Have a Drink on Me: No One Believed Him When He Said He Hadn’t Been Drinking

I knew very little about Auto-brewery syndrome (ABS) prior to taking on this subject for this blog. My initial thoughts prior to researching it for the article (“No one believed him when he said he hadn’t been drinking. Then researchers found his body was producing alcohol(1)”) was that I had missed out. By that I mean that in my own drinking days, this would have been a great excuse to get me out of my troubles. It could have saved a lot of heartache. Not to minimize the ABS concept, that was just me gut thinking in jest. 

“Auto-brewery syndrome (ABS), also known as gut fermentation syndrome, is a rarely diagnosed medical condition in which the ingestion of carbohydrates results in endogenous alcohol production (2)”

The article references a case report (2) in the British Medical Journal and describes a 40 something year old male who was arrested for driving while intoxicated (DUI). However, he swears he wasn’t drinking. His his initial blood alcohol level was found to be 0.2% — about 2.5 times the legal limit and the equivalent of consuming 10 drinks an hour. I was initially skeptical as I’m sure many others are. Afterall, wouldn’t every alcoholic busted for DUI make the claim? I would have. Gut fermentation syndrome occurs when yeast in the gastrointestinal tract causes the body to convert carbohydrates ingested through food into alcohol. The process typically takes place in the upper GI tract, which includes the stomach and the first part of the small intestine. The case report describes:

“We believe that our patient’s symptoms were triggered by exposure to antibiotics, which resulted in a change in his gastrointestinal microbiome allowing fungal overgrowth. Candida and S. cerevisiae, which can convert carbohydrates to endogenous alcohol, were detected in his intestinal secretions and stool. S. cerevisiae is known to use acetate for anaerobic alcohol fermentation (2).”

Sarcasism would have one say that a pizza and beer dinner would only be the cost of

the pizza as the pizza would ferment and he’d make his own beer in the gut. How lucky you might think. This may have it’s advantages, however, at the cost of a DUI for only eating pizza, this could be costly. In all seriousness, the science behind this is plausible. There are a number of studies, case series, and case reports confirming the syndrome as well as an established diagnostic protocol (2). 

Have a great day, and in the meantime, you be the judge, and have a drink on me (or a piece of pizza 🙂


  1. https://www.cnn.com/2019/10/25/health/beer-stomach-autobrewery-syndrome-trnd/index.html
  2. https://bmjopengastro.bmj.com/content/6/1/e000325

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Robert Duprey MD

Robert P. Duprey Jr studied medicine as a 2nd career medical student who went to medical school in his 40’s after honorable discharge and ‘retirement’ from 25 years in the US Military (USCG & US Army). He was a registered nurse (RN) with specialty training as a psychiatric RN in the US Army for 15 years. During this time he also became a Master’s level psychotherapist in 2002. While on US Army active duty he also became a Psychiatric Nurse Practitioner while working full time in 2011. He served as a Psych NP on active duty, to include a combat tour in Iraq, until his ‘retirement’ in 2014 and moved to Philippines with his 3 children. At this time he started medical school overseas at Oceania University of Medicine based out of Samoa accredited by Philippine Accrediting Association of Schools, Colleges and Universities (PAASCU). He continued to work as a Psych NP throughout medical school to support his children and to not have to take out loans for medical school tuition. Originally from Rhode Island, he completed medical school clerkship rotations throughout the USA with a graduation in May 2019 earning the esteemed credential of MD. He has successfully completed USMLE Steps 1, 2CS, and 2CK. He will take Step 3 this September as he applies for Psychiatry Residency. Having been and RN, NP and now MD, he is a believer of Physician led multidisciplinary healthcare teams