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By Amy Norton<\/b>
HealthDay Reporter<\/i><\/p>\n
TUESDAY, Aug. 18, 2020 (HealthDay News)<\/p>\n
In a first, doctors have used a fecal transplant to treat a rare condition that causes the body to brew its own alcohol<\/a>.<\/p>\n The disorder, known as auto-brewery syndrome (ABS), occurs when yeast builds up in the gut and converts sugar<\/a> from food into alcohol<\/a>. The result is a lot like being drunk: Blood alcohol spikes, causing symptoms such as dizziness<\/a>, disorientation, coordination problems and mood changes<\/a>.<\/p>\n And as anyone with ABS knows, it’s a miserable and perplexing condition, according to Barbara Cordell, an adjunct professor at Panola College, in Texas.<\/p>\n Cordell is also president of the nonprofit Auto-Brewery Syndrome Information and Research. Her interest in the condition began through personal experience, when her husband developed symptoms — though it took years to trace them to ABS.<\/p>\n That is a typical scenario, Cordell said. Few doctors actually recognize and treat the condition, she noted.<\/p>\n That’s why the new case, reported Aug. 18 in the Annals of Internal Medicine<\/i>, is “exciting,” Cordell said. It’s the first known instance of doctors treating ABS with a fecal transplant — a procedure largely considered investigational.<\/p>\n Cordell said it could be a “breakthrough” for people with severe cases of ABS that do not respond to simpler fixes, like diet<\/a> changes.<\/p>\n Fecal transplants involve transferring stool<\/a> from a healthy donor into the patient’s gastrointestinal tract. The idea is to change the bacterial composition of the gut, hopefully to a healthier balance.<\/p>\n The procedure is sometimes used to treat severe gastrointestinal infections caused by Clostridium difficile<\/a><\/i> bacteria.<\/p>\n It is also being tested as a treatment for certain chronic gut conditions, including ulcerative colitis<\/a> and irritable bowel syndrome<\/a> (IBS<\/a>). Dr. Danny De Looze, of University Hospital Ghent, in Belgium, recently completed a study of patients with stubborn cases of IBS<\/a> — and found the transplant can ease their symptoms.<\/p>\n So when De Looze encountered a patient with severe auto-brewery syndrome, a light bulb went off.<\/p>\n “Knowing the success of (fecal transplant) in C. diff<\/i>, I thought it would be a good idea to treat him the same way,” De Looze said.<\/p>\n The patient, a 47-year-old man, had already tried the known conservative treatments for ABS: a low-carbohydrate diet<\/a> and anti-fungal medication. Yet his blood alcohol levels remained high and his symptoms persisted.<\/p>\n That all changed after the transplant, using a donation from the man’s adult daughter. Nearly three years later, he has remained symptom-free, according to De Looze. He also regained his driver’s license, which was taken away after a random police check found soaring blood-alcohol levels.<\/p>\n Whether fecal transplants will become an option for more ABS patients is difficult to predict.<\/p>\n ABS, itself, remains mysterious. But among the cases reported so far, there does seem to be a common denominator, Cordell said: Prolonged antibiotic use. It’s thought that in certain vulnerable people, that disrupts the gut’s normal bacterial makeup<\/a> in a way that allows alcohol-producing yeast to thrive.<\/p>\n De Looze’s patient started noticing symptoms one month after taking back-to-back courses of antibiotics. He’d also had gastric bypass surgery<\/a> 14 years prior.<\/p>\n According to Cordell, gastric bypass is thought to be one of the factors that makes people susceptible to auto-brewery syndrome. The same is true of certain conditions that disrupt the gut’s microbial balance — including Crohn’s disease, short bowel syndrome and obesity<\/a>.<\/p>\n “But some people with auto-brewery have no underlying conditions,” Cordell said. “We don’t know why they get it.”<\/p>\n Often, ABS does respond to a low-carb diet<\/a> and anti-fungal medication. But for particularly tough cases, Cordell said, a fecal transplant makes sense.<\/p>\n “We’re not talking about doing this for everyone,” she stressed. “But this is an option we’ve been thinking about for the sickest patients.”<\/p>\n De Looze said he would “certainly encourage” doctors to try the approach.<\/p>\n Ideally, he noted, a clinical trial would be done to formally test the treatment. “But since this is a very rare disease,” De Looze said, “it will be practically impossible.”<\/p>\n He added that his patient suffered no side effects. However, fecal transplants are not risk-free: The U.S. Food and Drug Administration recently warned that they can transmit serious infections. That was based on reports of six patients who developed new bacterial infections<\/a> after having fecal transplants to treat C. diff<\/i> infections.<\/p>\n![\"MedicalNews\"](\"https:\/\/images.medicinenet.com\/images\/HealthDay\/healthday.png\")
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