Show Notes
Host Nicole Kupchik is joined by Dr. Kaveh Hoda to unpack one of the most overlooked drivers of sepsis: the gut. Often called “the motor of MODS,” the GI tract can push the body toward recovery, or accelerate systemic collapse. In this episode, Dr. Hoda explains the importance of microbiome diversity, the breakdown of gut barriers leading to leaks and inflammation, and how critical illness disrupts the small intestine. More importantly, he shares what clinicians can do to support GI function at the bedside, from early nutrition strategies and listening to bowel sounds, to C.diff management. Plus, Sepsis Survivor Hailey Bain shares her story of septic shock, which was triggered by a ruptured appendix and originally mistaken for gynecologic pain. Her experience highlights how sepsis can escalate if early warning signs are missed.
Featured Guests:
Kaveh Hoda, MD, Gastroenterologist, Hepatologist and Host of The House of Pod
Twitter @thehouseofpod
BlueSky @KavehMD
Key Takeaways:
The gut is a central driver, not a bystander in sepsis. The GI tract can ignite systemic inflammation, worsen organ failure, and shape overall prognosis.
Critical illness rapidly destroys microbiome diversity. Within days in the ICU patients lose microbial variety, a major blow to immunity, mucosal integrity, and gut resilience.
Even good bacteria can become harmful. Under stress and illness, bacteria that were once benign can act more virulent and contribute to sepsis progression.
Antibiotics, proton pump inhibitors, and ICU stress can compound damage. While necessary interventions, they also accelerate microbiome disruption, making the gut even more vulnerable
Clostridioides difficile, formerly known as clostridium difficile (C.diff) thrives when the microbiome collapses, however fecal microbiota transplant (FMT) has been changing the game. The transplant remains one of the most effective modern treatments for recurrent C.diff in critically ill patients.
Sepsis survivors can struggle with long-term gut and nutrition problems. Muscle wasting, anorexia, IBS, malnutrition and increased infection risk require holistic post-ICU care and high protein nutrition.
—
Get in Touch: [email protected]
Or Visit Us At: SepsisPodcast.org
Connect with Nicole on Socials: @nicolekupchik
Connect with Sepsis Alliance on Socials: @sepsisalliance
To Learn More About Sepsis, Visit Sepsis.org
Produced by: Human Content and Sepsis Alliance
Sepsis is a life-threatening emergency that happens when your body’s response to an infection damages vital organs and, often, causes death. In other words, it’s your body’s overactive and toxic response to an infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment. Sepsis can lead to severe sepsis and septic shock.
Sepsis Alliance is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
More from The Sepsis Spectrum
Sepsis doesn’t just overwhelm the body, it can turn the lungs into ground zero for multi-organ dysfunction. In this episode, host Nicole Kupchik sits down with Dr. Julie Bastarache to explore how sepsis triggers Acute Respiratory Distress Syndrome (ARDS) in a significant portion of critically ill patients. Dr. Bastarache explains why sepsis-induced ARDS isn’t a single entity but a spectrum of clinical, physiologic and biologic responses, each requiring its own approach. From the fundamentals of mechanical ventilation and why low tidal volume remains lifesaving, to the emerging, and surprising protective effects of GLP-1 receptor agonists, Dr. Bastarache’s reverse translational science bridges bedside observations back into the lab, to uncover new pathways and potential therapies. Plus, mental health counselor Kristan Seaford, shares her Sepsis Survival story of how pushing through the holiday season while caring for children sick with strep and the flu, led her to overlooking her own symptoms until she was fighting for her life.
Acute kidney injury (AKI) is far more dangerous and complex than previously understood. In this episode, host Nicole Kupchik sits down with Dr. Gonzalo Matzumura to break down what really happens inside the kidneys during sepsis. From disrupted renal perfusion, tubular cell injury, and overwhelming inflammation, clinicians and, more importantly, patients, face high stakes when it comes to treating sepsis-related AKI. Dr. Matzumura sheds light on why prevention, recognition, and calling in the nephrologist earlier can mean the difference between lifelong disease, kidney replacement therapy, and full recovery. We’re also joined by Josh and Chelsea Woodward who share their powerful sepsis survival story, recounting how just a few red spots on Josh’s skin quickly spiraled into a medical crisis, underscoring just how quickly AKI and sepsis can escalate and why awareness is essential.
In this episode, Nicole Kupchik sits down with Dr. Craig Jenne to unravel how the liver’s immune response shifts during sepsis. Together, they explore how an organ known for detoxifying and defending the body can actually fuel inflammation and injury. From leukocyte traps to immune misfires, we’re looking at the cellular chaos behind sepsis and what it takes to restore balance. A fascinating deep-dive for clinicians, researchers, and anyone curious about the unseen complexity of critical illness.
What if the key to controlling inflammation, and even saving lives from sepsis, lies not in the bloodstream, but in the brain? In this episode, Nicole Kupchik talks with Dr. Kevin J. Tracey, President and CEO of the Feinstein Institutes for Medical Research at Northwell Health, whose groundbreaking work in neuroimmunology and bioelectronic medicine is redefining how we understand the vagus nerve and how it communicates with the immune system to regulate inflammation. From surprising results of sheep studies to the promise of vagus nerve stimulation devices, Dr. Tracey explains how rethinking the body’s electrical signs could transform sepsis care, redefine inflammation, and reveal new frontiers in treatment. We also hear from Kimberly Emanuel, a sepsis survivor who endured the breakdown of her body systems before her remarkable recovery.
When sepsis strikes, the damage doesn’t always end with the infection. Nicole Kupchik is joined by Dr. Mitchell Elkind from the American Heart Association to explore how inflammation during sepsis can overwhelm the cardiovascular system, causing arrhythmias, heart failure, and even stroke. From acute AFib to long-term heart damage and the hidden role of cytokines, we dig into the silent injuries that outlast recovery. Plus, we hear a powerful firsthand story from sepsis survivor Mary Millard, whose cardiac journey illustrates the complex chain reaction that infection can trigger.