Cause and effect are the two pillars that the world operates on. Every action has a reaction. But what if you find a reaction that has no discernable action? A person was left stumped when they found alcohol in their urine without any alcohol consumption. Had her kidneys secretly applied for a liquor license? Or was it a medical condition called the 'urinary auto-brewery syndrome'. Probably the latter.
The Bizarre Case Of Peeing Alcohol
The first reported case of this bizarre condition was a woman in Pittsburgh. She could brew alcohol due to the fermentation of yeast in the bladder. The condition is called the ‘bladder fermentation syndrome’ or the ‘urinary auto-brewery syndrome.’ The findings of this study on the medical condition were reported in Annals of Internal Medicine.
It is different from the traditional auto brewery syndrome which takes place in the gastro intestinal tract, after the ingestion of carbohydrates, potentially making the person intoxicated even if they haven’t consumed alcohol. The doctors learned about the syndrome after the first case of the 61-year-old woman with liver damage and poorly controlled diabetes, according to a report on Science Alert. The case is found for the first time where alcohol can be brewed inside a person’s bladder irrespective of alcohol or carbohydrate consumption.
She visited the University Of Pittsburgh Medical Centre Presbyterian Hospital for a liver transplant waitlist but the doctors found something unusual. She was diagnosed with diabetes and live cirrhosis; however, she was removed from the registry and directed to a substance dependency treatment center instead. The doctors suspected that she had an alcohol problem but she denied any consumption.
They suspected that she had severe alcohol addiction because the urine tests for alcohol were consistently positive. The doctors in a report mentioned that the technicians believed she was hiding an alcohol use disorder as the tests were blatant.
Mystery Unsolved- How Did The Doctors Figure Out?
The doctors said that the plasma test results for ethanol and urine test results for ethyl glucuronide and ethyl sulfate which were the metabolites of ethanol were negative but the urine tests for ethanol were positive so something was missing. The patient kept denying that she consumed alcohol and did not show signs of being under any form of intoxication when she visited the clinic through her urine showed high levels of ethanol content.
The doctors were surprised to find large amounts of glucose in her urine which is a condition called Hyperglycosuria. The condition occurs when there are high levels of budding yeast in urine samples. The researchers wrote in the report that the findings led them to test whether the yeast colonizing in the bladder could ferment sugar to produce ethanol.
Kenichi Tamama of the University Of Pittsburgh Medical Center in Pennsylvania had performed various experiments to comprehend the medical condition. He discovered that the woman’s urine contained yeast. The mystery he solved was an uncommon one. He figured out, the diabetes induced a high level of sugar in the urine.
The team found high levels of ethanol production which could be due to the yeast fermenting sugar in the bladder. They tested her urine and the results led to bizarre results. The yeast was identified as Candida Glabrata which is natural yeast found in the body, it is similar to the brewer’s yeast but it has never been found in such abundance.
Not That Uncommon After All
The doctors tried to eliminate the yeast with anti-fungal treatments but it didn’t work because of the poorly controlled diabetes. Despite her condition, she was up for liver transplantation but none of the reports by the doctors could identify what the patient was suffering from. Through their research, they became aware of other reports, involving similar production of ethanol in urine but it was a post-mortem case and some experiments run in vitro.
The researchers mentioned that it was possible that other patients would have gone through this medical condition before but it would have been hard to recognize as the symptoms are unusual and unknown to the pathology. The doctors said the experience of two liver transplant teams at different institutions demonstrates that it is easy for them to overlook signals which auto-brewery syndrome can present.
Tamama says peeing alcohol isn’t a big deal as it has no impact on the patient’s health. Experts have made efforts to eradicate the yeast. The only case it was unsuccessful was because the patient had diabetes. The experts did not disclose further details of the patient but they have reconsidered the patient for liver transplantation.
The doctors reiterated that clinicians must be diligent about paying close attention to medical record documentation and laboratory results and should always investigate the event of incongruences. The experts published a report on this titled, ‘Urinary Auto-brewery Syndrome: A Case Report.’
And no, this can not be your excuse for being caught driving under the influence.