AbstractThe term “auto‐brewery syndrome” has been frequently used to describe patients who show features of alcohol intoxication because of abnormal yeast proliferation after ingesting carbohydrate‐rich meals. We present a case of a 3‐y‐old girl with short bowel syndrome (SBS) who demonstrated signs of alcohol intoxication on repeated occasions. A blood test indicated an ethanol concentration of 15 mmol/l, and cultures from gastric fluid and faeces showed the presence of Candida kefyr. An association was found between the introduction of a carbohydrate‐rich fruit drink and the occurrence of symptoms. Conclusion: The possibility of endogenous ethanol fermentation should be considered in patients with SBS and the diagnosis of auto‐brewery syndrome added to the differential diagnosis list for D‐lactic acidosis. Management includes both antifungal treatment and special diet modification.