A WOMAN visited hospital seven times complaining of slurred speech and extreme tiredness, but kept being told she was just drunk.
Though her breath reeked of booze and she had elevated blood alcohol levels, the 50-year-old insisted that not a drop of alcohol had passed her lips - but it took doctors two years to believe her.
It turns out the woman had a rare condition which gave her the appearance of being intoxicated.
Called auto-brewery syndrome, the metabolic condition causes fungi in the gut create alcohol through fermentation and makes sufferers seem like they've had a few too many.
Medics at the Stony Brook University Hospital in New York, US, have previously shown people with the condition often have a high-sugar, high carbohydrate diet.
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Researchers say awareness of this syndrome - which has social, legal, and medical consequences - is essential for it to be properly diagnosed and managed.
But only about 20 people globally have officially been diagnosed.
Over two years, the woman, from Toronto, Canada, visited the emergency department multiple times, complaining of extreme daytime sleepiness and slurred speech.
Dr Rahel Zewude, an infectious disease specialist at the University of Toronto who was involved in her care, told CNN: “She visited her family doctor again and again and went to the emergency room seven times over two years."
The woman had been on several antibiotic courses to treat recurrent urinary tract infections (UTI), alongside a proton pump inhibitor to reduce the amount of acid in her stomach.
Despite not indulging in booze, she also had elevated blood alcohol levels and her breath reeked of the stuff too.
Both the woman and her family repeatedly told doctors that she didn't drink due to religious reasons.
Yet, after each hospital visit, she was discharged with the diagnosis of alcohol intoxication.
After being sent home, the patient still needed up to two weeks off work to recover from each episode of slurring and extreme sleepiness. During this time she ate very little.
Her symptoms would get better after one to two weeks, but would return every one to two months later.
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On her third hospital visit, the mum was even certified under the Mental Health Act. She discharged herself before undergoing psychiatric assessment.
It wasn't until her seventh A&E visit that an emergency doctor thought auto-brewery syndrome might be the cause of the woman's strange symptoms.
She was prescribed medication and referred to a dietitian, who found that carbohydrate-heavy meals would lead to a rapid rise in the patient's blood alcohol levels.
According to Dr Zewude, the mum's string of drunken symptoms started after she went on multiple rounds of antibiotics, which killed off beneficial bacteria in her gut and allowed harmful fungi to take over.
Needing fuel, the fungi in her gut began turning every carb she ate into alcohol.
'SUBSTANTIAL CONSEQUENCES'
Dr Zewude: “If she didn’t eat many carbs, the symptoms weren’t so bad.
"But then she might have a slice of cake or another big carbohydrate meal, which led to a rapid rise in her alcohol level.
"These were the times where she might be getting lunch ready for her kids and just fall asleep.”
After following a low-carb diet for a month and taking a course of anti-fungal medication, the woman's symptoms went away and remained absent for four months.
She slowly started to eat carbohydrates again, but one month after doing this she had a recurrence of slurred speech and drowsiness, which led to a fall.
She was advised to restart the low-carbohydrate diet again, and her symptoms resolved.
Writing in the Canadian Medical Association Journal, Dr Zewude and her co-authors, said: "Auto-brewery syndrome carries substantial social, legal, and medical consequences for patients and their loved ones.
"Our patient had several (emergency department) visits, was assessed by internists and psychiatrists, and was certified under the Mental Health Act before receiving a diagnosis of auto-brewery syndrome, reinforcing how awareness of this syndrome is essential for clinical diagnosis and management."
A brewery worker was recently slapped with a drink-and-drive charge before it was discovered he suffers with ‘auto-brewery syndrome’.
