He seemed drunk without taking a sip of alcohol. It took years to get the rare illness diagnosed

For nearly 10 years, Eric Poulin has been having episodes where he seems drunk — without taking even out a sip of intoxicant.

The Nova Scotia adult male has auto-brewery syndrome. His gut produces ethanol at a value faster than his metabolic process can clear it, causing him to become intoxicated even though he's had no alcohol.

At home, he was having distressing episodes he had no recollection of.

"I'd have the kids tell me things happened, that I was crying and saying I was going to die," he said in an interview. "I don't remember any of it."

Auto-brewery syndrome is rare. According to the Cleveland Clinic, fewer than 100 cases have been documented. It is also understudied, making it difficult to identify and diagnose. 

The syndrome is caused by an imbalance of microorganisms in a person’s gut, said Dr. Rahel Zewude, who was not aware of Poulin's particular case but has treated patients with auto-brewery syndrome.

“The bacteria, fungi that are able to ferment alcohol become the predominant species in the gut of that person, so that leads to that continuous gut fermentation, high levels of alcohol and intoxication symptoms,” said Zewude.

Poulin’s symptoms, which can include slurred speech, smelling like alcohol and impaired cognition, often emerge unpredictably.

Dr. Luke Chen, a hematologist and professor in the department of medicine at Dalhousie University, has an interest in rare diseases and is helping Poulin get the support he needs.

“The difficult thing with rare diseases is that once you get a diagnosis, the journey is not over yet, you have to get to the right treatment,” Chen said. 

Auto-brewery syndrome is usually managed by following a low-carbohydrate diet and taking antifungal treatment. Poulin tried to cut carbs out of his diet years ago, but he continues to have symptoms. Experts have guided him through antifungal treatment as well, but with no success. 

Another route Poulin’s team is exploring is a fecal microbiota transplant — a treatment meant to restore healthy gut bacteria — in the form of a capsule.

Poulin's wife, Sarah, keeps a close eye on his symptoms and advocates for his case. She believes auto-brewery syndrome is probably underdiagnosed.

She is launching an app called ABStrack that helps people with auto-brewery syndrome track their symptoms and present them to health-care professionals.

"It might help people who are in Eric's situation where they know something's wrong and maybe people don't believe them, think they're closet drinkers," Sarah Poulin said.

Meanwhile, Poulin lives his life at the whim of auto-brewery syndrome. He hasn’t been able to work since 2023 because of his condition, and said it's also been difficult to be a father to his five kids. 

“I don’t know what’s going to happen day to day, hour to hour, so that really leaves a lot of limitations on what I can do, where I can go, work, money, everything," he said.

"My whole life has been flipped upside down by this."

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