Study Confirms Bacteria as Culprit in Auto-Brewery Syndrome
A recent study, the largest of its kind, has confirmed that bacteria, not fungi, are the primary cause of auto-brewery syndrome (ABS). ABS is a rare medical condition where individuals become intoxicated after eating, despite not consuming any alcohol.
Researchers analyzed stool samples from 22 ABS patients and their unaffected household partners. They identified two common bacterial species that were more abundant in individuals with ABS, corroborating previous findings from a 2019 study.
Although ABS cases are rarely diagnosed and treatment remains uncertain, this study provides valuable insights into the condition. Patients with ABS often face challenges in obtaining a proper diagnosis and may experience liver damage, social stigma, and legal issues due to elevated ethanol levels in their bodies.
Key Findings and Implications
The study, led by infectious disease expert Elizabeth Hohmann and gastroenterologist Bernd Schnabl, sheds light on the role of gut bacteria in ABS. The researchers discovered that bacterial cultures from ABS patients produced higher levels of ethanol during flare-ups, correlating with elevated blood alcohol levels.
Common bacterial species such as Klebsiella pneumoniae and Escherichia coli, known for ethanol production, were more prevalent in ABS patients. One patient experienced significant symptom improvement after receiving stool transplants, suggesting a potential treatment avenue for ABS.
The study highlights the importance of promoting gut bacteria that metabolize ethanol effectively through dietary changes, stool transplants, or probiotics. While fungal involvement in ABS cannot be ruled out entirely, targeting bacterial genes involved in metabolic pathways may offer therapeutic benefits.
Broader Implications for Gut Health
The study also underscores the significance of gut microbiome balance in human health. ABS patients exhibited extreme imbalances in their gut microbiomes, raising questions about the prevalence of microbial ethanol production in the general population and its potential health implications.
Furthermore, the research suggests a link between ethanol-producing gut microbes and conditions like fatty liver disease, emphasizing the broader impact of gut microbial metabolites on human health.
Published in Nature Microbiology, this study contributes valuable insights into the underlying mechanisms of ABS and paves the way for novel treatment strategies targeting gut bacteria and metabolic pathways.

