Can negative results of 40 g glucose load test exclude auto‐brewery syndrome? Comment to: “Auto‐brewery syndrome caused by oral fungi and periodontal disease bacteria” by Takahashi <i>et al</i>. Acute Med Surg. 2021 May 3; 8: e652.

Smędra, Anna; Trzmielak, Monika; Góralska, Katarzyna; Dzikowiec, Magdalena; Wochna, Katarzyna; Brzeziańska-Lasota, Ewa; Berent, Jarosław

doi:10.1002/ams2.757

Acute Medicine & Surgery

2022

DOI: 10.1002/ams2.757

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Can negative results of 40 g glucose load test exclude auto‐brewery syndrome? Comment to: “Auto‐brewery syndrome caused by oral fungi and periodontal disease bacteria” by Takahashi et al. Acute Med Surg. 2021 May 3; 8: e652.

Anna Smędra

Monika Trzmielak

Katarzyna Góralska

et al.

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The Human Body as an Ethanol-Producing Bioreactor—The Forensic Impacts

Šoša

2023

Fermentation

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Auto-brewery syndrome (ABS), also called gut fermentation syndrome, is an extremely infrequent but also underrecognized disorder where ethanol is produced endogenously, similar to a typical bioreactor. The reliability of forensic alcohol analysis results is frequently challenged as the ethanol concentration in the breath, blood, and/or urine constitutes important evidence for prosecuting drivers under the influence of the alcohol. This further emphasizes the need to understand ABS, as in legal proceedings it is often presented as grounds for acquittal due to the concept that the findings could have corresponded to endogenously produced ethanol. However, this rare and underdiagnosed medical condition should not be considered as purely a lawyer’s favorite argument. Manifestations of ABS can have a severe impact on a patient’s life and pose social consequences as well. Unfortunately, barely anything has been unearthed, and aspects such as genetic susceptibility, gut-mucus-eating microorganisms, and fecal microbiome transplantation were reviewed for the first time in this context. The framework of this review was not limited to the gut microbiota exclusively; moreover, the overgrowth of microorganisms is linked to the use of antibiotics. Studies have indicated that carbohydrate fermentation occurs in locations other than in intra-intestinal flora. Accordingly, the literature was searched for cases of patients with ABS with yeast infections in their genitourinary or oral systems.

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The Human Body as an Ethanol-Producing Bioreactor—The Forensic Impacts

Šoša

2023

Fermentation

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Gut fermentation syndrome as an alibi for a driver tested positive for alcohol: a case-based discussion

Toruńska,

Engelgardt,

Krzyżanowski

2024

Problems of Forensic Sciences

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The intestinal fermentation syndrome (IFS) also known as the auto-brewery syndrome (ABS), is an extremely rare diagnosis. This syndrome involves the endogenous production of alcohol by microorganisms in the digestive system after consuming a high-carbohydrate meal. The article describes the case of a 65-year-old driver who was found to have 0.24 mg/l of alcohol during a sobriety test, which, according to Polish law, is defined as a state after consuming alcohol and is considered a misdemeanour. He explained his condition by the occurrence of the intestinal fermentation syndrome. After a thorough analysis of the documentation submitted, it was concluded that there was no basis for assuming that the ethyl alcohol found in the exhaled air resulted from the accused’s health condition, medications taken by him or meals consumed, and the presence of the discussed disease was excluded. The specificity of the intestinal fermentation syndrome encourages the use of the diagnosis as an alibi for alcohol detected in the body. Hence, in such cases, it is important to carefully conduct diagnostics, including differential diagnosis, microbiological tests and, above all, a provocation test with glucose with simultaneous monitoring of the alcohol level in the body. During diagnostics, the possibility of additional alcohol intake should also be excluded to avoid false results and misdiagnosis.

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Can negative results of 40 g glucose load test exclude auto‐brewery syndrome? Comment to: “Auto‐brewery syndrome caused by oral fungi and periodontal disease bacteria” by Takahashi et al. Acute Med Surg. 2021 May 3; 8: e652.

Cited by 2 publications

References 2 publications

The Human Body as an Ethanol-Producing Bioreactor—The Forensic Impacts

The Human Body as an Ethanol-Producing Bioreactor—The Forensic Impacts

Gut fermentation syndrome as an alibi for a driver tested positive for alcohol: a case-based discussion

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