There’s always a catch.
A 61-year-old woman has come into a lifetime supply of free alcohol that she can never enjoy, because she has to flush every drop of it down the toilet.
Researchers at the University of Pittsburgh say they’ve diagnosed the unidentified woman with “urinary auto-brewery syndrome.” The extremely rare and largely undocumented condition causes her to produce ethanol alcohol in her bladder and expel it through her urine.
They published the findings on Monday in the Annals of Internal Medicine journal, in the hope that other doctors will be able to recognize the same rare condition in patients who insist they are sober.
The study authors say they were alerted to the woman’s plight when she applied for a liver transplant. She already had “cirrhosis and poorly controlled diabetes,” but urine tests also suggested that she was an alcoholic, the paper said.
Staff at one hospital confronted the woman about her alleged alcoholism and urged her to seek a treatment program. She repeatedly denied the accusations, saying that she was sober and that she hasn’t been sneaking drinks.
The woman ultimately turned to the University of Pittsburgh’s School of Medicine and Medicinal Center, where doctors ran more intensive tests on her “drunk” urine.
“Initially, our encounters were similar, leading our clinicians to believe that she was hiding an alcohol use disorder,” researchers at the school wrote.
However, urine and blood tests revealed that the woman couldn’t have been slamming back booze on the side.
Urine tests found plenty of ethanol but none of the chemical markers left behind when the body metabolizes alcohol, the paper said. Doctors found no trace of ethanol in her blood.
There was also something weird about the bottles of urine they collected. The longer those bottles sat in the lab, the more alcohol doctors found in later tests.
Researchers suspect yeast in the woman’s bladder was essentially gobbling up the sugar in her urine and spitting out ethanol. That process, known as fermentation, is commonly used to brew beer.
Yeast and sugars in her urine also caused the lab samples to continue fermenting outside her body, the paper said.
The yeast was ultimately identified as Candida glabrata, a species that lives naturally in the body and is related to brewer’s yeast. This form of yeast doesn’t normally accumulate in the body in such large quantities, according to the paper.
The case echoes another documented instance of auto-brewery syndrome from the U.S. last year. In that case, a North Carolina man was pulled over for drunk driving despite never having touched a drop of alcohol.
Doctors later discovered that fungi in the man’s stomach were producing enough alcohol to get him drunk.
The Pittsburgh case is unusual because the woman showed no signs of intoxication, despite having enough alcohol in her body to impair her vision. The study suggests that the woman remained sober because the alcohol wasn’t getting into her bloodstream.
Doctors couldn’t get the yeast out of her bladder but they did manage to restore her to the liver transplant list.
The woman is thought to be the only living case of this type of auto-brewery syndrome.
In other words, she presents a golden opportunity for studying a little-known condition.