North Texas Research Forum 2024



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North Texas


Medical City Arlington


Internal Medicine

Document Type


Publication Date



gut fermentation syndrome, auto-brewery syndrome


Digestive System Diseases | Internal Medicine | Medicine and Health Sciences


A disorder known as "auto-brewery syndrome" or "gut fermentation syndrome" occurs when bacteria or fungus in the urinary, oral, or gastrointestinal tract ferment endogenously, producing ethanol. Patients with auto-brewery syndrome frequently report eating a diet heavy in sugar and carbohydrates and exhibit many of the symptoms and indicators of alcohol intoxication while disputing alcohol consumption. Research on Nonalcoholic Fatty Liver Disease indicates that endogenous alcohol synthesis may have bacterial roots; these bacteria may also be the causative agents in GFS. Probiotics, low-carb diets, anti-fungal medications, and antibiotics are currently used as therapies for GFS. Fecal microbiota transplantation may also have a part in the management of GFS. This case report discusses a case of gut fermentation syndrome complicated with NASH cirrhosis, esophageal varices, and portal hypertension. The case report further investigates the clinical presentation, diagnostic journey, complications, and therapeutic management of a patient diagnosed with auto-brewery syndrome. In this case report, we discuss a 50-year old male who had presented with recurrent anemia concerning for a GI bleed leading to multiple blood transfusions. Management included patient education regarding the condition and discussing lifestyle changes such as a strict adherence to a low carb, high protein diet. The case report further discusses the medico-legal implications commonly associated with gut fermentation syndrome.

Original Publisher

HCA Healthcare Graduate Medical Education

Gut Fermentation Syndrome: Unraveling the Enigma of Auto-Brewery Syndrome.



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