How to Cure Auto-Brewery Syndrome
Around this time last year, a strange disease began to appear in the media: Auto-brewery syndrome (ABS). Even if the patient does not drink alcohol, the body will automatically produce alcohol to make the patient drunk.
When all other possible treatments are not working, doctors boldly used poop transplant to successfully treat human intestinal ABS, marking the first case in medical literature.
ABS is caused by microorganisms (usually fungi) in the gut feasting on recently-eaten carbohydrates to produce their own brew of alcohol.
Most of us carry a small number of fermenting microorganisms, but in ABS cases, the microbial population is large, so the fermentation process will get out of control. This can sometimes happen after certain antibiotics make the gut out of balance.
A few years ago, a 47-year-old man in Belgium was admitted to the hospital. Since he started taking antibiotics, he had been experiencing unexplained moments of inebriation. And it had been going on for two months.
The patient told the doctor that he had not consumed alcohol for 4 consecutive days, and yet upon further testing, his blood ethanol level were more than 17 times what is considered normal.
The doctor diagnosed him with gut fermentation syndrome or ABS, and prescribed oral antifungal and a low-carbohydrate diet. But it only helped a little. Even an increased dose of high-potency antifungal amphotericin for four weeks did not seem to be successful: the patient still felt inebriated, and his wife reported that she could smell alcohol from his breath.
Later, after being ticketed for drunk driving during a random police checks, the patient and doctor decided to try something more drastic: a faecal microbiota transplantation, more commonly knew as a poop transplantation.
In recent years, poop transplantation has been used as a promising new method to rebalance the gut microbiota among certain groups of people. However, they seem to only work against certain infections, and there are potential life-threatening risks that need to be taken into consideration.
However, the man was willing to try, and the samples eventually came from a voluntary donation from his 22-year-old daughter. Fortunately, the poop transplant worked well. In the past three years, the patient is free of ABS symptoms, and the blood ethanol level has returned to normal. He even got his driver's license back.
The research team wrote in the case study: “Based on our experience, we recommend that clinicians who are working to resolve gut fermentation syndrome consider feacal microbiota transplantation therapy, especially if traditional therapies fail. In addition, we can image a future point. After evaluating the safety of fecal microbiota transplantation, we can imagine that this approach might become the standard treatment for gut fermentation syndrome."
While dietary habits, drug therapy and probiotics are usually sufficient to deal with ABS, in some resistant cases, we may need a more extreme approach. Feacal transplants are a promising avenue for more research.
The case study was published in the Annals of Internal Medicine.
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