Fig. 2

Pathophysiology of bladder fermentation syndrome and gut fermentation syndrome. a In bladder fermentation syndrome, ethanol produced through alcoholic fermentation by Crabtree-positive yeast is urinary-eliminated without getting absorbed into systemic circulation because the transitional epithelium in the urinary bladder serves as a barrier to ethanol. b In gut fermentation syndrome, ethanol produced through alcoholic fermentation by yeast and/or bacteria is absorbed into systemic circulation through the columnar epithelium in the intestine, causing alcohol intoxication. A dysfunctional gut barrier caused by dysbiosis and ethanol may also be involved in its pathogenesis