Doctors have reported the first known case of a woman who urinates alcohol after a never-before-seen condition effectively turned her bladder into a microbrewery.

Reporting the unusual case in the Annals of Internal Medicine, the condition came to light when doctors at the University of Pittsburgh Medical Center Presbyterian Hospital were examining a 61-year-old woman for placement on the liver transplant waitlist. The woman was suffering from liver cirrhosis and diabetes, illnesses often associated with alcoholism and heavy alcohol use.

However, she claimed to rarely touch alcohol. Doctors were, understandably, skeptical about this claim at first because her urine tests for alcohol were repeatedly positive. Multiple doctors also advised her to seek treatment for alcohol use disorder, but she continued to insist she had not had anything to drink.

Then, some of the clinicians noted her urine test results for ethyl glucuronide and ethyl sulfate, substances produced by the break down of ethanol (alcohol), were negative. Equally, her blood tests came back negative for ethanol. This meant the alcohol was not in her bloodstream, so she didn’t report feeling drunk or intoxicated.

The strange set of circumstances eventually led the doctors to take a closer look at her pee. They discovered the woman’s bladder had become colonized with a strain of yeast called Candida glabrata, a fungus that's part of the normal human flora that’s closely related to brewer's yeast (Saccharomyces cerevisiae).

They took samples of the yeast, placed it in a petri dish under certain conditions, and watched whether it fermented. Lo and behold, the sample produced alcohol.

It appears that the woman’s bladder had effectively acted like a booze brewery. To make alcohol, whether its beer or hard liquor, you need water and sugar, paired with yeast and an absence of oxygen. The anaerobic (no oxygen) conditions make the yeast ferment the sugars into ethanol and carbon dioxide. The woman's urine contained sugar as a symptom of her poorly controlled diabetes. Paired with the yeast that had colonized her bladder, the conditions were ideal for fermentation and the production of alcohol. 

“I think the biggest reason for the patient to develop this condition is her poorly controlled diabetes because the bladder environment with high levels of glucose is definitely an optimistic condition for the growth and activity of the yeast,” Kenichi Tamama, study author and Associate Professor of Pathology, told IFLScience.

“And diabetes itself is also known to cause immune dysfunction, which should also contribute to this resilient yeast colonization in the bladder in this case.”

 The doctors eventually diagnosed the woman with a novel case of “urinary auto-brewery syndrome” or “bladder fermentation syndrome.”  

The “auto-brewery” effect has never been seen in a bladder before, although it has been documented a handful of times in the digestive system. Unfortunately, with this form of the condition, people report feeling tipsy and “foggy-headed” because the alcohol enters the bloodstream. It can also result in nausea, vomiting, impaired sensations, memory blackout, and even loss of consciousness.

All in all, it's not as fun as it might first sound.