Auto-Brewery Syndrome in Addiction

Auto-Brewery Syndrome in Addiction

Substance Abuse and Addiction are problems that affect a large portion of the Continental United States, and even worldwide. Expenditures exhausted on medical care for addiction tend to address the superficial addiction and fail to assess underlying medical conditions or issues which could negatively impact the patient and be detrimental to their recovery.

Common medical conditions such as Diabetes or Hepatitis can be root causes of Auto-Brewery Syndrome, and are quite prevalent in the Addiction demographic.

What is Auto-Brewery Syndrome?

What is Auto-Brewery Syndrome?

Auto-brewery syndrome or gut fermentation syndrome is a condition in which ethanol is produced through endogenous fermentation by fungi or bacteria in the gastrointestinal (GI) system.

Patients with auto-brewery syndrome present with many of the signs and symptoms of alcohol intoxication, however they deny any consumption of Alcohol, generally reporting a high-sugar, high-carbohydrate diet.

This condition is generally more prevalent in individuals with medical co-morbidities such as diabetes, obesity, and Crohn’s Disease. However, it is also possible for a perfectly healthy individual to present with this condition.

What can cause Auto-Brewery Syndrome in Addiction?

Various yeasts from the Candida and Saccharomyces families are the common gut yeasts that turn pathogenic and cause auto-brewery syndrome. Existing conditions, such as diabetes or liver problems, can impact the diagnosis of Auto-Brewery Syndrome.

Patients with type 2 diabetes mellitus (DM) or liver cirrhosis (LC) tested higher for endogenous ethanol levels than a control group without the disease.

But the Ethanol levels peaked highest in a group of patients with both type 2 DM and LC, where the blood alcohol concentration reached 22.3 mg/dL.

Statistics of Auto-Brewery Syndrome and Addiction

Auto-brewery syndrome is a rare condition. The disease has been identified in both male and female adults and children in many countries and is likely under diagnosed. Currently, there are over 20 million people in the United States who are both active and former addicts.

According to the Centers for Disease Control and Prevention (CDC), from 2000 to 2015, more than half a million individuals died from drug overdoses. 91 Americans die every day from an opioid overdose.

In 2017, the number of opiate overdose deaths has jumped to 144 per day. Addiction plays a multi-faceted role in how it affects society. Not only is it detrimental for the abuser’s overall health and risk of developing disease, it affects incarceration rates, vehicle accidents, employment and the overall financial burden placed on the government and health insurers.

The National Institute on Drug Abuse has estimated that the annual financial burden to be in excess of $78.5 billion, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.

Side Effects of Auto-Brewery Syndrome in Addicted Patients

Side Effects of Auto-Brewery Syndrome

Auto-brewery syndrome has significant effects on a person’s life. The patient may experience side effects of

  • Vomiting
  • Belching
  • Chronic Fatigue Syndrome
  • Dizziness
  • Loss of coordination
  • Disorientation
  • Veisalgia
  • and irritable bowel symptoms.

Chronic fatigue syndrome can result in health problems such as anxiety, depression, and poor productivity.

Because of the production of significant alcohol levels, people can test over the legal driving limit without consuming any alcohol. The randomness of intoxication episodes can result in difficulties for the patient, including injuries from falls, legal difficulties following driving citations, and strain on social relationships.

The obscurity of the condition challenges practitioners to diagnose and find a successful treatment. A comprehensive history and physical is essential, including a detailed diet history. Family members should supplement the intake history since patients may not remember their episodes of intoxication or what they ate prior to an episode.

Treatment Options for Auto-Brewery Syndrome in Substance Abuse Treatment Centers

Treatment Options for Auto-Brewery Syndrome
Treatment Options for Auto-Brewery Syndrome

At Detox of South Florida, a premier Florida drug and alcohol treatment center, several therapeutic and diagnostic modalities are utilized at our facility, in order to provide comprehensive care to our patients.

These modalities have been tried and tested, and use the latest, cutting-edge technology to provide in-depth insight into different areas of interest pertaining to drug and substance abuse and tend to veer away from traditional pharmacological approaches employed in current practice.

GI symptom detection and treatment are a part of our treatment protocols, alongside other traditional detoxification protocols instituted.

A high level of attention is given to educating our patients on the importance of treating this curable condition in its early stages, in a caring stigma-free environment. Detox of South Florida is very fortunate to have a resident Gastroenterologist Physician,

Dr. Vikram Tarugu, who is an expert in all GI conditions, available 5 days a week to address the Gastrointestinal needs of our patients.

References:

Hafez EM, Hamad MA, Fouad M, Abdel-Lateff A. Auto-brewery syndrome: Ethanol pseudo-toxicity in diabetic and hepatic patients. Hum Exp Toxicol. 2017 May;36(5):445-450.

Welch BT, Coelho Prabhu N, Walkoff L, Trenkner SW. Auto-brewery Syndrome in the Setting of Long-standing Crohn’s Disease: A Case Report and Review of the Literature. J Crohns Colitis. 2016 Dec;10(12):1448-1450.

Jansson-Nettelbladt E, Meurling S, Petrini B, Sjölin J. Endogenous ethanol fermentation in a child with short bowel syndrome. Acta Paediatr. 2006 Apr;95(4):502-4.

Dahshan A, Donovan K. Auto-brewery syndrome in a child with short gut syndrome: case report and review of the literature. J. Pediatr. Gastroenterol. Nutr. 2001 Aug;33(2):214-5.

Bivin WS, Heinen BN. Production of ethanol from infant food formulas by common yeasts. J. Appl. Bacteriol. 1985 Apr;58(4):355-7.

Malik F, Wickremesinghe P, Saverimuttu J. Case report and literature review of auto-brewery syndrome: probably an underdiagnosed medical condition. BMJ Open Gastroenterol. 2019;6(1):e000325.

Spinucci G, Guidetti M, Lanzoni E, Pironi L. Endogenous ethanol production in a patient with chronic intestinal pseudo-obstruction and small intestinal bacterial overgrowth. Eur J Gastroenterol Hepatol. 2006 Jul;18(7):799-802.

Green AD, Antonson DL, Simonsen KA. Twelve-year-old female with short bowel syndrome presents with dizziness and confusion. Pediatr. Infect. Dis. J. 2012 Apr;31(4):425.