One man was charged with drink driving after crashing his truck and spilling 11,000 salmon onto a highway in Oregon. Another was secretly recorded by his wife, who was convinced he was a closet alcoholic. And in Belgium, a brewery worker was recently pulled over and given a breathalyser test, which said that his blood alcohol level was more than four times the legal limit.

The problem? None of those men had been drinking: they all were diagnosed with a rare condition known as auto-brewery syndrome, in which a person’s gut ferments carbohydrates into ethanol, effectively brewing alcohol inside the body.

This week, the man in Belgium was acquitted of a drink-driving offence – he wasn’t a boozer, the court found; his body was essentially making its own beer.

It’s the latest turn in the spotlight for the strange disorder, which periodically appears in a flurry of headlines after a particularly odd or egregious case. Most incidents involve accusations of drink driving, when people who have the disorder, known as ABS, get behind the wheel of a car believing they are sober. Reactions to such defences often range from admiring to dismissive, but medical doctors and science have long backed up that the strange condition does exist.

The condition has been studied in some capacity for more than a century. When a person with the syndrome ingests carbohydrates, fungi in their gastrointestinal tract converts it into ethanol. The process brings on all the normal effects of inebriation – lack of co-ordination, memory loss, aggressive behaviour – without the alcohol consumption.

Perhaps most confounding is that the disorder can cause blood alcohol levels in people that would be lethal if achieved conventionally. One woman, who was pulled over in New York and breathalysed after having a flat tyre, measured 0.4, a level that is considered to be potentially fatal. While many people with the condition do exhibit the more traditional effects of alcohol consumption, others have been known to behave mostly sober, even when tests show they clearly are not.

In Belgium, the brewery worker – a 40-year-old man who wishes to remain anonymous, according to his lawyer – was pulled over by the police in April 2022 and registered a blood alcohol reading that was more than four times the legal limit. A month later, he was pulled over again and registered more than three times the limit.

It was the third time the man had been cited – he had been pulled over and fined for driving under the influence in 2019. He was unaware that he had ABS until his latest charge – tests administered by three doctors confirmed that he had the condition and validated his claim in court.

“I think he was somehow relieved that he finally knew what was up,” the man’s lawyer, Anse Ghesquiere, said. Her client is now following a strict diet and receiving medical treatment to avoid flare-ups and manage the condition.