Gut Microbes Brew Alcohol: Donor Stool Transplants Offer Hope for Auto-Brewery Syndrome

Researchers detail auto-brewery syndrome (ABS), a rare condition where gut microbes convert carbohydrates into ethanol, causing involuntary intoxication. A Nature Microbiology study identifies overabundant bacteria (notably E. coli and Klebsiella) and fermentation pathways that drive ethanol production during flares, while fungal overgrowth is less central than once thought. The work also documents a successful treatment: a donor stool–derived capsule fecal microbiota transplant that produced long-lasting remission in at least one patient, implying a diagnostic framework and the potential for microbiome-directed therapies to manage ABS.