ABNORMAL GUT FERMENTATION - THE AUTO-BREWERY SYNDROME

The ''auto-brewery'' syndrome, caused by yeast or bacterial fermentati on in the small intestine, is due to increased levels of blood ethanol resulting from abnormal gut fermentation. This causes psychological, musculoskeletal, gastrointestinal and respiratory problems and is diff icult to distinguish from other conditions, including food intolerance . Abnormal intestinal fermentation is associated with on alteration in gut permeability and B vitamin, zinc and magnesium deficiencies due t o malabsorption. Diagnosis is based an on oral glucose challenge with positive results indicated when blood ethanol concentration is greeter than 22 mu mol/L. Management of ''auto-brewery'' syndrome includes di etary restriction of fermentable simple sugars, refined carbohydrates, yeast products and mouldy foods. Antifungal drugs are recommended alo ng with vitamin and mineral supplements.