For nearly 10 years, Eric Poulin has been having episodes where he seems drunk — without taking even a sip of alcohol.
The Nova Scotia man has auto-brewery syndrome. His gut produces ethanol at a rate faster than his metabolism can clear it, causing him to become intoxicated even though he’s had no alcohol.
For years, he was dismissed by the health-care system as a closeted alcoholic. 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. This has made it difficult for Poulin to be taken seriously by the health-care system.
“The most difficult thing in medicine is to diagnose an atypical presentation of a rare disease,” said Dr. Luke Chen, a hematologist and professor in the department of medicine at Dalhousie University.
Chen has an interest in rare diseases and is helping Poulin get the support he needs.
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.
“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.
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 is launching an app called Abstrack that helps people with auto-brewery syndrome track their symptoms and present them to health-care professionals.
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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