Gut Fermentation (or the ‘Auto-brewery’) Syndrome: A New Clinical Test with Initial Observations and Discussion of Clinical and Biochemical Implications

Abstract

In order to identify those patients who ferment dietary carbohydrate to ethanol in their gut, a new clinical test which is easy to perform is described whereby blood alcohol (EtOH) levels are measured 1 h after a 5 g glucose load in patients who have abstained from EtOH for 24 h and who have fasted for at least 3 h prior to the test. In patients, 25/36 (69%) undergoing a 50 g oral glucose tolerance test and 311/510 (61%) undergoing the 5 g loading produced measurable blood EtOH levels after 1 h. Some clinical and biochemical implications are discussed. It is proposed that this new test could be of considerable help in clinical evaluation of a significant number of unwell patients.