Sometimes your own stomach can get you drunk
We explore some of Wikipedia’s oddities in our 6,150,520-week series, Wiki Wormhole.
This week’s entry: Auto-Brewery Syndrome
What it’s about: A party in your stomach, and everyone brought booze! Auto-brewery syndrome (ABS) is a not-as-fun-as-it-sounds condition where gastrointestinal bacteria or yeast start fermenting the carbs you eat, creating alcohol in the stomach, which renders the sufferer intoxicated. In other words, your own body starts spontaneously getting you drunk, and damn that isn’t the most logical response to 2020 we’ve ever heard.
Biggest controversy: Much like alcohol itself, doctors may be the cause of, and solution to, all of life’s problems (or this one, at least). There’s a high correlation between ABS and various types of abdominal surgery. Removing part of the small intestine (a procedure usually done because of Crohn’s disease or necrotising enterocolitis) may mean carbohydrates aren’t absorbed properly, leaving them to ferment and then be absorbed further down the digestive tract by the large intestine. Surgically dilating the duodenum (the first section of intestine leading out of the stomach) can have a similar effect.
Strangest fact: While there’s only one recorded case, the bladder can also make you pee out booze. The patient in question was diabetic, and there was enough sugar in their bladder that the yeast (presumably from an infection, but Wikipedia simply says “the yeast” and doesn’t elaborate) fermented. They weren’t inebriated (stomach alcohol then passes through the intestines where it’s absorbed; bladder alcohol is pretty quickly expelled from the body), but their urine smelled like wine. Which means it’s only a matter of time before a subculture of urine-wine snobs develops.
Thing we were happiest to learn: ABS is pretty easily treatable. The cause can sometimes be yeast causing fermentation, in which case doctors prescribe an antifungal medication. Otherwise, the prescription is probiotics and a high-protein, low-carb diet, so if you’re following trendy health fads, you’re probably already fighting off brewery syndrome without even realizing it.
Thing we were unhappiest to learn: ABS can be part of a vicious cycle. One of the potential causes is cirrhosis of the liver, which can lead to elevated levels of ethanol in the body, which in turn can contribute to cirrhosis of the liver.
Also noteworthy: The brewery in your gut doesn’t card. A 13-year-old girl once developed ABS after eating a meal high in carbs. She had two forms of yeast in her system—C. glabrata and S. cerevisiae—that converted the carbs to alcohol, getting the girl drunk.
Best link to elsewhere on Wikipedia: Since most of the links on the ABS page are to thrilling topics like enterococcus faecium or pyruvate decarboxylase, we’re going to go two steps away, past alcohol intoxication (a downer of a page which focuses on alcohol’s negative effects and blows right past the fun, exciting side of alcohol that leads to the negative effects), and on to the alcohol enema, a practice also known as butt-chugging. We assumed this would be the exclusive province of your lower-rung fraternities, but the only practitioners mentioned here are the ancient Maya, who often added psychotropic drugs to their alcohol enema, “seeking to reach a state of ecstasy,” and a 58-year-old Texas man who died after his wife administered an alcohol enema of three liters of sherry. (The man was an alcoholic who could no longer imbibe due to a throat injury.) A 52-year-old man (state unknown, but let’s just say Florida) was also found dead while still connected to an enema bag full of white wine. Regardless of your rectum’s drink of choice, butt-chugging can be extremely dangerous because the lower intestine absorbs alcohol faster than the stomach, so besides getting severely drunk quickly, the rush of alcohol hitting all at once can overwhelm the liver. The body also can’t reject a high level of alcohol by vomiting. We didn’t think The A.V. Club would ever need to make this public service announcement, but if you’re reading this, please don’t inject alcohol into your butthole.
Further Down the Wormhole: ABS is part of Wikipedia’s category on psychoactive substance-related disorders, which includes medical terms like positional alcohol nystagmus and post-acute-withdrawl syndrome, but also has decidedly non-medical terms like the bad trip, a “frightening and unpleasant experience” caused by hallucinogens. Film has tried to recreate the phenomenon of a bad trip—literally, in any number of psychedelic films of the late ’60s and early ’70s, and figuratively, in the case of the Acid Western. The subgenre is characterized by a dreamlike and apocalyptic tone drawn from ’60s counterculture. From Alejandro Jodorowsky’s 1971 El Topo (for which Pauline Kael coined the term “Acid Western”) to Jim Jarmusch’s 1996 Dead Man, Acid Westerns reverse the genre’s traditional portrayal of the journey west as one of liberation and rebirth; instead the West is chaotic and nightmarish, and the journey leads toward death.
The Acid Western page ends with a ridiculously thorough rundown of film genres, including everything from Beach Party to Body Swap to Mexican Sex Comedy to Nunsploitation to Italian Futurist. That last term was short-lived, encompassing a handful of films from 1916 to 1919, but it was part of a larger Futurist movement, based largely in Italy and Russia, which glorified modernity and applied its ethos to art, architecture, literature, dance, and even food. Can an art aesthetic produce good recipes? We’ll dig in next week.