GHAPPcast

In this clinical discussion on CHB, Scott Springer, PA-C, and Dawn Drazek, NP, explore real-world application of treatment guidelines, including the 2018 AASLD recommendations. They break down when to initiate therapy based on HBV DNA levels, ALT elevations, and HBeAg status, while also highlighting the importance of patient-centered care—especially in unique populations such as those who are pregnant, have chronic kidney disease, or present with cirrhosis. The conversation also covers HCC screening best practices, simplified treatment approaches inspired by hepatitis C management, and clinical considerations when choosing between agents like tenofovir DF, tenofovir AF, and entecavir. With practical insights and guidance for managing hepatitis B in diverse patient populations, this session is an invaluable resource for APPs, hepatology providers, and clinicians looking to stay current with HBV care. Learn how to bridge the gap between complex guideline criteria and everyday practice.

Living with Primary Biliary Cholangitis (PBC) often means facing daily challenges such as fatigue, itching (pruritus), sleep disruption, and the emotional impact of managing a chronic liver disease. In this GHAPP podcast, physician assistants Lindsay Yoder, PA-C and Melissa Franco, PA share real-world strategies for improving quality of life for patients with PBC. They discuss how to screen for and manage common symptoms like fatigue and itching, when to look for alternative causes such as thyroid issues or vitamin deficiencies, and how to approach difficult conversations about disease progression, cirrhosis, and potential transplant evaluation. The episode also highlights the importance of patient-centered care—balancing treatment options with individual preferences, lifestyle modifications, diet, exercise, and mindfulness to empower patients in their care journey. Whether you’re a healthcare provider looking for practical insights or a patient seeking support, this discussion offers valuable tools to improve both physical and emotional outcomes in PBC management.

Living with Primary Biliary Cholangitis (PBC) often means navigating not only physical symptoms but also challenges with mental health, including depression, anxiety, fatigue, and cognitive “brain fog.” In this expert discussion, physician assistants Lindsay Yoder, PA-C, and Melissa Franco, PA, share real-world strategies for screening, addressing, and supporting the mental health needs of patients with PBC. They highlight how APPs can normalize conversations about anxiety and depression, connect patients with support groups, and collaborate with mental health professionals to deliver holistic care. This conversation explores practical tools such as screening approaches, open-ended patient questions, referrals to psychologists, psychiatrists, and social workers, as well as lifestyle and support strategies that empower patients and reduce stigma. Whether you are a healthcare professional seeking guidance or a patient looking for support, this discussion provides valuable insights into improving quality of life and long-term outcomes for individuals with PBC.

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In this episode of the GHAPPcast, the official podcast of Gastroenterology and Hepatology Advanced Practice Providers, host Mikhail Alper, PA-C, sits down with Natalie Oliver, PA-C, a hepatology expert from Houston Methodist Hospital and Liver Specialists of Texas. Together, they explore the critical topic of biomarker validation in liver cancer, highlighting the role of the NCI Early Detection Research Network (EDRN) in setting standards for HCC surveillance. This conversation dives into why standardization, validated assays, and harmonized study designs are essential to making biomarkers reliable across different patient populations and practices. Natalie shares her firsthand experience using tools like AFP, AFP-L3, DCP (PIVKA-II), and the GALAD score to improve the accuracy of HCC detection, reduce false positives, and guide patient conversations. Real patient stories emphasize the life-saving impact of early detection and the importance of consistent surveillance, especially in high-risk groups such as those with cirrhosis, chronic hepatitis B or C, and MASLD. Whether you’re a clinician, researcher, or student, this episode provides valuable insights into how biomarker innovation and collaboration can improve outcomes in liver cancer care and transplant medicine.

In this engaging episode, nurse practitioners HoChong Gilles from the Central Virginia VA Healthcare System and Ann Moore from Arizona Liver Health share their expertise on navigating challenging conversations in the care of patients with Primary Biliary Cholangitis (PBC). They explore some of the most difficult topics to address—including disease chronicity, symptom management for fatigue and pruritus, and discussing prognosis—while offering practical communication strategies to build trust, encourage adherence, and provide hope. The conversation covers techniques like motivational interviewing, teach-back methods, and integrating educational resources with psychosocial support. HoChong and Ann highlight the importance of multidisciplinary collaboration, peer support networks, and advocacy groups in enhancing patient understanding and engagement. Whether managing asymptomatic patients, addressing treatment fatigue, or guiding those at risk for disease progression, this discussion delivers valuable, real-world insights for clinicians dedicated to improving quality of life and long-term outcomes in PBC care.

