A poo transplant successfully treated a man who was brewing alcohol in his own gut

Clinicians who have patients with gut fermentation syndrome should consider treatment with fecal microbiota transplantation, especially if more traditional therapy has failed. Researchers from University Hospital Ghent, Ghent, Belgium describe the first case report showing efficacy of this method for treating the rare syndrome. The case report is published in Annals of Internal Medicine.

Gut fermentation syndrome, also known as auto-brewery syndrome, is a rare condition in which the body produces ethanol in the gut after carbohydrate-rich meals. The condition is problematic because it leads to elevated blood alcohol levels, a feeling of drunkenness, variably disturbed liver function, and other indications of ethanol intoxication.

The authors describe the case of a 47-year-old man who had intermittent episodes of feeling drunk during the previous two months, even when he had not consumed any alcohol. After a series of tests ruled out other conditions, the clinicians suspected gut fermentation syndrome. The patient was prescribed a low-carbohydrate diet and antimycotic drugs, but continued to show signs of alcohol intoxication despite not consuming any. The clinicians proposed a fecal microbiota transplantation, after which symptoms of ethanol intoxication disappeared immediately. The man regained his normal carbohydrate-rich diet and reported drinking on occasion. This successful outcome lasted at least until the latest follow-up of 34 months. The researchers suggest that these findings present a new option for other patients with difficult-to-treat gut fermentation syndrome.