GHAPPcast

In this video, Amy Ladewski, PA-C, a physician assistant at Northwestern Memorial Hospital in Chicago, shares expert insights on how to develop a personalized treatment plan for irritable bowel syndrome with constipation (IBS-C). Amy explains why a one-size-fits-all approach doesn’t work, emphasizing the importance of reviewing each patient’s medical and psychosocial history, prior therapies, and most bothersome symptoms—whether constipation, abdominal pain, bloating, or distension. She highlights the role of FDA-approved therapies, gut-directed behavioral interventions such as cognitive behavioral therapy and hypnotherapy, as well as dietary strategies like the low FODMAP diet in optimizing care. Amy also stresses the importance of health literacy, insurance access, and collaboration with GI dietitians to ensure patients understand and can apply their treatment plan. For those with overlapping functional defecatory disorders, she underscores the value of diagnostic testing and pelvic floor physical therapy to achieve better outcomes. This holistic, individualized approach empowers patients with IBS-C to improve both bowel function and overall quality of life. For additional educational resources, visit GHAPP.org and the GHAPP ACE App.

In this episode, nurse practitioners Chantil Jeffreys, FNP, from Gastro One in Memphis, and Tuesday Werner, DNP, from Mayo Clinic Arizona, explore the vital role of community resources in supporting patients living with chronic hepatitis B. Drawing on over four decades of combined experience in hepatology and transplant medicine, they discuss practical ways clinicians can help patients connect with local and national support systems—from free screening and vaccination programs to educational workshops, mental health counseling, and advocacy initiatives. The conversation highlights trusted organizations such as the Hepatitis B Foundation, American Liver Foundation, and the CDC Hepatitis B Information Center, along with culturally sensitive programs like Asian Pacific Community in Action and 211 Arizona. Listeners will learn how education, early intervention, and advocacy can combat stigma, empower patients, and improve long-term outcomes.

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In this video, Amy Ladewski, PA-C, a physician assistant at Northwestern Memorial Hospital in Chicago, shares her expertise on having focused and meaningful conversations with patients living with irritable bowel syndrome with constipation (IBS-C) and other neurogastromotility disorders. Amy emphasizes the importance of building rapport, using a patient-centered approach, and assessing not only bowel habits but also quality of life outcomes—from the ability to work and attend school to participating in family and social activities without being limited by symptoms. She explains how to use tools like the Bristol Stool Scale, evaluate stool frequency and evacuation, and ask targeted questions about abdominal pain, bloating, and distension to determine whether current therapies are effective. Amy also highlights the need to monitor side effects, ensure predictability of treatment, and adjust therapies when symptoms remain uncontrolled. With several FDA-approved therapies available for IBS-C, patients do not need to settle for ongoing discomfort. This discussion provides clinicians with practical strategies to guide therapy decisions and empowers patients to seek treatments that truly improve their daily lives. For more educational resources, visit GHAPP.org and the GHAPP ACE App.

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In this episode of the GHAPPcast, Patrick Horne, NP and Chris Lovell, CRNP discuss the critical role of biomarkers in hepatology and liver disease management. They explain what biomarkers are, how they are used in clinical practice to detect conditions such as hepatocellular carcinoma (HCC), and how they can measure treatment response. The conversation explores the rigorous biomarker development and validation process, beginning with discovery and assay development, through retrospective and prospective validation, and ultimately assessing population impact. Patrick and Chris highlight the role of the Early Detection Research Network (EDRN), established by the National Cancer Institute, in ensuring biomarkers meet strict scientific standards before clinical application. They also emphasize why it is important for clinicians to understand these processes—so they can have greater confidence in applying biomarkers to improve early detection and patient outcomes. This discussion offers a clear, evidence-based perspective on how biomarkers shape the future of liver disease diagnosis and care.

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In this podcast episode, nurse practitioner Gabriella McCarty and physician assistant Kim Orleck share expert insights on IBS with constipation (IBS-C)—one of the most common yet misunderstood gastrointestinal conditions. They explain how the diagnostic approach has shifted from a “diagnosis of exclusion” to a positive diagnostic strategy supported by ACG and AGA guidelines and the Rome criteria. Together, they highlight the importance of taking a thorough history, identifying red flags such as rectal bleeding, family history of colon cancer, unexplained weight loss, and anemia, while avoiding unnecessary and costly testing. Gabriella and Kim also explore how to communicate the brain–gut connection and concepts like visceral hypersensitivity to patients, helping them feel validated and understood rather than dismissed. By focusing on patient education, shared decision-making, and timely diagnosis, they show how providers can build confidence, reduce delays in care, and start treatment sooner for patients struggling with IBS-C. This conversation provides practical guidance for GI clinicians and reassurance for patients navigating IBS constipation. For more educational resources, visit GHAPP.org and explore the GHAPP ACE App.

