A Massachusetts man experienced severe inebriation due to his intestines autonomously producing alcohol, a condition known as autobrewer syndrome. His recovery began after ingesting fecal bacteria from a healthy donor.

This retired U.S. Marine, in his 60s, faced unusual symptoms following multiple antibiotic treatments for prostate inflammation. Until then, he maintained good health and only occasionally drank alcohol. His sudden, overwhelming intoxication left him disoriented and lethargic.

He sought help at emergency rooms repeatedly, but medical staff were skeptical about his claims of not drinking. Eventually, a diagnosis of autobrewer syndrome—a rare condition where gut microbes produce excessive alcohol—was confirmed.

His severe inebriation hindered routine activities, and he even required breathalyzer locks on his vehicles to avoid legal issues.

After connecting with a patient support group, he discovered fecal transplants could potentially treat his condition. This led him to contact Dr. Elizabeth Homan from Massachusetts General Hospital.

Initially, Dr. Homan dismissed his voicemail messages, as he sounded intoxicated. Eventually, the man’s wife reached out, explaining the situation, which prompted a collaboration with Dr. Bernd Schnabl, an expert on autobrewer syndrome. Together, they planned a fecal transplant for him.

Prior to the procedure, Homan, Schnabl, and their team conducted a comprehensive study on the causes of autobrewer syndrome. They analyzed stool samples from 22 patients with the condition and 21 healthy relatives, looking for variations in gut bacteria. “Our lab had a distinct smell,” Schnabl recollects.

The research revealed that fecal samples from patients produced significant alcohol when cultured, likely due to high levels of specific intestinal bacteria such as Escherichia coli and Klebsiella pneumoniae, which ferment sugars to create alcohol. Previous cases had primarily linked the syndrome to excessive yeast growth.

To treat the Massachusetts man, Homan administered oral capsules derived from a healthy male donor’s fecal matter, known for having an optimal gut microbiome. “This donor has been carefully selected and is a personal trainer who prioritizes fitness,” she explains. When the capsules were analyzed, researchers noted exceptional gut microbiota within them.

Gradually, the man’s autobrewer syndrome resolved as the harmful alcohol-producing bacteria in his gut were replaced with healthier strains from the donor. “One of the highlights of this case was meeting his daughter, a medical school graduate, who expressed gratitude for bringing her ‘old dad back,'” Homan shared.

Schnabl mentions that most individuals likely produce minimal alcohol in their intestines due to the presence of Escherichia coli and Klebsiella pneumoniae. However, significantly elevated levels lead to inebriating alcohol production, often triggered by long-term antibiotic use that disrupts the microbiome, which was the case for this patient.

Currently, Homan and Schnabl are conducting a large-scale trial to assess the effectiveness of oral fecal transplants for other patients with autobrewer syndrome.