Endogenous alcohol is ethanol that is produced naturally in all living humans. The resulting blood alcohol concentration (BAC) is generally low. However, auto-brewery syndrome is associated with very high BACs. It occurs after eating meals rich in carbohydrates.
Although everyone has endogenous alcohol in their bloodstream, auto-brewery syndrome is rare. Its origin is in the small bowel. There, very high levels of gastrointestinal yeast convert carbohydrates into ethanol. A type of yeast, Saccharomyces cerevisiae is the major cause of this condition.
Auto-brewery syndrome is different from the usual fermentation in the large bowel. Normal yeast levels in the large bowel produce ordinary endogenous alcohol.
This study investigated the effect of diabetes mellitus, liver cirrhosis, and presence of both on BAC after consuming a carbohydrate-rich meal.
Studied were controls, those with diabetes, those with liver cirrhosis, and those with both diseases. After they consumed large quantities of carbs, their BAC was measured. The BAC of the controls was the lowest. The BAC of those with either diabetes or liver cirrhosis was significantly higher. The highest BAC was among those with both diseases.
Source: Hafez, E., et al. Auto-brewery syndrome: ethanol pseudo-toxicity in diabetic and hepatic patients. Hum. Exp. Toxicol. 2016. DOI
10.1177/0960327116661400. PMID 27492480.
Note: Liver abnormalities that prevent the body from breaking down alcohol normally can also cause high BAC without drinking.
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