In a recent paper, Dinis-Oliveira outlined his own theory for what creates the optimal conditions for ABS to develop. He describes it as a “perfect metabolic storm” where the pH of the stomach increases and combines with food stagnation and the backflow of food into the stomach from the intestines, as seen in certain medical conditions.
Carson, the 64-year-old ABS patient from the UK, recently discovered he suffers from a genetically inherited disorder that affects the connective tissues in his body, known as hypermobile Ehlers Danlos Syndrome (hEDS). These connective tissues are primarily composed of the protein collagen and tend to provide support to other tissues in the skin, tendons, ligaments and blood vessels, as well as in some internal organs. Patients with hEDS can have hyper-flexible joints, but it also affects the digestive tract, where it can cause abnormal movements of the involuntary muscles that control digestion. This can make a patient’s gut more sluggish, leading to a delayed emptying of the stomach contents into the small intestine. (Read more about the effects of Ehlers Danlos Syndrome.)
No link has been studied yet between hEDS and ABS, but Carson believes this delayed emptying of his stomach could have contributed to his own ABS. Around one in 5,000-20,000 people suffer from hEDS, so more research is needed to determine if there is a link.
Cordell believes there could be other causes too. “We’ve also learned much more about dietary triggers and external triggers such as solvents/chemicals, pollution, stress, and trauma in causing ‘flares’ of endogenous alcohol production,” she says.
Solvents are something Carson has associated with his own ABS – one of his early experiences with ABS occurred shortly after he had re-sealed a wooden floor using products containing volatile organic compounds. However, as solvents themselves can cause intoxication if inhaled, this relationship requires more research.
Following a strict diet guided by nutritionists, combined with antifungal treatments and multivitamins has allowed Carson to get his own ABS under control. “It is like a tightrope walk still,” he adds. “I am constantly saying: ‘Am I ok, am I alright?’ When I am feeling a bit tired, we do a breath-analyser.”
For Carson the most upsetting part of his experience with ABS has been the effect it has had on his mental health. He uses the “mind palace” memory technique made famous by the TV series Sherlock as an analogy. In the TV show, the Sherlock Holmes describes how he recalls information by keeping it stored in imagined rooms inside a large building – as an analogy.
“When I am in that blackout state, I no longer have access to the mental rooms of these events,” says Carson. “This is extremely unsettling and you end up doubting yourself.”
Carson says while he knows these episodes have taken place from his family, his own memories of them frustratingly out of reach. “There are several rooms where I cannot get into, as those rooms are locked and I have to accept that I will never get to them,” he says. “It is not that the memories are not there, it is just that in your conscious state you cannot access them.”
But as Carson has learned more about his condition, and what might be causing it, he and his wife hope fewer of those rooms will be locked in the future.
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