B T Welch1, N Coelho Prabhu2, L Walkoff3, S W Trenkner3. 1. Mayo Clinic Department of Radiology, Rochester, MN, USA welch.brian@mayo.edu. 2. Mayo Clinic Department of Gastroenterology and Hepatology, Rochester, MN, USA. 3. Mayo Clinic Department of Radiology, Rochester, MN, USA.
Abstract
CLINICAL BACKGROUND: A 71-year-old male with 50-year history of Crohn's disease was evaluated for acute onset of dizziness and slurred speech. Blood ethanol levels were elevated despite abstinence from alcohol for over 30 years. CT enterography demonstrated massive dilation of the small bowel with anastomotic stricture. DISCUSSION: Auto-brewery syndrome may be considered in a patient with chronic obstruction or hypomotility presenting with elevated serum ethanol levels in the setting of high carbohydrate intake. Although treatment algorithms lack validation, judicious use of antibiotic therapy, carbohydrate control, and short courses of antifungal therapy have all been reported in the literature. Importantly, clinical consideration of 'auto-brewery' should be undertaken with substantial caution, given the lack of validated mechanisms linking endogenous ethanol production to peripheral blood ethanol.
CLINICAL BACKGROUND: A 71-year-old male with 50-year history of Crohn's disease was evaluated for acute onset of dizziness and slurred speech. Blood ethanol levels were elevated despite abstinence from alcohol for over 30 years. CT enterography demonstrated massive dilation of the small bowel with anastomotic stricture. DISCUSSION: Auto-brewery syndrome may be considered in a patient with chronic obstruction or hypomotility presenting with elevated serum ethanol levels in the setting of high carbohydrate intake. Although treatment algorithms lack validation, judicious use of antibiotic therapy, carbohydrate control, and short courses of antifungal therapy have all been reported in the literature. Importantly, clinical consideration of 'auto-brewery' should be undertaken with substantial caution, given the lack of validated mechanisms linking endogenous ethanol production to peripheral blood ethanol.
Authors: Ahmed B Bayoumy; Chris J J Mulder; Jaap J Mol; Maarten E Tushuizen Journal: United European Gastroenterol J Date: 2021-04-22 Impact factor: 4.623
Authors: Megan R Sanctuary; Jennifer N Kain; Shin Yu Chen; Karen Kalanetra; Danielle G Lemay; Destanie R Rose; Houa T Yang; Daniel J Tancredi; J Bruce German; Carolyn M Slupsky; Paul Ashwood; David A Mills; Jennifer T Smilowitz; Kathleen Angkustsiri Journal: PLoS One Date: 2019-01-09 Impact factor: 3.240