptoms. The mainstay of treatment includes:

• Antifungal medications: These are used to treat the underlying fungal infection that is causing the fermentation process in the gut. Examples include:
  • Fluconazole [2]
  • Nystatin [3]
  • Oral azole compounds [3]
• Antibiotics: In some cases, antibiotics may be prescribed to treat any bacterial infections that may be contributing to the condition.
• Low-carb diet: A strict low-carb diet is often recommended to reduce the amount of fermentable carbohydrates in the gut.

Other Treatment Options

In severe or refractory cases, other treatment options may include:

• Levofloxacin therapy: This has been shown to be effective in resolving auto-brewery syndrome in some patients [6].
• Traditional therapy: However, this is often ineffective and may require alternative approaches [8].

It's essential to note that the effectiveness of these treatments can vary depending on the individual case, and a comprehensive treatment plan should be developed under the guidance of a healthcare professional.

References:

[1] J Saverimuttu (2019) - Antifungal medications seem to be the mainstay of treatment for this syndrome. [2] Nov 2, 2018 - What are the treatment options? ; Antifungal drugs and other medications to help treat auto brewery syndrome include: fluconazole; nystatin; oral ... [3] by P Wickremesinghe (2021) - We used nystatin as a first- line treatment when appropriate, as it has the least amount of side effects and an established safety record. [4] Feb 4, 2020 - Medication. Doctors can treat auto-brewery syndrome with antifungals and, in some cases, antibiotics. [5] by J Saverimuttu (2019) - Antifungal medications seem to be the mainstay of treatment for this syndrome. [6] by RT Zewude (2024) - 3,8 Levofloxacin therapy resolved auto-brewery syndrome in a patient in whom K. pneumoniae was identified as a culprit pathogen. [7] Jun 8, 2020 - Medications: Doctors prescribe a strict dose of antifungals and, in some cases, antibiotics, to treat the symptoms associated with auto-brewery ... [8] by TA Riggs (2022) - Treatment involves antifungals and a low carb diet, which are often ineffective.

Differential Diagnosis of Auto-Brewery Syndrome

Auto-brewery syndrome, also known as gut fermentation syndrome, can mimic other gastrointestinal and liver conditions, making differential diagnosis crucial for accurate diagnosis.

• Irritable Bowel Syndrome (IBS): IBS can cause symptoms similar to auto-brewery syndrome, such as abdominal pain, bloating, and changes in bowel movements. However, IBS does not involve the production of ethanol.
• Liver conditions: Auto-brewery syndrome can be mistaken for liver conditions like cirrhosis or hepatitis, which can also cause elevated liver enzymes and altered mental status.
• Gastrointestinal disorders: Conditions such as gastroparesis, small intestine bacterial overgrowth (SIBO), and inflammatory bowel disease (IBD) can present with similar symptoms to auto-brewery syndrome.
• Head injury or psychiatric disorder: In some cases, auto-brewery syndrome may be misdiagnosed as a head injury or psychiatric disorder due to the altered mental status and confusion associated with ethanol production.

Key points to consider in differential diagnosis:

• Rule out other possible causes of symptoms such as IBS, liver conditions, gastrointestinal disorders, head injury, or psychiatric disorder.
• Consider the patient's medical history, laboratory results, and physical examination findings to determine the likelihood of auto-brewery syndrome.
• Strict supervision and monitoring are essential to rule out undisclosed ethanol consumption.

References:

[8] Comorbidities such as diabetes, liver disease, gut dysmotility disorders, and inflammatory bowel disease are associated with auto-brewery syndrome. [9] Auto-brewery syndrome (ABS) is a condition characterized by the fermentation of ingested carbohydrates in the gastrointestinal tract of the body caused by fungi or bacteria.

[10] Differential Diagnosis. Rule out other possible causes such as head injury, psychiatric disorder, and hidden drinking. [14] The diagnosis of ABS often mimics o ther gastrointestinal and liver condit ions. IBS, for example, can cause ... Auto-brewery syndrome (ABS), also called gut fermentation ...

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