> “Genetic predisposition for inactive aldehyde dehydrogenase enzyme and subsequent inefficient alcohol metabolism, may also play a role. In our patient, we sus

> “Genetic predisposition for inactive aldehyde dehydrogenase enzyme and subsequent inefficient alcohol metabolism, may also play a role. In our patient, we suspect her recurrent antibiotics for UTI and dexlansoprazole use led to gut dysbiosis with potential contribution of genetics, resulting in auto-brewery syndrome.” If the patient was genetically predisposed to have inactive ALDH, that would explain how they could reach such a high BAC without excess carbohydrate or exogenous alcohol consumption.