Pathology
In the context of fisting, sepsis is a life-threatening condition that arises when the body over-responds to an infection within the fist chute. A cascade of events leads to widespread inflammation and organ dysfunction. The development of sepsis involves several key stages:
- Infection | Sepsis usually begins with an infection due to perforation of the bowel or microbial infection. Conditions such as ruptured diverticula, tears (fissures), and proctitis facilitate rapid colonization. Colonized lube can precipitate rapid infection.
- Immune Response | In response to the infection, the immune system releases chemicals into the bloodstream to help fight off the invading microorganisms.
- Inflammatory Response | Sometimes, these immune system goes haywire and causes inflammation throughout the body.
- Leaky Vessels | The inflammatory response causes blood vessels to dilate and leak fluid into surrounding tissue. The loss of blood volume triggers extremely high blood pressure.
- Clogged Vessels | Abnormal blood clotting begins, causing micro clots to form that impede blood flow.
- Organ Failure | The combination of inflammation, vasodilation, and clotting abnormalities can result in impaired blood flow to vital organs. This can lead to organ dysfunction or failure, affecting organs such as the kidneys, liver, lungs, and heart.
- Septic Shock | In severe cases, sepsis can progress to septic shock, characterized by a significant drop in blood pressure that can lead to multiple organ failure. Septic shock is a medical emergency and requires immediate intervention.

Figure 1.1: Pathology of Sepsis
A body-wide response to an infection resulting from poor fisting hygiene, excessively aggressive play without time for the fist chute to rest and recover, and perforation are all causes of sepsis.
Image courtesy of Medpage Today.
Early recognition and prompt treatment are crucial to improving outcomes for individuals with sepsis.
Injury Indices
Damage to Fist Chute
Low
Sepsis typically does not cause long term damage to the fist chute; however, septic shock (advanced sepsis) results in organ damage, including the intestinal tract. The severity of this damage may affect your ability to bottom.
Life-threatening Injury
Extremely High
Untreated sepsis will likely result in death within 24 to 48 hours of its development.
Probability of Condition
Very Low
The likelihood of developing sepsis is extremely low with traditional fisting. Untreated perforations will almost always lead to sepsis.