How to Get Drunk on Bread

It almost sounds like a Sherlock Holmes case: A 61-year-old man staggers into a Texas emergency
room feeling light-headed, nauseous, and dizzy. The nurses think he looks kinda hammered,
so they give him a Breathalyzer test, and sure enough, his blood alcohol concentration
clocks in at a very drunk .37 percent. But thing is, the guy claims he hasn’t had
a single drink today. In fact, he says he’s been experiencing
sudden and unexplained bouts of drunkenness for years. So what’s up? Is the guy a closet drinker?
Is he suffering some kind of amnesia, or sleep-boozing, or what? The doctors decide to check the man’s pockets
for hidden booze, then monitor him in an isolated hospital room for 24 hours. They have him
eat a lot of carb-heavy foods while staff take various readings and watch what happens
to his blood alcohol content. What they eventually find, is that the guy
has an over-abundance of brewer’s yeast in his digestive system, and it’s basically
turning his guts into a fermentation vat, converting carbohydrate sugars into ethanol,
and getting him sloshed. As you’ve probably guessed by now, this
story actually happened, back in 2010. And in the end, the man’s doctors diagnosed
him with auto-brewery, or gut fermentation syndrome. Basically, his digestive system
was turning carbohydrates into alcohol. Cue the beer belly jokes.… Here’s what his doctors figured was happening: When most people eat yeasty foods, the yeast
passes right on through their body. But sometimes it’s possible for that yeast to stick around
in larger numbers. The Texan man’s troubles seem to have started
after he completed a hardcore round of antibiotics that wiped out his good gut bacteria, eliminating
the competition and allowing yeasts and other fungi to take over. So whenever he’d eat carbohydrates, the extra
yeast in his digestive system would start fermenting those carbs into alcohol, which
would end up in his bloodstream. He was literally getting drunk on bread. The doctors treated the man by having him
take antifungal drugs and probiotics to restore his good bacteria. They also had him eat a
low-carb diet help to keep the yeast in check. Now, this wasn’t the first-ever case of auto-brewery
syndrome. Some children with short bowel syndrome — an
intestinal condition that makes proper nutrient absorption difficult — have also shown signs
of extra yeast causing intoxication. And researchers in Japan have documented similar
reports of serious digestive yeast infections and spontaneous tipsiness, dating back to
the 1970s. Even so, this syndrome is both rare and controversial,
because all we have is this handful of mysterious case studies. It’s just hard to figure out what’s actually
causing the problem without more research — like a controlled clinical trial. Plus, when it comes to getting drunk without
drinking, an over-abundance of yeast may not be the only factor involved. There’s also a problem with certain enzymes. Normally, alcohol gets broken down by particular
liver enzymes. But in some people, genetic mutations mean
they don’t produce those enzymes properly. So they can end up feeling drunk after drinking
a relatively small amount of alcohol. This mutation affects a disproportionate number
of Asian people — about one in three, which could help explain why Japan has the highest
number of reported gut fermentation syndrome cases. Combine extra yeast with a rice-heavy diet
and abnormal enzymes and you might find yourself getting accidentally sauced as those carbohydrates
turn to ethanol that doesn’t get processed quickly enough. It’s pretty easy to test for these enzyme
deficiencies, but so far there’s no definitive test for auto-brewery syndrome in people with
the usual enzymes. Since it’s so difficult to clearly diagnose,
it would be hard for researchers to set up studies and trials. So, until there’s a better way to diagnose
it, auto-brewery syndrome is a condition that will probably continue to be rare and mysterious. Thanks for watching this episode of SciShow,
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