[Chapters from alcohology].

Auto-brewery or intestinal fermentation syndrome is a rare disorder in which the symptoms of alcohol intoxication of varying severity develop without alcohol consumption. The fermentation activity of the altered intestinal microbiome is responsible for endogenous alcohol production. The set of symptoms not only raises differential diagnostic questions, but also has serious legal implications due to the resulting alcohol intoxication. The article reviews both the steps of diagnostic work and therapeutic options, the basis of the latter is the antifungal treatment. As the intestinal fermentation syndrome may lead to the development of non-alcoholic hepatic and pancreatic pathology, accurate diagnosis is important to prevent the development of such complications. Orv Hetil, 2024; 165(47): 1854–1859.