Imagine a scenario in which the authorities pull you over for DUI. You have not been drinking, and you tell them so. When tested, however, your results show an elevated BAC. Neither law enforcement nor the doctors who performed the testing believe you when you tell them that you have not had anything to drink.

Though it sounds like the stuff of horror movies, this precise scenario once played out for a driver in North Carolina. Law enforcement took the driver, a man in his 40s, to the hospital after he refused a breath test. Hospital staff tested his blood alcohol level and found it to be approximately 2.5 times the legal limit.

Neither the driver nor the test results lied. The driver’s own body produced the alcohol found in his bloodstream.

Rare medical condition

The man has a rare medical condition called gut fermentation syndrome, also known as auto-brewery syndrome. An alteration to the environment of the digestive tract can provide a habitat in which the yeast can grow. When the patient eats carbohydrates, the excess yeast in the upper digestive tract reacts chemically with them, producing alcohol that impacts the body.

Though the worldwide medical community has been aware of ABS since 1912, the first reported cases in the United States first showed up in the 1980s. The condition is often misunderstood, even by those within the medical community.

Similar symptoms

Part of the reason why ABS may go undiagnosed is that the symptoms it produces are identical to those of inebriation, including the following:

  • Gait changes
  • Drowsiness
  • Sour-smelling breath

One notable characteristic of ABS is that it can produce unusually high blood alcohol levels that do not affect the patient as severely as expected.

Once a diagnosis takes place, an ABS patient is likely to respond to antifungal medication that kills the yeast and relieves symptoms. Unfortunately, however, patients with ABS may receive skepticism from family members, medical professionals and law enforcement, who may think that they are lying to conceal a covert drinking habit or to avoid DUI arrest.