A groundbreaking study published in Nature Microbiology reveals that auto-brewery syndrome (ABS) occurs when specific gut bacteria convert ordinary carbohydrates from food into ethanol, which then circulates through the bloodstream. The research team from Massachusetts General Brigham, working alongside scientists from the University of California San Diego, has identified the exact microbes and metabolic processes responsible for this unusual phenomenon.
The collaborative study examined 22 individuals diagnosed with ABS, comparing them with 21 household members and 22 healthy participants. Laboratory analysis revealed that stool samples from patients experiencing active symptoms produced substantially higher ethanol levels than samples from unaffected individuals.
While normal digestion naturally creates minimal alcohol quantities in everyone, people with ABS generate concentrations sufficient to trigger visible signs of intoxication. The condition remains extremely uncommon, yet medical experts suspect many cases go undetected due to insufficient awareness among healthcare providers, diagnostic challenges, and associated social stigma.
Individuals living with ABS often endure years without proper diagnosis, potentially facing relationship difficulties, health complications, and legal troubles stemming from unexplained intoxication episodes. Current diagnostic procedures prove difficult to access, requiring closely monitored blood alcohol testing that many medical facilities cannot readily provide.
The research findings offer promising developments for those affected by the syndrome. According to Dr. Elizabeth Hohmann, co-senior author and member of the Infectious Disease Division at Mass General Brigham, the study demonstrates potential for fecal transplantation as a treatment option. In one documented case, this procedure resulted in sustained symptom improvement.
“Auto-brewery syndrome is a misunderstood condition with few tests and treatments. Our study demonstrates the potential for fecal transplantation,” Dr. Hohmann explained. She added that identifying the specific bacteria and microbial mechanisms could pave the way for simplified diagnostic methods, more effective treatments, and enhanced quality of life for those living with this rare disorder.
The research opens possibilities for developing stool-based diagnostic tests, which could make identifying the condition more accessible and dependable in clinical settings.
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