Auto-brewery syndrome (ABS): When your body becomes a brewery



In the realm of medical anomalies, auto-brewery syndrome (ABS) emerges as a captivating and exceedingly rare condition, also known as gut fermentation syndrome. In this article, we will explore the intriguing world of ABS, its causes, manifestations, diagnosis, treatment, and its profound impact on the lives of individuals grappling with it.

What is auto-brewery syndrome?

Auto-brewery syndrome, often abbreviated as ABS, represents a baffling and rare medical phenomenon where the human body morphs into an internal brewery, fermenting carbohydrates and producing alcohol within the digestive system. This enigmatic condition can induce symptoms of alcohol intoxication sans the consumption of alcoholic beverages. Though identified in the 1970s, ABS remains shrouded in mystery due to its rarity.

What triggers the auto-brewery syndrome?

The precise origins of auto-brewery syndrome continue to elude researchers. Nonetheless, it is attributed to an overgrowth of specific yeast or fungal strains in the digestive system, particularly the small intestine. These microorganisms, typically aiding digestion, turn hyperactive in ABS, converting ingested carbohydrates into alcohol.

What are the main factors contributing to the syndrome?

  1. Prolonged antibiotic use
  2. Carbohydrate-rich meals or drinks
  3. Diabetes
  4. Irritable bowel syndrome (IBS)
  5. Crohn’s disease
  6. Short bowel syndrome

Symptoms of auto-brewery syndrome

ABS symptoms vary in intensity and duration among individuals. While some may experience mild manifestations, others grapple with severe, incapacitating episodes. Common symptoms include:

1. Intoxication: ABS individuals may display alcohol intoxication signs such as impaired coordination, slurred speech, and altered mental state, despite not having consumed any alcoholic beverages.

2. Digestive issues: ABS can precipitate gastrointestinal problems, including bloating, diarrhea, and abdominal discomfort.

3. Mood changes: Some people with ABS report mood swings, irritability, and confusion during episodes.

4. Fluctuating blood alcohol levels: The unpredictability of endogenous ethanol variations makes it difficult to predict when symptoms will manifest.

Diagnosing auto-brewery syndrome

Diagnosing auto-brewery syndrome can be a complex and lengthy process, as it often involves ruling out other possible causes of the symptoms. Healthcare providers may use various approaches to determine the presence and severity of the disorder. They may resort to medical history, breathalyzer, and lab analysis. The confirmatory test for this syndrome is the raised levels of blood or breath ethanol after a glucose challenge test.

A clinical dilemma

While categorized as a rare disorder, this syndrome is also considered to be underdiagnosed, meaning that the reported number of cases does not truly reflect the potential number of cases that may exist.

Even rarer are two cases of auto-brewery syndrome identified, one in the oral cavity and one in the urinary bladder.

Can auto-brewery syndrome be treated?

ABS management hinges on symptom severity, aiming to control fermentation and curtail alcohol production. A well-thought therapy should include:

  • Drug therapy
  • Multi strain probiotic supplements
  • Diet modification (low carb and high protein)
  • Avoid alcohol consumption and dietary antibiotics

Impact on the lives of those affected

Auto-brewery syndrome is a serious medical phenomenon that can have serious implications for those living with it. The unpredictability of ABS episodes disrupts daily life, social interactions, and work obligations, leading to:

Social isolation: The stigma tied to unpredictable intoxication-like symptoms often triggers social withdrawal.

Employment challenges: The unpredictable nature of the condition makes it difficult for individuals to maintain regular employment.

Psychological toll: Anxiety, depression, and other emotional strains are common among those suffering from the disorder.

Quality of life: ABS can significantly impact both patients and their families, disrupting daily routines and straining relationships due to the constant need for symptom management and dietary vigilance.

Auto-brewery syndrome is often mistaken for alcohol consumption, creating social and legal issues for those afflicted by this enigmatic condition.


Auto-brewery syndrome is a genuine medical disorder that can lead to an individual experiencing intoxication effects even in the absence of alcohol consumption. Although classified as an uncommon condition, it is often not recognized, indicating that many might have it without realizing it. That is why it is crucial to familiarize yourself with the typical symptoms so you can determine whether you should seek medical evaluation and treatment.