A hidden army of gut microbes can manufacture alcohol inside the body — and scientists may finally know how to stop it.
Scientists have identified specific gut bacteria and biological pathways that cause alcohol to be produced within the body in people with Intestinal Fermentation Syndrome (ABS).
This rare condition and often misunderstood causes individuals to become intoxicated despite not having consumed alcohol.
The was led by researchers at Mass General Brigham, in collaboration with the University of California, San Diego, and was published this Thursday in the journal Nature Microbiology.
Gut Fermentation Syndrome develops when certain intestinal microbes break down carbohydrates and convert them into ethanol (alcohol), which then enters the bloodstreamexplains .
Small amounts of alcohol can be produced during normal digestion in anyone, but in people with ABS, these levels can rise high enough to cause noticeable intoxication.
Although the condition is extremely rare, researchers believe it is often neglected because many clinicians do not know it, the diagnosis is difficult and social stigma can discourage adequate assessment.
People with ABS often experience years without a correct diagnosis. During this time, they may face social isolation, medical complications and even legal problems due to inexplicable drunkenness.
Confirming the condition is challenging because the diagnostic method considered standard requires carefully supervised alcohol testing over time, which are not widely available.
To better understand what triggers the disease, researchers studied 22 people diagnosed with ABS21 of their unaffected housemates, and 22 healthy control participants. The team analyzed and compared the composition and activity of gut microbes in the three groups.
When stool samples collected during active ABS attacks were tested in the laboratory, the patients’ samples produced much higher levels of ethanol than samples from their peers or healthy controls.
This finding suggests that the stool-based tests could one day help doctors diagnose the condition more easily and accurately.
Until now, scientists had limited knowledge about which specific microbes were responsible for Intestinal Fermentation Syndrome.
Detailed stool analysis revealed that several bacterial species appear to play a fundamental role, including Escherichia coli ea Klebsiella pneumoniae.
During symptom flares, some patients also experienced markedly elevated levels of enzymes involved in fermentation pathwayscompared to control participants.
The researchers note that although these organisms have been identified in some patients, determining the exact causative microbes in each individual remains a challenge. complex and time-consuming process.
The research team also closely followed a patient whose symptoms improved after receiving a , when other treatments had failed.
Os periods of relapse and remission closely corresponded to changes in specific bacterial strains and metabolic activity in the gut, reinforcing the biological evidence behind the diagnosis.
After a second fecal transplant, which included a different antibiotic pretreatment, the patient remained symptom-free for more than 16 months.
“Intestinal Fermentation Syndrome is a poorly understood condition with few tests and treatments. Our study demonstrates the potential of fecal transplantation,” said the senior co-author. Elizabeth Hohmannresearcher at Mass General Brigham.
“More comprehensively, by determining the specific bacteria and microbial pathways responsible, our findings could pave the way for easier diagnosis, better treatments and a improved quality of life for individuals living with this rare condition.”
