Last month in Belgium, a driver was arrested for driving under the influence but was later found to have a rare metabolic disorder known as "auto-brewery syndrome." This condition causes carbohydrates in the gut to ferment, leading to increased levels of ethanol in the blood and resulting in symptoms of intoxication.
Individuals with this syndrome produce alcohol in their bodies similar to that found in alcoholic beverages but may not feel its effects as strongly.
Meital Levi, a renowned clinical dietitian, explains that this syndrome is extremely rare, with only a few dozen known cases worldwide. She elaborates that those affected may experience symptoms of intoxication, such as fatigue, dizziness, and disorientation, despite not consuming alcohol. The severity of these symptoms depends on the amount of ethanol produced, with some individuals barely noticing any effects while others may feel significantly impaired.
Levi emphasizes the importance of tailored dietary management to reduce symptoms for those with the syndrome. Diagnosis can be made through blood tests or breathalyzer tests for alcohol. Adjusting the individual's diet to minimize carbohydrate intake is crucial in managing symptoms.
Furthermore, Levi notes that auto-brewery syndrome can develop at any stage of life and may not necessarily be congenital. It is likely caused by enzyme deficiencies, suggesting a potential link to conditions like irritable bowel syndrome. This highlights the importance of considering underlying health factors in managing the disorder.
Meital LeviPhoto: Nisso shalev LeibovichDr. Sigal Frishman, director of the Nutrition and Diet Unit at Rabin Medical Center and chief dietitian of Clalit's hospital division, adds that one-fifth of the world's population suffers from irritable bowel syndrome, with the most common symptom being lower abdominal bloating. These individuals undergo breath tests to assess their tolerance to various sugars, and to determine if consuming those sugars leads to fermentation in the intestines.
According to Dr. Frishman, those with irritable bowel syndrome experience symptoms such as gas, cramps, and abdominal bloating because sugars are not absorbed into the blood but remain in the digestive system, causing fermentation. In the breath test performed for those with this syndrome, methane or hydrogen, two gases released, are checked, rather than ethanol produced in the bodies of those with the auto-brewery syndrome.
Dr. Sigal FrishmanPhoto: Rabin Medical CenterShe further explains that this rare syndrome prevents carbohydrates and sugars from being absorbed into the blood, leading them to the colon where fermentation occurs, resulting in symptoms of intoxication, including nausea, dizziness, dry mouth, mood changes, and more. To treat the syndrome, it is necessary to avoid foods containing the sugars and carbohydrates that trigger the condition.
And at what age does this occur?
"The syndrome can occur at a young age but also in adulthood. Among other factors, it may appear following an event of prolonged illness, including frequent diarrhea or long-term antibiotic use, which alters the composition of bacteria in the colon. This change can affect how they respond to sugars and carbohydrates we consume."