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A 50-year-old woman's potentially fatal disease was dismissed seven times by doctors — who accused her of being drunk.
The woman, from Canada, suffered the rare and intriguing condition auto-brewery syndrome, which causes alcohol to be produced in the body, leading to symptoms like slurred speech, sudden sleepiness and blurred vision - as if the patient is intoxicated.
However it took two years before she was diagnosed, as doctors ignored her insistent claims that she had not been drinking.
On one occasion an emergency physician wrongly diagnosed a psychiatric condition, and she was certified under the Mental Health Act, meaning doctors could treat her against her will.
Auto-brewery syndrome (ABS) causes carbohydrates in the stomach to be fermented, increasing ethanol levels in the blood and resulting in signs of intoxication
Alyssa Kelsch, 26, from Salt Lake City, Utah, was also diagnosed with the condition in 2018 after months of doctors appointments and specialists visits. Pictured: The tattoo artist with glassy eyes during an episode of feeling 'drunk'
Auto-brewery syndrome is a condition that affects less than 100 people worldwide and causes microbes in the gut to spontaneously convert sugar into alcohol.
It is thought to be triggered by a poor diet, antibiotics or other factors that lead to a dominance of yeast and other micro-organisms in the gut that help create alcohol.
The substance is absorbed into the bloodstream, making someone 'drunk' even if they haven't been drinking.
Two years before she was diagnosed, the woman started to become extremely sleepy during the day and would fall asleep suddenly while getting ready for work or making dinner, as reported in the Canadian Medical Association Journal.
She'd drink a glass of wine while on vacation, but in recent years, she had stopped drinking completely because of her religious beliefs.
The woman visited her family physician multiple times with excessive tiredness and also went to the ER with slurred speech, the smell of alcohol on her breath and falls caused by her drowsiness.
At her first ER visit, her alcohol level was 39 millimoles per liter (less than two is considered a normal level).
Doctors discharged her from the ER saying she was drunk, despite the fact there was no reports of her drinking, which was corroborated by her family.
During later visits, she had three separate assessments by psychiatrists who provided care related to addiction medicine at the hospital.
On her seventh visit to the ER, a diagnosis of auto-brewery syndrome was suggested.
She was referred to a dietician, who put her on a low carbohydrate diet, which eased her symptoms.
A low-carb, sugar-free diet helps by reducing the amount of yeast that accumulates in the intestines that would turn into alcohol in the stomach.
'Auto-brewery syndrome carries substantial social, legal, and medical consequences for patients and their loved ones,' said Dr Rahel Zewude, University of Toronto, of the doctors who documented the woman's case.
'Our patient had several [emergency department] visits, was assessed by internists and psychiatrists, and was certified under the Mental Health Act before receiving a diagnosis of auto-brewery syndrome, reinforcing how awareness of this syndrome is essential for clinical diagnosis and management.'
This is not the first time the bizarre illness has been documented in medical literature.
Alyssa Kelsch, 26, from Salt Lake City, Utah, was also diagnosed with the condition in 2018 after months of doctors appointments and specialists visits.
She had 'fruity breath', glossed over eyes, would break into fits of laughter and had slurred speech.
The tattoo artist now is on a course of anti-fungal medication to help stop her food from making her 'drunk.'