Endogenous ethanol fermentation in a child with short bowel syndrome

Acta Paediatr. 2006 Apr;95(4):502-4. doi: 10.1080/08035250500501625.


The term "auto-brewery syndrome" has been frequently used to describe patients who show features of alcohol intoxication because of abnormal yeast proliferation after ingesting carbohydrate-rich meals. We present a case of a 3-y-old girl with short bowel syndrome (SBS) who demonstrated signs of alcohol intoxication on repeated occasions. A blood test indicated an ethanol concentration of 15 mmol/l, and cultures from gastric fluid and faeces showed the presence of Candida kefyr. An association was found between the introduction of a carbohydrate-rich fruit drink and the occurrence of symptoms.

Conclusion: The possibility of endogenous ethanol fermentation should be considered in patients with SBS and the diagnosis of auto-brewery syndrome added to the differential diagnosis list for D-lactic acidosis. Management includes both antifungal treatment and special diet modification.

Publication types

  • Case Reports

MeSH terms

  • Beverages
  • Candida / physiology
  • Child, Preschool
  • Dietary Carbohydrates / metabolism*
  • Ethanol / metabolism*
  • Female
  • Fermentation / physiology*
  • Fruit / metabolism
  • Humans
  • Saccharomyces cerevisiae / physiology
  • Short Bowel Syndrome / complications
  • Short Bowel Syndrome / metabolism*
  • Short Bowel Syndrome / microbiology
  • Syndrome


  • Dietary Carbohydrates
  • Ethanol