In a rare case, doctors in Canada treated a 50-year-old woman with a syndrome that makes her gut produce alcohol, and feel intoxicated without getting drunk, according to a case report published in the Canadian Medical Association Journal on Monday. 

Doctors at the University of Toronto and Mount Sinai diagnosed the woman with auto-brewery syndrome — a rare condition in which gut fungi create alcohol through fermentation.

For two years the woman suffered from extreme daytime sleepiness and slurred speech and, despite not drinking alcohol, had elevated blood alcohol levels and alcohol on her breath.

However, every time doctors dismissed her case with a diagnosis of being drunk — despite saying she had not been drinking.

In the last 5 years, she had recurrent Urinary Tract Infections (UTIs), which required frequent courses of proton pump inhibitors ciprofloxacin and nitrofurantoin, as well as gastrointestinal reflux disease, treated with dexlansoprazole.

In the past, she would drink a glass of wine on holidays; however, in recent years, she had stopped drinking altogether because of her religious beliefs.

Along with her husband and children, she visited the emergency department seven times before the correct diagnosis could be made, displaying a lack of awareness of the syndrome among physicians.

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“Auto-brewery syndrome carries substantial social, legal, and medical consequences for patients and their loved ones,” said Dr. Rahel Zewude, University of Toronto, with co-authors.

The doctors “suspect recurrent antibiotics for UTI and dexlansoprazole use led to gut dysbiosis with potential contribution of genetics” resulting in the rare syndrome.

The woman was treated with antifungal medication and low-carbohydrate diets.

Auto-brewery syndrome occurs when microorganisms capable of fermenting alcohol from carbohydrates outgrow normal gut flora.

It is rare because it requires several host factors to interact with a substantial overpopulation of fermenting microorganisms and high carbohydrate consumption.

“Comorbidities such as diabetes, liver disease, gut dysmotility disorders, and inflammatory bowel disease are associated with auto-brewery syndrome,” the study showed. 

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