Automatic Beer Syndrome, a strange disease that makes you get drunk on your own even if you don't drink alcohol – BBC News Thai

A Belgian man recently made headlines after he was acquitted of drink driving. Even though his blood alcohol level was more than three times the legal limit. With the help of medical experts, the 40-year-old established that he had a strange disease called Automatic Brewery Syndrome (ABS) or a condition in which the body is unable to produce alcohol on its own. What is ABS? How did the dog help this man control this condition?

Ray Lewis was certain of two things when he woke up in a hospital in Oregon, USA. The first was that he was in serious trouble when he lost control of his truck carrying 11,000 salmon, which led to an accident. The vehicle belongs to the Department of Fisheries and Wildlife. The agency where he works as a technician

Secondly, even though the police reported that his blood alcohol level was high. But he did not drink a single beer on the night of the incident in December 2014.

“I didn't touch a single drop of alcohol. I knew I would have to drive the truck on icy roads for two hours,” the 54-year-old recalls.

Eight months later this biology technician was also diagnosed with ABS. He learned that his body produces alcohol and makes him drunk on its own.

(A social media post from Fox 13 Seattle shows the destroyed remains of a truck after Ray's car accident in 2014)

ABS, or gut fermentation syndrome (GFS), is a condition that remains mysterious. Which leads to high levels of alcohol in the blood until it causes symptoms of poisoning, even if the patient drinks little or no alcohol at all.

This condition occurs when bacteria in the intestine, urinary tract or oral cavity convert ingested carbohydrates and sugar into alcohol. This process is called alcohol production within the body

This condition causes patients to have slurred speech, staggered walking, and hangovers after drinking alcohol.

One of the first known cases of ABS was recorded in the 1940s in a hospital in Uganda and autopsy results were published in the British Medical Journal. The patient was a 5-year-old boy who died from a ruptured stomach. During the surgery, the doctor discovered that “the child's digestive system had a strong smell… and it was clearly the smell of alcohol.”

ABS is a very rare disease. A 2021 research article published in the American Journal of Gastroenterology found that fewer than 100 people have been diagnosed with the disease in the United States, although some experts estimate that there are likely many more patients who have not been diagnosed.

Doctors aren't sure why some people get the disease.

It is known that the human body produces small amounts of alcohol in the intestines. This is part of the digestion process. But in most people, these alcohols are eliminated before they enter the bloodstream.

“We all produce alcohol naturally. But people with ABS produce much higher amounts of alcohol. Which causes the alcohol to enter the bloodstream,” explains Dr. Ricardo Jorge Denis Oliveira, a biomedical consultant and forensic expert from Portugal who has published several studies. About this disease

“Unfortunately, in general, patients usually only become aware of their illness after a serious event has occurred, such as being accused of a crime.

Dr. Dennis Oliveira ABS has been compared to a “perfect metabolic storm,” meaning the disease is caused by a combination of factors. The first factor is often linked to a pre-existing health condition, such as diabetes, obesity or Crohn's disease, he commented. (Inflammatory bowel group diseases)

The second factor relates to medications that patients often receive, such as antibiotics and immunosuppressants. This affects our intestinal microbiota, bacteria and other organisms that live in our intestines.

When American nurse Joe Cordell began slurring his words and fainted during Thanksgiving dinner with his family, he thought he had eaten too much turkey.

But later, a colleague at the Texas hospital where he worked accused him of being drunk while working – a serious offense that could get him fired.

“They said my breath smelled like alcohol,” said Cordell, 75. “People thought I was an alcoholic.”

“I felt very embarrassed and ashamed. Because I am a person who loves to work and I have never missed a day of work.”

Even his wife Barbara suspected for some time that he had a drinking problem. As a nurse herself she still doesn't believe her husband. She even searched the house for hidden liquor bottles and monitored any alcoholic beverages found in the house.

“At first I was suspicious of Joe too, and I marked the bottles of alcohol we had and checked them to make sure they hadn't been eaten or drunk,” she admits.

In addition to strict accusations and investigations. Joe also said that he was afraid of the symptoms of diabetes that appeared without him realizing it.

“These drunk symptoms look really bad,” he said, “mentally and physically.”

Joe was diagnosed with ABS in 2010, four years after his symptoms first appeared, and continues to function. But the blood alcohol level should be checked every day.

This experience led Barbara to found a support and advocacy group for ABS called “Spontaneous Brewery Syndrome Advocacy and Research” which has approximately 850 members.

“Every day we hear stories from patients about being denied medical treatment,” she said.

“The worst is they were looked down upon, ridiculed, and called liars. They were accused of faking illness and were treated badly.”

She also said that many of the members she worked with all described alcohol withdrawal symptoms after they began their treatment plans.

“Over time, they become accustomed to drinking alcohol and resort to it to avoid feeling guilty.”

Joe said he felt a strong craving for alcohol. “I have to find a cure. But now I have stopped for 10 years.”

The doctor will begin a differential diagnosis to rule out other possibilities that may be causing the symptoms. The doctor may then conduct a blood test to analyze the amount of bacteria present in the patient's digestive system. To see if there is an abnormal distribution of alcohol-producing microorganisms.

In addition, doctors often perform a glucose response test. The patient will receive food high in carbohydrates or consume glucose on an empty stomach. After a few hours patients without ABS have almost undetectable blood alcohol levels. Meanwhile, patients with ABS have higher blood alcohol levels.

Dr. Dennis Oliveira says ABS can often be controlled with medication along with a low-carb diet. In addition to using nutritional supplements that help balance intestinal bacteria.

This method worked for Joe. Who had been asymptomatic for nearly a decade

But even Ray maintains a low-carb diet and abstains from any alcoholic beverages. He still has some side effects. Although there have been no severe symptoms since 2020

However, he found a way to help deal with this condition. That was a rescue dog named Mia.

This labradoodle has been trained to smell chemical changes in Ray's body. This includes early signs of alcohol in the stomach. When Mia discovered the change, she would stand in front of him and look intently.

“Before there was Mia. I rarely left the house for fear of what might happen to myself or others,” Ray said.

“When I had the accident the luck that still exists is that I didn't hit anyone. It was only me who got hurt.

Ray was not as lucky as many who are arrested for drunk driving. And when the medical illness was proven, they were acquitted.

The judge eventually saw through it and explains, “I'm still responsible for the alcohol in my system, regardless of how it got there.”

“I have a disease, no matter what the court decides. All that's left is to fight for what's right.

He and his wife Ciara are appealing the decision due to the impact of the lawsuit and the current ABS situation. Causing Ray to quit his job

But that didn't make him give up. Or you lose your sense of humor

“A lot of people think that people with ABS are free drinkers. I've only experienced this while drinking alcohol.”