I ran across this article the other day describing a case worthy of an episode of House.  It details the story of a gentleman who got drunk out of the blue without consuming any alcohol at all.  He went to the ER one day complaining of feeling dizzy and was found to have a blood alcohol level of 0.37 percent (the legal limit for driving while intoxicated in our state is 0.08.)  Suspicious that he was a closet drinker, doctors kept him isolation for 24 hours to ensure he was not sneaking any alcohol and monitored his blood alcohol concentration.  It still remained at 0.12 percent long after it should have returned to zero.

An overgrowth of a yeast called saccharomyces cerevisiae within this man’s intestines caused his bizarre condition.  Saccharomyces cerevisiae is used in the brewing industry to make alcohol and is commonly known as brewer’s yeast.  Doctors treated him with a restricted carbohydrate diet and antifungal medication and his ailment resolved.

The story is an extreme example of a much broader condition called intestinal dysbiosis.  While this particular case has its own specific term, auto-brewery syndrome, it is very rare. Intestinal dysbiosis, a more inclusive term, is very common and I see it quite frequently in my practice.

Intestinal dysbiosis is an imbalance in the bacteria in your intestines.  Certain species of bacteria belong in your gastrointestinal tract.  They have a symbiotic relationship with you.  They help you by keeping other, less optimal bacteria out or in check. They also aid in the production of some vitamins and keep your intestinal lining healthy.  In turn, you give them a place to live.  When these bacteria are disrupted, other opportunistic bacteria and yeast can take up residence in your intestines.  Supposedly, if you take your intestines and scrape all of the bacteria out of them and place it on a scale, it would weigh between two to five pounds.  (I don’t know how they know this, and am not sure I want to.)

Anything that can disrupt your usual intestinal bacteria can cause intestinal dysbiosis.  Antibiotics are a frequent trigger since they kill off some healthy intestinal bacteria along with whatever other bug they are supposed to kill.  Symptoms vary but often include abdominal bloating and discomfort (particularly with eating); constipation and/or diarrhea; excessive flatulence, and worsening of symptoms with ingestion of alcohol and/or a large amount of carbohydrates, especially simple sugars.  Dysbiosis can cause a number of symptoms outside of the gastrointestinal tract as well: decreased mental clarity, fatigue, malaise, generalized muscle and joint aches, and food intolerances.  Sometimes the only symptoms may be those outside of the gastrointestinal tract.

What can be done about this common but frequently unrecognized condition?  Just as the poor gentleman with auto-brewery syndrome was treated, a two-part approach exists.  One of the most critical components is following a carbohydrate restricted diet.  Utilizing probiotics (capsules containing normal, healthy bacteria that should be in your gut) and antifungal, antibacterial, and/or antiparasitic medications or supplements as appropriate constitutes the other part.  Sometimes, if symptoms are mild, they may respond to the addition of an over-the-counter probiotic to a nutrient-dense, whole food diet.  If you ever have to take an antibiotic, it’s reasonable to take a probiotic capsule at least 2 hours apart from any antibiotic dose (so the antibiotic doesn’t kill the probiotic on the way down) and to continue the probiotic for a week or two after finishing the last dose of antibiotic to help maintain your healthy bacteria.

If you think you may have intestinal dysbiosis, I recommend seeing a functional medicine practitioner.  You can find one here.  If you have any blood in your stools or severe abdominal pain, you should see your doctor right away.  

This article in no way constitutes medical advice and if you are having physical symptoms, these should be addressed by an appropriate health care practitioner.  Live long and live well.

©2013 by Luc Readinger, MD

Beer Belly: Man Becomes Drunk When Stomach Turns Into a Brewery

A Case Study of Gut Fermentation (Auto-Brewery) with Saccharomyces cerevisiae as the Causative Organism


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