In this engaging session from the second ADH Conference, nurse practitioner Allan Guerra and physician assistant Jhuli Patel discuss the importance of collaboration across specialties in the management of patients with Primary Biliary Cholangitis (PBC). Drawing from their respective experiences in solo and group GI practices, they highlight the critical role Advanced Practice Providers (APPs) play in identifying, diagnosing, and managing this rare liver disease. The conversation explores how effective communication with gastroenterologists, hepatologists, medical science liaisons, and multidisciplinary care teams—including social workers and office managers—can improve care coordination, medication access, and patient education. Julie and Alan also emphasize using evidence-based guidelines and leveraging EHR platforms like Athena to track labs and imaging. This session reinforces the value of teamwork and advocacy in delivering seamless, patient-centered care for individuals with PBC.

Join Sudhisha Jala, PA-C, and Rachael Bierschenk, ARNP, for an insightful and practical podcast episode on managing Primary Biliary Cholangitis (PBC) in real-world clinical settings. With combined experience in gastroenterology and hepatology, these two seasoned APPs explore the most common and challenging symptoms of PBC—fatigue and pruritus—and share both non-pharmacological strategies and evidence-based pharmacological interventions to improve patient outcomes. From light therapy and low-impact exercise to bile acid sequestrants and novel PPAR agonists, they highlight what works, what to watch for, and how to tailor care to each patient's needs. This episode also delves into the importance of early adherence to treatment—even in asymptomatic patients—and how to counsel patients through concerns about long-term medication use. Learn when to consider specialist referrals, differentiate PBC fatigue from other causes, and discover how APPs are uniquely positioned to deliver whole-person care. Whether you're new to managing PBC or looking to refine your approach, this conversation offers valuable pearls and clinical confidence. For more APP-focused education, visit the GHAPP website or download the GHAPP ACE App.

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In this video, Mary Clarke, a GI motility nurse practitioner in San Diego, addresses the difference between functional constipation and constipation-predominant Irritable Bowel Syndrome (IBS-C). Drawing from the Rome IV criteria developed by the Rome Foundation, Mary explains how functional constipation is defined by infrequent bowel movements, hard stool consistency, and difficulty evacuating—without the presence of significant pain. In contrast, IBS-C includes the same constipation symptoms plus recurrent abdominal pain related to defecation, bloating, and visceral hypersensitivity. Mary also explores the role of gut-brain interaction and how altered motility and stress can influence symptom patterns in DGBIs (Disorders of Gut-Brain Interaction). She emphasizes the importance of accurate diagnosis, as conventional treatments for constipation—like fiber supplements or OTC laxatives—may not be effective and could worsen symptoms in IBS-C. Instead, IBS-C may respond better to targeted therapies, including prescription treatments, exercise, cognitive behavioral therapy (CBT), and complementary alternative medicine (CAM). This overview helps clinicians and patients better understand how to differentiate these two GI conditions and tailor treatment plans accordingly. For more education, visit the GHAPP website or download the GHAPP Ace App.

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In this episode of the GHAPPcast, Kate Scarlata, RDN, a nationally recognized GI-focused dietitian, joins Amy Ladewski, PA-C, from Northwestern Medicine, to explore personalized, evidence-based dietary strategies for patients with Irritable Bowel Syndrome with Constipation (IBS-C). Using a real-world case study approach, they discuss the impact of fiber choice, the role of psyllium versus fermentable fibers like wheat dextrin and inulin, and how over-supplementation can worsen IBS symptoms. Kate provides practical, patient-friendly tips on how to reduce symptom-triggering foods without overwhelming dietary restrictions, highlighting how to reintroduce safe, low-FODMAP options without using the term "FODMAP." The episode also compares the benefits of kiwi fruit versus prunes, addresses common dietary missteps, and emphasizes the need for a gentle, individualized approach to fiber and food intake. Amy and Kate discuss when to escalate care with pharmacologic therapies, how to identify pelvic floor dysfunction, and why partnering with GI dietitians and psychologists is key to long-term success. For APPs treating patients with IBS, this episode is full of clinical pearls, counseling strategies, and lifestyle interventions to improve outcomes. Learn more by visiting GHAPP.org or downloading the GHAPP ACE App to access more GI-focused content and patient care tools.

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In this episode, Mary Clarke, a GI motility nurse practitioner based in San Diego, discusses the powerful role of complementary and alternative therapies—especially exercise—in managing Irritable Bowel Syndrome (IBS). With a focus on IBS-C (constipation-predominant IBS), Mary explains how regular physical activity can improve gastrointestinal motility, reduce abdominal pain and bloating, support emotional well-being by lowering stress levels, and positively influence the gut microbiome. She reviews different forms of aerobic and low-impact exercise, including walking, cycling, swimming, and yoga, and provides practical strategies for patients at all activity levels to build sustainable routines. Mary also highlights the physiological mechanisms behind exercise-induced gut improvement, including cytokine regulation, enhanced digestion, improved nutrient absorption, and reduced inflammation. This video offers actionable guidance for clinicians and patients looking to incorporate lifestyle interventions into IBS treatment plans. Learn more at the GHAPP website or by visiting the GHAPP ACE App.