Not Your Average Beer Gut!

Not Your Average Beer Gut!

When we hear reports of DUI stops, and arrests, and then hear the breath or blood test results, far too many people forget about the presumption of innocence unfortunately. In fact, when people learn what I do they often ask, "how do you defend someone when you can see the test results show them to be guilty?;" Or more often they state: "isn't that unfortunate that you can stay busy doing that?" No not all! This exposes the problem with blind reliance on what is thought to be the truth.


When we hear reports of DUI stops, and arrests, and then hear the breath or blood test results, far too many people forget about the presumption of innocence unfortunately. In fact, when people learn what I do they often ask, "how do you defend someone when you can see the test results show them to be guilty?;" Or more often they state: "isn't that unfortunate that you can stay busy doing that?" No not all! This exposes the problem with blind reliance on what is thought to be the truth. In EVERY DUI case there is an issue that calls the case into question, whether it is the breath tests, the blood test, the roadside sobriety tests, or even something as simple as the arresting officer having a file full of reprimands for dishonesty. The simple truth of the matter is this: one never knows until you take the time to investigate the investigation, the testing methods, and  sometimes even your client.

Not too long ago new a discovery was made, or rather re-discovered. The phenomenon of brewing alcohol in our own bodies. Autobrewery Syndrome. It was widely reported by NPR in the following article.

A 61-year-old man — with a history of home-brewing — stumbled into a Texas emergency room complaining of dizziness. Nurses ran a Breathalyzer test. And sure enough, the man's blood alcohol concentration was a whopping 0.37 percent, or almost five times the legal limit for driving in Texas.

There was just one hitch: The man said that he hadn't touched a drop of alcohol that day.

"He would get drunk out of the blue — on a Sunday morning after being at church, or really, just anytime," says Barabara Cordell, the dean of nursing at Panola College in Carthage, Texas. "His wife was so dismayed about it that she even bought a Breathalyzer."

Other medical professionals chalked up the man's problem to "closet drinking." But Cordell and Dr. Justin McCarthy, a gastroenterologist in Lubbock, wanted to figure out what was really going on.

So the team searched the man's belongings for liquor and then isolated him in a hospital room for 24 hours. Throughout the day, he ate carbohydrate-rich foods, and the doctors periodically checked his blood for alcohol. At one point, it rose 0.12 percent.

Eventually, McCarthy and Cordell pinpointed the culprit: an overabundance of brewer's yeast in his gut.

That's right, folks. According to Cordell and McCarthy, the man's intestinal tract was acting like his own internal brewery.

The patient had an infection with Saccharomyces cerevisiae, Cordell says. So when he ate or drank a bunch of starch — a bagel, pasta or even a soda — the yeast fermented the sugars into ethanol, and he would get drunk. Essentially, he was brewing beer in his own gut. Cordell and McCarthy reported the case of "auto-brewery syndrome" a few months ago in the International Journal of Clinical Medicine.

When we first read the case study, we were more than a little skeptical. It sounded crazy, a phenomenon akin to spontaneous combustion. I mean, come on: Could a person's gut really generate that much ethanol?

Brewer's yeast is in a whole host of foods, including breads, wine and, of course, beer (hence, the name). The critters usually don't do any harm. They just flow right through us. Some people even take Saccharomyces as a probiotic supplement.

But it turns out that in rare cases, the yeasty beasts can indeed take up long-term residency in the gut and possibly cause problems, says Dr. Joseph Heitman, a microbiologist at Duke University.

"Researchers have shown unequivocally that Saccharomyces can grow in the intestinal tract," Heitman tells The Salt. "But it's still unclear whether it's associated with any disease" — or whether it could make someone drunk from the gut up.

We dug around the scant literature on auto-brewery syndrome and uncovered a handful of cases similar to the one in Texas. Some reports in Japan date back to the 1970s. In most instances, the infections occurred after a person took antibiotics — which can wipe out the bacteria in the gut, making room for fungi like yeast to flourish — or had another illness that suppresses their immune system.

Still, such case reports remain extremely rare. Heitman says he had never heard of auto-brewery syndrome until we called him up. "It sounds interesting," he says. But he's also cautious.

This case has generated a large amount of discussion among DUI defense attorneys nationwide. The real question that this case presents for us is just how many of our clients over the years have suffered from this syndrome to a lesser extent than this extreme example? How many DUI charges have been based on false consumption, if you will? While reported as rare, there are several historical examples.

As a result I can’t help but wonder if, over the years, perhaps that rare person who swears they never drank a drop, or that client who swears they only drank one bottle of beer was, in fact, 100% innocent despite what the test read? If, indeed, they had this problem to a smaller extent than the Texas man did, how much did the syndrome that involuntarily contribute to the DUI arrest? Herein lies the problem with blindly believing your eyes - excuse the oxymoron pun.

Dedicated investigation of ALL aspects of a client’s case is mandatory. While this syndrome is only now making the headlines and therefore starting awareness, and educating the popular culture is in its infancy, and these cases that seem pretty far out, they are real. As a result, the fact they exist is exactly why defense attorneys that are focused and dedicated to DUI defense have been asking clients about health and stomach issues upon initial consult for years. Those of us well versed in the concept of breath testing are well aware that, the biggest problem with breath testing is the breath itself. Breath testing uses the same pathways to measure the air as those that are used to ingest alcohol. This pathway (the trachea), is frequently contaminated with contents of the stomach placed there by way of heartburn, hiccups, small amounts of vomit, or other regurgitation methods that seems minor, but frequently contaminate the pathway of breath testing.

This reported story of Autobrewery Syndrome in the medical Journal paper is what the medical community calls a "case report" and such reports are often the first of many reports of others with this condition. While this may seem a "convenient," way of reporting a rare condition as something more prevalent that is not yet the case. However, the importance of case studies is highlighted by the fact that historically, there was a "case study" of homosexual men in the San Francisco area with a rare tumor - Kaposi's sarcoma. Ultimately, this led to the discovery of AIDS as being a rather common disease not just an isolated report. Linking Autobrewery and AIDS is not the goal here, but rather, it highlights the evolution of knowledge. What is initially thought to be impossible does in fact exist. Perhaps it is more frequent than we think. Consequently, case reports, such as this, are an important mechanism to relate to the medical and scientific community. It means that there is fact something worthy that should be further investigated for diagnosis. Not only is this a medical investigative necessity, but it is also a legal necessity.

If you're charged with DUI and you know something else is "going on," because you know how much you drank and your test is radically different, make sure you mention it to your attorney. Better yet, when interviewing and choosing an attorney during the consultation period, ask about this; ask about his/her experience of dealing with challenging breath tests; experience in working with experts; experts previously interviewed used, and even cross examined. Mention the things that even sound crazy, but yet you think is important. Chances are, you could be onto something. While the rare phenomenon does exist, it does not mean that it will actually be the case for you. We need to make sure false claims are not being made and the defense, if present, MUST be used appropriately. It must be distinguished from an illegitimate excuse, versus being most appropriately applied.

Related Reading: Determination of Endogenous Ethanol in Blood and Breath by Gas Chromatography-Mass Spectrometry