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Bayoumy AB, Mulder CJJ, Mol JJ, et al. Gut fermentation syndrome: A systematic review of case reports. United European Gastroenterol J. 2021;9(3):332-342doi: 10.1002/ueg2.12062.
Bayoumy, A. B., Mulder, C. J. J., Mol, J. J., & Tushuizen, M. E. (2021). Gut fermentation syndrome: A systematic review of case reports. United European gastroenterology journal, 9(3), 332-342. https://doi.org/10.1002/ueg2.12062
Bayoumy, Ahmed B, et al. "Gut fermentation syndrome: A systematic review of case reports." United European gastroenterology journal vol. 9,3 (2021): 332-342. doi: https://doi.org/10.1002/ueg2.12062
Bayoumy AB, Mulder CJJ, Mol JJ, Tushuizen ME. Gut fermentation syndrome: A systematic review of case reports. United European Gastroenterol J. 2021 Apr;9(3):332-342. doi: 10.1002/ueg2.12062. Epub 2021 Apr 22. PMID: 33887125; PMCID: PMC8259373.
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United European Gastroenterol J. 2021 Apr;9(3):332-342. doi: 10.1002/ueg2.12062. Epub 2021 Apr 22.

Gut fermentation syndrome: A systematic review of case reports.

United European gastroenterology journal

Ahmed B Bayoumy, Chris J J Mulder, Jaap J Mol, Maarten E Tushuizen

Affiliations

  1. Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, The Netherlands.
  2. Department of Gastroenterology and Hepatology, Amsterdam UMC, Amsterdam, The Netherlands.
  3. Department of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands.
  4. Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, The Netherlands.

PMID: 33887125 PMCID: PMC8259373 DOI: 10.1002/ueg2.12062

Abstract

BACKGROUND: The gut fermentation syndrome (GFS), also known as the endogenous alcohol fermentation syndrome or auto brewery syndrome, is a rare and underdiagnosed medical condition where consumed carbohydrates are converted to alcohol by the microbiota in the gastrointestinal or urinary tract. The symptoms of GFS can have severe impact on patients' wellbeing and can have social and legal consequences. Unfortunately, not much is reported about GFS. The aim of this systematic review was to assess the evidence for GFS, causal micro-organisms, diagnostics, and possible treatments.

METHODS: A protocol was developed prior to initiation of the systematic review (PROSPERO 207182). We performed a literature search for clinical studies on 1 September 2020 using PubMed and Embase. We included all clinical studies, including case reports that described the GFS.

RESULTS: In total, 17 case reports were included, consisting of 20 patients diagnosed with GFS. The species that caused the GFS included Klebsiella pneumoniae, Candida albicans, C. glabrata, Saccharomyces cerevisiae, C. intermedia, C. parapsilosis, and C. kefyr.

CONCLUSIONS: GFS is a rare but underdiagnosed disease in daily practice. The disease is mostly reported by Saccharomyces and Candida genera, and some cases were previously treated with antibiotics. Studies in Nonalcoholic Fatty Liver disease suggest a bacterial origin of endogenous alcohol-production, which might also be causal micro-organisms in GFS. Current treatments for GFS include antibiotics, antifungal medication, low carbohydrate diet, and probiotics. There might be a potential role of fecal microbiota transplant in the treatment of GFS.

© 2021 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC. on behalf of United European Gastroenterology.

Keywords: Candida albicans; Saccharomyces cerevisiae; auto-brewery syndrome; drunkenness disease; endogenous alochol fermentation syndrome; gut fermentation syndrome; microbiota; nonalcoholic fatty liver disease; nonalcoholic steatohepatitis

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