A man in the US has started producing beer in his gut after it accidentally became colonised by high levels of brewer鈥檚 yeast.
The normally healthy 46-year-old began to experience mental fogginess, dizziness and memory loss in 2011 and had to give up his job. He saw multiple doctors, but they couldn鈥檛 work out what was wrong. A psychiatrist prescribed him antidepressants in 2014, but this didn鈥檛 help.
A few months later, the man was pulled over and arrested for erratic driving. His blood alcohol reading was 200 milligrams per 100 millilitres, about the level that would be expected if he had consumed 20 standard alcoholic drinks. He maintained that he hadn鈥檛 had anything alcoholic to drink, but the police didn鈥檛 believe him.
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On another occasion, the man was hospitalised after falling and hitting his head. Doctors detected a large amount of alcohol in his system, but also didn鈥檛 believe him when he said he hadn鈥檛 been drinking.
Baffled, the man saw a gastroenterologist, who discovered high levels of a fungus called Saccharomyces cerevisiae in his stool. This fungus is also known as brewer鈥檚 yeast, because it is used by beer-makers to convert carbohydrates in grains into alcohol.
Rare condition
Subsequent tests showed that a similar conversion process was happening in the man鈥檚 gut. Every time he ate carbohydrates, his blood alcohol level shot up, sometimes to as high as 400 milligrams per 100 millilitres.
In 2017, the man attended a specialist clinic at Richmond University Medical Center in New York, where he was diagnosed with auto-brewery syndrome. This is a rare condition that occurs when certain gut microbes become overgrown and convert carbohydrates to alcohol.
The man鈥檚 auto-brewery syndrome was probably triggered by a prolonged course of antibiotics that he took in early 2011 for a thumb injury, says Fahad Malik, one of the doctors at the Richmond University Medical Center who made the diagnosis.
These antibiotics probably disrupted the man鈥檚 balance of gut microbes, causing abnormal growth of S. cerevisiae, which normally exists at low levels in the human gut, says Malik. The abundant yeast then converted any carbohydrates he ate into a beer-like substance.
Malik and his colleagues are the first to describe auto-brewery syndrome resulting from antibiotic use. However, it has also been reported in people with gut disorders like Crohn鈥檚 disease, most commonly due to overabundance of another fungus called Candida albicans, which is also known for its role in vaginal thrush. Last month, doctors in China also reported a case of .
Malik treated the man with anti-fungal medication, probiotics, and a strict low-carbohydrate diet to get rid of the excess brewer鈥檚 yeast in his gut. He has now been symptom-free for almost two years.
鈥淗e was extremely happy when he started to recover, because for years, no one believed him,鈥� says Malik, who will present the case at the annual meeting of the American College of Gastroenterology later this month. 鈥淭he police, doctors, nurses and even his family told him he wasn鈥檛 telling the truth, that he must be a closet drinker,鈥� he says. 鈥淣ow he is off antidepressants, he鈥檚 back at work and he鈥檚 finally getting on with his life.鈥�
