How to get drunk without consuming alcohol

Is it possible to feel intoxicated without ever consuming an alcoholic beverage?

Although it’s extremely rare, experts say it can happen.

According to Dr. Douglas Dieterich, M.D., the director of the Institute for Liver Medicine at the Mount Sinai Health System in New York City, the condition is known as auto-brewery syndrome, or ABS.

The doctor informed Planet Chronicle Digital that the syndrome develops when a patient's gut is colonized by a fungus that converts carbohydrates and sugar into alcohol through fermentation.

Dieterich advised doctors to rule out other causes and ensure the patient is not drinking surreptitiously before diagnosing them with ABS.

Here's a deeper dive.

A real-life case of auto-brewery syndrome

Despite not drinking alcohol, a 50-year-old woman exhibited symptoms of intoxication, including alcohol-scented breath, slurred speech, and high blood alcohol levels during multiple emergency department visits, as detailed in a recent case study published in the Canadian Medical Association Journal.

The woman suffered from frequent urinary tract infections, which were treated with multiple rounds of antibiotics and stomach acid-reducing medications.

According to the published report, the patient was eventually diagnosed with auto-brewery syndrome.

The consequences of ABS, which include medical, legal, social, and financial impacts, are of utmost importance to patients and their loved ones, according to Dr. Rahel Zewude, the lead author of the study and an infectious diseases and microbiology fellow at University of Toronto in Canada.

"Awareness of this rare syndrome among both the medical community and the general public can significantly decrease the time it takes to diagnose it."

"ABS carries paramount medical, legal, social and financial consequences for patients and their loved ones."

Over a two-year period, the woman in the case study visited her physician and the emergency department at least seven times, reporting symptoms such as excessive sleepiness, slurred speech, falls, and alcohol smells on her breath.

Despite her claims of not consuming alcoholic drinks, her family members confirmed that she had an elevated blood alcohol limit of 39 mmol/L during her first ED visit, resulting in a diagnosis of alcohol intoxication.

The woman's liver enzymes were normal and a CT scan of her head showed no acute findings, according to the study.

Despite scoring a zero on the CAGE screening test, which evaluates patients for alcohol use disorder, three psychiatrists offered addiction-related care to the woman during her visits to the emergency department.

According to the American Addiction Centers website, a total score of 2 or higher is considered clinically significant.

The woman was diagnosed with possible auto-brewery syndrome after experiencing episodes every one to two months and visiting the ED seven times. She was prescribed an antifungal medication called fluconazole and referred to a gastroenterologist.

After finishing a one-month course of fluconazole and sticking to a low-carb diet, her symptoms started to improve.

When she increased her carbohydrate intake, symptoms returned after four months, according to the study.

The symptoms resolved after taking another course of fluconazole and adhering to a low-carb diet.

A course of probiotics was also prescribed to help foster better gut health.

What makes a person susceptible to ABS?

Several factors contribute to ABS, according to Zewude.

She informed Planet Chronicle Digital that the disease is likely to manifest when these factors coincide with a high-carbohydrate diet.

The gut microbiome, which is the population of microorganisms in the gut, is one of the main factors causing disruption.

Zewude stated that in ABS, fungi that ferment alcohol dominate our gut before other non-fermenting bacteria.

"Frequent or prolonged use of antibiotics can disrupt the gut microbiome."

ABS, or abdominal aortic aneurysm, can also be a risk for individuals with diabetes and gastrointestinal illnesses such as Crohn's, liver disease, and ulcerative colitis, according to Zewude.

Ethanol metabolism and clearance can be influenced by genetic predispositions.

Testing for and treating ABS

An oral glucose challenge can be used to test for ABS in a supervised setting, with the patient first measuring their fasting blood alcohol level.

According to Zewude, if a person had fasted for eight hours and did not consume any alcohol, they would not be able to detect the baseline level.

"Diet modification is an extremely important part of reducing or resolving symptoms of auto-brewery disease."

The patient consumes a large amount of glucose and their alcohol levels are measured at 30-minute, 1-hour, 2-hour, 4-hour, 8-hour, and 24-hour intervals.

Zewude explained to Planet Chronicle Digital that if their alcohol level increases after consuming glucose, it can confirm that alcohol is being fermented in the gut from carbohydrates, which is ABS.

To ensure the patient's safety and prevent alcohol consumption during the test, the expert recommended conducting it in a monitored clinic.

A multidisciplinary approach involving a liver specialist or gastroenterologist, primary care physician, infectious diseases specialist, and registered dietitian is recommended for managing the rare condition, according to health experts.

The case study mentioned earlier noted that antifungal medications and a low-carb diet are typically used to treat it.

Reducing or resolving symptoms of auto-brewery disease requires diet modification, according to Simone Gmuca, a registered dietitian in Douglaston, New York, who shared her insights with Planet Chronicle Digital.

According to Gmuca, who was not associated with the research, a sugar-free, low-carb diet has been proven to be effective in managing symptoms. The fewer carbohydrates consumed, the lower the likelihood of carbohydrate fermentation in the gut.

The doctor advised patients to steer clear of carbohydrates such as breads, pastas, crackers, sugary drinks, potato chips, and fruit juices while undergoing treatment.

Gmuca stated that consuming more lean protein, healthy fats, and low-starch vegetables can aid in feeling full and lower the likelihood of nutrient shortages.

She advised patients with ABS to consume a diet rich in lean meats, fish, avocados, olive oil, nuts, seeds, and leafy green vegetables.

For more Health articles, visit www.Planet Chronicle/health

Despite being known for over 50 years, ABS is still not well understood in medical literature, with limited information on diagnosis and treatment, according to health experts.