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In this video, physician assistant Kim Orleck of Atlanta Gastroenterology Associates, part of United Digestive, answers some of the most common questions about IBS medications and how to evaluate treatment success. Kim explains how clinical studies show bowel improvement—measured by complete spontaneous bowel movements—can often begin as early as one week, sometimes even within days, while abdominal pain relief typically takes 6–8 weeks to reach maximal benefit. She emphasizes the importance of setting realistic expectations so patients don’t discontinue therapy too soon. With no current biomarkers for IBS, Kim highlights how progress is assessed by carefully tracking the patient’s response across constipation, abdominal pain, and bloating symptoms. She also shares best practices on when to reassess therapy—usually at the 2–3 month mark—to ensure both bowel and pain improvements are achieved. This discussion offers valuable guidance for clinicians and patients navigating the complexities of irritable bowel syndrome (IBS-C) management.

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In this episode, nurse practitioner Gabriella McCarty draws on over 26 years of GI, IBD, and hepatology experience to discuss irritable bowel syndrome with constipation (IBS-C) and why patient education and shared decision-making are essential for better outcomes. Gabriella highlights how IBS-C can present with a variety of symptoms, including bloating, several days without a bowel movement, or even diarrhea caused by overflow constipation, making it a condition that is often misunderstood. She emphasizes that treatment is not one-size-fits-all—ranging from diet and lifestyle changes to over-the-counter options, prescription therapies, and newer targeted treatments such as guanylate cyclase-C agonists. By empowering patients with knowledge about the many available options, clinicians can improve patient confidence, encourage collaboration in care, and address years of frustration many individuals experience when they feel unheard. This conversation underscores the importance of individualized treatment approaches in IBS-C and offers practical insights for GI providers and their patients. Learn more at GHAPP.org

Empowering patients with Primary Biliary Cholangitis (PBC) starts with education, communication, and long-term support. In this episode, nurse practitioner Sarah Dawkins, from Duke University Medical Center, and Alison Moe, PA-C, from Atlanta Gastroenterology Associates, discuss the vital role Advanced Practice Providers (APPs) play in the longitudinal care of PBC patients. From explaining prognosis, symptoms, and treatment expectations to addressing quality-of-life challenges like fatigue, pruritus, bone density loss, and anxiety, they share practical strategies for building trust and improving patient outcomes.

You’ll hear how APPs act as the “quarterback” of care—providing education beyond the clinic visit, coordinating with multidisciplinary teams (dermatology, endocrinology, mental health, pharmacy), and connecting patients to trusted resources and support groups. Visual aids, personalized communication styles, and continuous follow-up all help patients better understand their diagnosis, medications, and long-term management.

Whether you’re a healthcare professional seeking best practices or a patient looking for clarity and support, this conversation highlights why APPs are essential in managing chronic liver disease and ensuring patients with PBC feel informed, empowered, and never alone.

In this podcast, pharmacist Jeffrey Dunn and Dr. Ed Pezalla boil down how U.S. managed care really works—covering Medicare, Medicaid, and commercial insurance, the difference between self-insured vs. fully insured risk, and how PBMs and health plans split responsibilities across the pharmacy vs. medical benefit. You’ll learn why formularies, prior authorizations, step therapy, and utilization management exist, how to navigate them, and what to check on the back of the insurance card before you start a PA. The conversation offers a practical playbook for clinics: map your region’s top payers, gather their PA criteria and forms, document the right clinical data up front (the #1 cause of denials is missing information), and build working relationships with payer teams. They also touch on the impact of specialty drug costs, biosimilars, and the growing role of technology/AI in streamlining approvals—all aimed at aligning outcomes, patient experience, and cost.

In this episode, physician assistant Alison Moe, PA-C, and Carolyn Legaspi, NP, explore the future of hepatitis B research and management, including promising therapeutic developments and critical care gaps. Together, they discuss the complexity of chronic hepatitis B infection, the global burden of disease, and why achieving a functional cure remains elusive despite current antiviral therapies. The conversation highlights cutting-edge research on therapeutic vaccines—including the first entering Phase 1 clinical trials in early 2024—and the potential role of immune modulators in achieving long-term viral suppression. Carolyn and Alison also address major research challenges, such as targeting HBV’s persistent cccDNA, reaching underserved populations, and the low global treatment rate (only 3% as of 2022). They emphasize the urgent need for improved access to testing, earlier intervention in children and adolescents, and strategies to close gaps in care, especially in high-risk communities. For healthcare providers, this discussion offers valuable insight into the evolving hepatitis B treatment landscape and the ongoing efforts to reduce liver-related morbidity and mortality worldwide.