Have you heard of this strange phenomenon that leads some people to feel the effects of intoxication without having consumed any alcoholic beverage?
This condition, called auto-brewery syndrome, involves gut microorganisms transforming food into ethanol. Recent research has identified which bacteria and which biological mechanisms are involved, offering new leads to refine diagnosis and management.
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This rare condition remains largely unknown, which often leads to years of misdiagnosis. Patients then experience episodes of alcohol intoxication in the absence of any consumption, with potential consequences for their well-being, their relationships and sometimes even with the law. The complexity of tests and sometimes insufficient training of caregivers make detecting this disorder particularly difficult.
To deepen knowledge of this syndrome, a team compared the gut microbiome of patients, their unaffected spouses, and healthy participants. The analyses showed that stool samples from patients generated much larger amounts of ethanol during symptomatic periods. This finding indicates the possibility of developing a simple diagnostic test based on stool analysis.
The work also made it possible to observe that certain bacteria, notably Escherichia coli and Klebsiella pneumoniae, appear to play a central role in this internal alcohol production. During crisis phases, patients also show increased levels of enzymes associated with fermentation pathways. However, accurately identifying the responsible microorganisms in each individual remains a lengthy and meticulous procedure.
A clinical case demonstrated the potential utility of fecal microbiota transplantation. Following this treatment, a patient experienced lasting improvement in his symptoms, with relapses being linked to changes in his bacterial flora. A second transplantation, coupled with a distinct antibiotic pretreatment, then allowed for a remission exceeding sixteen months, illustrating the benefit this approach could bring.
These results could therefore simplify diagnosis and inspire new treatment options.
The article, published in
Nature Microbiology, is the result of work by scientists from several institutions. It contributes to a more detailed understanding of the interactions between our gut flora and our health, demonstrating how certain imbalances can cause effects as surprising as ethanol intoxication without alcohol consumption.