title: Auto-brewery Syndrome in the Setting of Long-standing Crohn's Disease: A Case Report and Review of the Literature.
abstract: A 71-year-old male with 50-year history of Crohn's disease was evaluated for acute onset of dizziness and slurred speech. Blood ethanol levels were elevated despite abstinence from alcohol for over 30 years. CT enterography demonstrated massive dilation of the small bowel with anastomotic stricture.
  
  
  CONCLUSIONS
  Auto-brewery syndrome may be considered in a patient with chronic obstruction or hypomotility presenting with elevated serum ethanol levels in the setting of high carbohydrate intake. Although treatment algorithms lack validation, judicious use of antibiotic therapy, carbohydrate control, and short courses of antifungal therapy have all been reported in the literature. Importantly, clinical consideration of 'auto-brewery' should be undertaken with substantial caution, given the lack of validated mechanisms linking endogenous ethanol production to peripheral blood ethanol.
authors.affiliation: Mayo Clinic Department of Radiology, Rochester, MN, USA welch.brian@mayo.edu.
authors.forename: B T
authors.initials: BT
authors.lastname: Welch
authors.affiliation: Mayo Clinic Department of Gastroenterology and Hepatology, Rochester, MN, USA.
authors.forename: N
authors.initials: N
authors.lastname: Coelho Prabhu
authors.affiliation: Mayo Clinic Department of Radiology, Rochester, MN, USA.
authors.forename: L
authors.initials: L
authors.lastname: Walkoff
authors.affiliation: Mayo Clinic Department of Radiology, Rochester, MN, USA.
authors.forename: S W
authors.initials: SW
authors.lastname: Trenkner
mesh_terms: D000368:Aged; D003424:Crohn Disease / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging / Q000378:metabolism; D004040:Dietary Carbohydrates / Q000009:adverse effects; D000431:Ethanol / Q000097:blood*; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D013577:Syndrome; D014057:Tomography, X-Ray Computed
chemical_list: D004040:Dietary Carbohydrates; D000431:Ethanol