Understanding Auto-Brewery Syndrome in 2023: A Clinical and Comprehensive Review of a Rare Medical Condition

Abstract

Auto-brewery syndrome (ABS) occurs when the gastrointestinal tract produces excessive endogenous ethanol. This article examines various aspects of ABS such as its epidemiology, underlying etiology, diagnostic difficulties, management strategies, and social implications. By synthesizing the existing medical literature, we hope to identify understanding gaps, pave the way for further research, and ultimately improve detection, treatment, and awareness. The databases we used are PubMed, PubMed Central, and Google Scholar. We carefully screened all published articles from inception till date and narrowed down 24 relevant articles. We at Richmond University Medical Center and Mount Sinai are one of the leading medical centers for diagnosing and treating this rare condition in the United States.

Auto-Brewery Syndrome After COVID-19 Infection

“…Specifically, genetic polymorphisms of alcohol dehydrogenase and aldehyde dehydrogenase 2 may lead to a buildup of ethanol and acetaldehyde. 1 To our knowledge, this is the first case of ABS diagnosed after COVID-19 infection.…”

“…1 It is believed that fungal and/or bacterial dysbiosis in the oral cavity, gastrointestinal, or urinary system results in fermentation of ingested carbohydrates into ethanol, which is subsequently absorbed into the bloodstream. [1][2][3] Diagnosis is confirmed with blood alcohol levels after ingestion of a glucose load. 4 ABS has a significant impact on patient quality of life and negative social and legal consequences.…”

“…Auto-brewery syndrome (ABS), also known as gut fermentation syndrome and endogenous alcohol fermentation syndrome, is a rare, underdiagnosed, and understudied condition. 1 It is believed that fungal and/or bacterial dysbiosis in the oral cavity, gastrointestinal, or urinary system results in fermentation of ingested carbohydrates into ethanol, which is subsequently absorbed into the bloodstream. [1][2][3] Diagnosis is confirmed with blood alcohol levels after ingestion of a glucose load.…”