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Endogenous ethanol production in a patient with chronic intestinal pseudo-obstruction and small intestinal bacterial overgrowth

Spinucci, Giulio; Guidetti, Mariacristina; Lanzoni, Elisabetta; Pironi, Loris

European Journal of Gastroenterology & Hepatology: July 2006 - Volume 18 - Issue 7 - p 799-802
doi: 10.1097/01.meg.0000223906.55245.61
Case Reports

The case of the gastrointestinal production of ethanol from Candida albicans and Saccharomyces cerevisiae in a Caucasian man with chronic intestinal pseudo-obstruction is reported. The patient, who declared to have always abstained from alcohol, was hospitalized for abdominal pain, belching and mental confusion. The laboratory findings showed the presence of ethanol in the blood. Gastric juice and faecal microbiological cultures were positive for C. albicans and S. cerevisiae. At home, he was on oral antibiotic therapy with amoxicillin plus clavulanic acid for a small bowel bacterial overgrowth, associated with a simple sugar-rich diet. Twenty-four hours after stopping both the antibiotic therapy and the simple sugar-rich diet, the blood ethanol disappeared. A provocative test, performed by giving amoxicillin plus clavulanic acid associated with the simple sugar-rich diet was followed by the reappearance of ethanol in the blood. A review of the literature is reported.

Centre for Chronic Intestinal Failure, Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy

Correspondence to Loris Pironi, MD, Centre for Chronic Intestinal Failure, Department of Internal Medicine and Gastroenterology, S. Orsola-Malpighi Hospital, University of Bologna, Via Massarenti, 9, Bologna 40138, Italy

Tel and fax: +39 51 6363073;

e-mail: loris.pironi@unibo.it

Received 21 September 2005 Accepted 24 March 2006

© 2006 Lippincott Williams & Wilkins, Inc.