Drunk without drinking: local doctor and patients detail life with Auto-Brewery Syndrome
NEW YORK (WABC) -- Is it possible to be drunk without drinking?
Former New Jersey resident Mark Mongiardo would assure you it is.
Mongiardo has Auto-Brewery Syndrome, or ABS. It's a rare condition in which the body makes alcohol.
Mongiardo says his symptoms first emerged in 2006.
He was working as a high school teacher and coach in New Jersey, when staff at the school started complaining he smelled of alcohol.
Mongiardo said he never drank at work.
"I would never do that. I'm a teacher," Mongiardo told 7 On Your Side Investigates reporter Kristin Thorne. "It was very concerning to me. I really had no idea what was going on."
Mongiardo, who has never shared his story publicly until now, said administrators eventually placed him on paid administrative leave.
"I really could just see it in everyone's eyes," Mongiardo said. "They just really didn't believe what I said when I was saying I hadn't been drinking."
Mongiardo felt he had no choice but to leave the high school. He moved to Long Island with his wife and two children and got a teaching job there.
In 2018, three weeks into his new role as an athletic director, police pulled over Mongiardo.
He says police told him his car matched the description of a car someone had reported they saw someone littering from.
Mongiardo says, to his surprise, he had a blood alcohol content of .18 or .19. How could that be if he said he hadn't been drinking and didn't feel drunk?
"I kept telling my wife and my parents, I'm like, something's wrong with me, I have no idea what's going on," he said.
One afternoon in 2019, police pulled over Mongiardo for using his cell phone while driving and again, he was charged with drunk driving.
"During the school day, I had a meeting, I was forced to take a blood test and a breath test and I had alcohol in my system," he said. "I had no idea."
Mongiardo was put on paid administrative leave for the last two months of the school year and then administrators informed him his teaching contract wasn't being renewed.
"That's when I lost everything. I lost everything that somebody could lose," he said. "I had to sell my house, I had to sell my car. I couldn't get a job in education, I couldn't get a job at a grocery store. I had pending felony charges. You know, I was facing prison time for two DWI's when I had not been drinking."
Mongiardo says his mother started researching on Google whether the human body can make alcohol and that's when Auto-Brewery Syndrome came into the picture.
Mongiardo learned of gastroenterologist Dr. Prasanna Wickremesinghe on Staten Island, one of the few doctors in the world who specializes in the treatment of ABS.
Wickremesinghe took cultures from Mongiardo's intestines, did a blood alcohol content test in a controlled hospital environment and diagnosed Mongiardo with ABS.
"I started hysterically crying because I really felt that I had found the answer," Mongiardo said.
Dr. Wickremesinghe has been studying ABS since 2014 when he got his first ABS patient.
He believes ABS is triggered by antibiotics, which disrupts the floral in the gut and allows fungus and yeast to take over. When a person with ABS eats carbohydrates or sugar, the gut ferments alcohol.
"I've seen them go three times the DWI level in two hours," Wickremesinghe said of some of his patients.
Wickremesinghe said he has treated 30 patients for ABS, some from as far as Romania.
He says patients must undergo a colonoscopy and submit to an eight hour BAC test in a hospital. He said he requires most patients to come to Staten Island so Wickremesinghe himself can conduct all the tests.
He says during the BAC test, the patient is placed in an isolated environment, drinks a sugary liquid and their BAC is recorded every 30 minutes.
"We abort the test the moment it becomes positive," Wickremesinghe said.
He treats ABS with anti-fungals either orally or, if necessary, intravenously. He has patients follow a strict no-carb diet for the first six weeks and then a low carb diet for the months that follow as he attempts to lower the level of anti-fungal medication.
Wickremesinghe is getting ready to release the largest study ever on ABS using the patients he's treated. He says in addition to what he's uncovered about how to test for and treat ABS, he's also found that 60 percent of patients who have ABS suffer from acid reflux and 30 percent have anxiety or depression.
Wickremesinghe says he wants to make the medical community more aware of ABS.
"My major function now is to have this accepted by the medical community as a way of investigating and treating the patient," he said. "Like in anything in medicine, you won't make the diagnosis unless you think of the diagnosis."
He says he also worries about how the legal community views ABS.
The doctor treated a male patient in Ohio who was sentenced to two years in prison for drunk driving despite having ABS.
"My last patient was in Indiana and his judge didn't accept what he said. He was sent to jail for six months," Wickremesinghe said.
Michelle Giannotto, of Old Bridge Township, the wife of one of Wickremesinghe's former patients, is on a mission as well to make the medical and legal communities, as well as the public, more aware of the syndrome.
"This is a real medical condition and it can ruin people's lives," she said.
Giannotto's husband, Donato Giannotto, was diagnosed with ABS in 2016.
"After dinner he would start slurring his speech," Giannotto recounted. " I kept saying to his doctors, I don't know, he kind of looks like he's drunk."
Giannotto says she called more than 100 doctors across the country begging them to take her husband's case. "We were turned away by all of them" she said. "They'd never heard of it, they didn't know what to do, they didn't know how to treat it, they never had a case."
Giannotto said in January 2017 her husband had a sustained BAC of 0.3 for three days.
A doctor referred her to Dr. Wickremesinghe who began treating Donato Giannotto with anti-fungals through a pick line.
Before Donato's death in 2020, Giannotto and her husband became active within a Facebook support group for people with ABS. Giannotto continues to help people with ABS whom she meets on Facebook.
She says many of the people are living in a "private hell." "I don't know of any other medical condition where you need to hire a defense attorney for thousands and thousands of dollars and you're facing jail time and you're losing your job," she said.
It happened to Ray Lewis, of Oregon.
Lewis told Eyewitness News how in 2014 he crashed a tanker truck while at work, not because he was drunk, but because he couldn't negotiate a sharp turn. Lewis was badly injured in the crash.
Because of the severity of the accident, police took Lewis's BAC and he was charged with misdemeanor DUI.
"I was completely confused as how this could happen," he said. " I hadn't been drinking. Everyone's like, you could just plead guilty and I was like, I didn't do anything." Lewis was later diagnosed with ABS.
A judge still ordered Lewis pay $375,000 in restitution for damaging the state-owned tanker, do 120 hours of community service and attend AA meetings.
"Being charged with a crime for having a rare medical disease is just bizarre," Lewis said. " I'm not any different than anybody else that might have a disease and yet I'm treated that way in a court."
As for Mongiardo, he now lives in Florida with his family and is working at Target. He takes 30 pills a day to treat his ABS, follows a strict diet and takes a breathalyzer throughout the day, especially before getting behind the wheel.
The DWI charges against him were dismissed due to prosecutors' failure to prosecute him in a timely fashion. "I'm really coming out on the other side in a positive way," he said. "I'm happy I'm moving forward with my life."
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DO YOU NEED A STORY INVESTIGATED? Dan Krauth, Kristin Thorne, and the 7 On Your Side Investigates team at Eyewitness News want to hear from you! Call our confidential tip line 1-877-TIP-NEWS (847-6397) or fill out the form BELOW.
