The Curbsiders Internal Medicine Podcast

#494 C. diff, Diarrhea, the Microbiome, and New Therapies with Dr. Cynthia Sears. Live from Johns Hopkins Grand Rounds

Mon, 11 Aug 2025

Dominate C. diff! Learn to distinguish colonization from infection, select first-line therapies, and counsel patients on recurrence prevention and microbiome recovery. We’re joined by IDSA past president and expert on foodborne and intestinal infections, Dr. Cindy Sears (Johns Hopkins University) for a comprehensive update on Clostridioides difficile (C. diff, Cdiff, CDAD, CDI).

Claim CME for this episode at curbsiders.vcuhealth.org!

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Show Segments

00:00 Intro

03:00 Guest bio and hobby

04:25 Case of Charles Fleur Fontaine

06:00 Risk factors and epidemiology

08:00 Antibiotic hierarchy of risk

10:00 Diagnosis, testing strategies

14:00 Defining severity

17:30 Treatment options

20:00 Microbiome recovery strategies

24:00 Probiotics and postbiotics

27:00 Infection control counseling

30:00 C. diff and colon cancer

32:00 Recurrent C. diff strategies

35:00 Why some FMT and bezlotoxumab were discontinued

38:00 Microbiota replacement therapies

43:00 Prophylaxis strategies

45:00 Future therapies and ongoing research

47:00 Audience Q&A

52:00 Outro

Credits

Written and Produced by: Matthew Watto, MD, FACP

Cover Art and Infographic by:

Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP

Reviewer: Sai S Achi MD,MBA,FACP

Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Technical Production: PodPaste

Guest: Cynthia Sears MD

Disclosures

Dr. Sears reports no relevant financial disclosures. Dr. Williams financial relationships disclosed include a Merck grant or research support. This relationship has not ended.

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Bonus: Hypermobility Q&A with Bendy Bodies Dr. Linda Bluestein

Thu, 07 Aug 2025

In this special bonus episode, Dr. Linda Blustein (Bendy Bodies https://bit.ly/m/BendyBodies) addresses listener questions about Ehlers-Danlos syndrome (EDS) and hypermobility spectrum disorders.

00:00 – Introduction

00:59 – Can PCPs diagnose hEDS without a geneticist?

03:19 – Limitations of the Beighton Score

05:40 – 2017 hEDS criteria & upcoming revisions

10:29 – How to find a knowledgeable provider

12:52 – SVT vs POTS in a patient with EDS family history

19:53 – How to ask your provider if they’re comfortable treating dysautonomia

22:17 – MTHFR variants and hEDS

29:23 – Celiac, gluten sensitivity & EDS

31:48 – Food allergy vs sensitivity testing

34:11 – Lipoedema and hypermobility

39:00 – LDN, Ketotifen, and Cromolyn

43:41 – Medication sensitivity in EDS/POTS/MCAS patients

45:47 – Wrap up and resources

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REBOOT: #452 NAFLD/MASLD with Dr. Elliot Tapper

Mon, 04 Aug 2025

We have a classic Curbsiders episode for you. Expert guest Dr. Elliot Tapper (@ebtapper) shares his framework for approaching NAFLD/MASLD and the treatment tools he recommends including lifestyle modifications and medications.

#493: Joint Pain in Older Adults with Dr. Una Makris

Mon, 28 Jul 2025

Intro

Case 1 from Kashlak

General approach to joint pain in older adults

Diagnosing osteoarthritis

Management of osteoarthritis in older adults
- Non-pharmacological interventions
- Pharmacological interventions: topicals, orals, injectables
- When to refer for joint replacement

Case 2 from Kashlak

Diagnosis of Late onset rheumatoid arthritis (LORA)
- Differential Diagnosis and Distinguishing features
- Lab work/Imaging
- When to refer to rheumatology

Approach to managing LORA
- The 5Ms framework
- Initial treatment with glucocorticoids
- Ageism as a driver of undertreatment in older adults
- Treating to target

Key takeaways

Outro

Credits

Producers, Writers and Show Notes: Joseph (Lee) Young, MD, Leah Witt, MD, Rachel Miller, MD

Cover Art and Infographic: Leah Witt, MD

Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP

Reviewer: Emi Okamoto, MD

Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Technical Production: PodPaste

Guest: Dr. Una Makris

Disclosures

Dr. Makris reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.

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REBOOT: #454 Kidney Boy on Managing Diabetes and Hypertension in CKD

Thu, 24 Jul 2025

Here is a classic Curbsiders episode with one of our favourite guests of all time, Dr Joel Topf.

Learn how to manage diabetes and hypertension in chronic kidney disease with expert tips from Kidney Boy, Kashlak’s Chief of Nephrology, Dr. Joef Topf @kidney_boy.

Finerenone is FDA approved for managing CKD in patients with diabetes. **Update as of July 2025: The non-steroidal mineralocorticoid recepter antagonist, finerenone is now FDA approved to treat heart failure with LVEF at or above 40% based on results of the FINEARTS-HF trial. **

Claim CME for this episode at curbsiders.vcuhealth.org!

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