Ever felt drunk, hammered, wasted, absolutely smashed — but you haven’t touched a drop of alcohol?
You might have suffered from a rare gut condition called auto-brewery syndrome, which causes alcohol intoxication in people who haven’t had anything to drink.
Researchers now think they’ve figured out the specific way auto-brewery syndrome plays out in people’s bodies, they report in the journal Nature Microbiology.
Certain species of gut bacteria appear to drive auto-brewery syndrome — opening the door to treatment for the disorder.
One patient even experienced relief from the disorder after he underwent a fecal transplant, researchers found.
“Auto-brewery syndrome is a misunderstood condition with few tests and treatments. Our study demonstrates the potential for fecal transplantation,” said co-senior researcher Dr. Elizabeth Hohmann, an infectious disease specialist with Mass General Brigham in Boston.
“More broadly, by determining the specific bacteria and microbial pathways responsible, our findings may lead the way toward easier diagnosis, better treatments and an improved quality of life for individuals living with this rare condition," she said in a news release.
Auto-brewery syndrome occurs with a person’s gut bacteria start converting carbohydrates into ethanol, researchers said.
Digestion of carbs produces small amounts of alcohol in everyone, but in people with auto-brewery syndrome, these levels become high enough to cause drunkenness.
The condition is rare, but probably not as rare as previously thought, researchers said.
Fewer than a hundred cases have been documented, according to the Cleveland Clinic, but low awareness of auto-brewery syndrome makes it difficult for people and doctors to recognize and diagnose it.
For the new study, researchers compared 22 people with auto-brewery syndrome with 21 household partners who aren’t affected by the disorder, as well as another 22 healthy people.
“This study is the largest cohort of patients with auto-brewery syndrome to date,” researchers wrote in their paper.
Stool samples taken during a flare of the disorder produced significantly more ethanol in the lab than samples from either partners or healthy people, the study found.
This indicates that a stool-based test could be used to diagnose auto-brewery syndrome, researchers said.
Further, stool analysis indicated that several specific bacterial species are key drivers of the syndrome, including common causes of illness like E. coli and Klebsiella.
The study also contained a case study involving a man who’d developed auto-brewery syndrome after taking multiple courses of an antibiotic.
The man got a fecal transplant in which he consumed capsules containing gut bacteria obtained form a healthy donor, and his auto-brewery symptoms went away for three months, researchers said.
After a second fecal transplant, the man remained symptom-free for more than 16 months, researchers said.
“There is currently no consensus or standard therapy for auto-brewery syndrome, and unfortunately, patients with this debilitating condition can often suffer from delays in diagnosis, significant impairment in quality of life, and familial, social and legal difficulties,” researchers concluded in their study.