A rare and surprising clinical case involves a 50-year-old Canadian woman who went to the emergency room seven times with symptoms of drunkenness, despite not having consumed alcohol. Symptoms included drowsiness and difficulty speaking, accompanied by a strong odor of alcohol on the breath and high blood alcohol levels in tests. Only at the seventh visit did a doctor hypothesize that it might be homebrewing syndrome, an extremely rare condition.
Recently, another case was identified in Belgium, but very few cases have been documented in the scientific literature. According to experts, self-brewing syndrome develops over time, although the exact cause is still unclear. In the case of the Canadian woman, reported in the Canadian Medical Association Journal, it is believed that an imbalance in the intestinal flora, caused by an excessive proliferation of microorganisms capable of converting carbohydrates into alcohol, is at the basis of the syndrome.
“The authors of the report explain that the patient repeatedly took antibiotics for urinary infections and dexlansoprazole for gastroesophageal reflux, which may have caused intestinal dysbiosis. This, combined with genetic factors, would have led to home brewing syndrome.”
Home brewing syndrome, also known as drunkenness disease, is one rare condition in which the intestine produces large quantities of ethanol through the fermentation of carbohydrates, thanks to the action of microorganisms such as Saccharomyces cerevisiae, Candida albicans, Candida tropicalis and Candida glabrata. Recently, it has been hypothesized that some bacteria, such as Klebsiella pneumoniae, may also be involved.
People with this syndrome show increased populations of these microorganisms, which causes episodes of drunkenness, often associated with a high-carbohydrate diet or conditions such as diabetes, liver disease, intestinal motility disorders and intestinal inflammation. A genetic predisposition, with dysfunctions of the aldehyde dehydrogenase enzyme, can also contribute to the onset of the disease. However, following a low-carb diet can resolve these episodesas observed in the case of the Canadian patient.
To treat the woman, doctors prescribed a month of fluconazole, an antifungal, and a low-carb diet, which led to the disappearance of the symptoms. However, after resuming a high-carbohydrate diet, the patient had a new episode of drunkenness, falling and experiencing drowsiness and slurred speech. “The woman was again treated with fluconazole and advised to follow a low-carbohydrate diet. After two weeks of treatment, the symptoms disappeared,” the authors of the report conclude.
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