What is 'Auto-Brewery Syndrome'? Man whose body makes alcohol beats DUI rap

"It's not that it's rare. It's that it's rarely diagnosed," Giannotto told Newsweek in an interview.

Her experience with ABS started when her husband, Donato, developed an infection after undergoing routine nasal surgery. The condition sent him in and out of the ICU for months as doctors tried to figure out why his body was swelling and his oxygen levels were plummeting. Eventually, after 18 hospitalizations in 14 months — and a DUI arrest on top of it — Donato was diagnosed with ABS.

His body was essentially brewing its own booze every time he ate carbs, leading him to feel and appear drunk. "His blood-alcohol level would go as high as .30 [more than three times the legal limit] when he ate a big plate of pasta," Giannotto said. "He felt off. But it didn't click in his brain that he was intoxicated."

The Giannottos eventually found Dr. Prasanna Wick, a gastroenterologist in New York City who has since become one of the leading experts in ABS. He's also an advocate for educating the medical community and general public about the condition.

"There are lots of judges and physicians who don't even accept this diagnosis," Dr. Wick told Newsweek. He believes the condition is triggered when certain people are exposed to antibiotics, such as post-surgery or for an infection.

"Antibiotics disrupt the microflora in the intestines, allowing fungi to grow and proliferate," he said. "The fine balance in the gut is lost."

The human body doesn't differentiate between alcohol that's consumed by drinking and alcohol produced by fermentation in the gut, according to Dr. Wick. That's why people with ABS can act and feel drunk — slurring their words and stumbling — despite not having had a sip to drink.

Some people who have the condition and don't know it will build up an increased tolerance to the alcohol their stomachs are producing over time — similar to how a functioning alcoholic will require more and more booze to reach the same level of inebriation.

In one case from 2015, a New York woman who claimed to have ABS was pulled over for driving on a flat tire and blew a .40, a blood-alcohol level that's often considered fatal. She felt merely "a bit wobbly on her feet," her attorney told CNN at the time.

In a separate incident that same year, an Oregon man was diagnosed with ABS after he crashed his truck into a telephone pole, spilling 11,000 salmon across the highway. In spite of his diagnosis by two doctors, he was still convicted of a DUI because he was not permitted to use his medical diagnosis as a defense even though he had not consumed alcohol, according to a GoFundMe set up for his legal defense. He is still fighting those charges today.

The good news, Dr. Wick said, is that ABS can be treated. Once it's determined that a patient has not been drinking, he will put them on a no-carb diet and introduce an anti-fungal treatment to kill the bacteria that's fermenting the alcohol before slowly reintroducing carbohydrates.

The bigger issue, according to Giannotto, is the lack of public awareness, which has led people to lose their jobs and even their freedom when employers, judges and prosecutors refuse to believe that such a condition even exists. "People's lives have been turned upside down over this," she said.

"There's no legal precedent or case law that says this is a medical condition."

Donato died in 2020. ABS was listed on his autopsy as a contributing factor, Giannotto said.

Update 4/25/24, 10:30 a.m. ET: This article was updated with additional information.

Update 4/29/24 9:00 a.m. ET: This article was updated with additional information.

Uncommon Knowledge

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Newsweek is committed to challenging conventional wisdom and finding connections in the search for common ground.

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