GHAPPcast

Thank you to Ardelyx for your support on this podcast episode.

In this insightful episode, GI nurse practitioners Mary Clarke, Kristina Skarbinski, and Monica Nandwani explore the powerful connection between mental health and irritable bowel syndrome (IBS)—with a focus on IBS-C. The discussion highlights how stress, poor sleep, and emotional health can significantly impact gut function and symptom severity. Drawing on the updated 2024 Real-World IBS Survey, the team shares data showing how IBS affects quality of life, from daily discomfort to dietary restrictions and social withdrawal. Mary reviews how stress alters gut motility and gut-brain signaling, while Christina outlines pharmacologic strategies like neuromodulators (e.g., TCAs, SNRIs, SSRIs) and behavioral therapies including CBT and gut-directed hypnotherapy. The conversation also dives into dietary considerations, such as the low FODMAP diet, food reintroduction strategies, and identifying common symptom-triggering foods. Monica emphasizes the importance of collaborative care involving dietitians, psychologists, and telehealth resources to create a personalized treatment plan. This episode offers a practical, compassionate, and multidisciplinary approach to managing IBS-C through both medical and lifestyle interventions. Learn more at GHAPP.org or by downloading the GHAPP ACE App for on-the-go access to IBS education and resources.

Thank you to Ardelyx for your support on this FAQ video module.

In this episode, Kristina Skarbinski, a seasoned GI nurse practitioner based in Boston, shares essential insights on identifying alarm symptoms that may help distinguish Irritable Bowel Syndrome (IBS) from more serious gastrointestinal conditions. While IBS is a common functional disorder, it’s critical to recognize red flag symptoms that require further evaluation before making a diagnosis. Christina walks through key warning signs, including rectal bleeding, melena (black tarry stools), nocturnal bowel movements, progressive abdominal pain, unexplained weight loss, and anemia. She also explains the significance of an elevated fecal calprotectin level and the importance of family history in assessing the risk for colorectal cancer or inflammatory bowel disease (IBD). Patients over 50 should be up to date on colon cancer screening, especially when symptoms are new or worsening. If no alarm features are present, clinicians can confidently proceed with IBS evaluation using the Rome IV criteria and symptom-based testing. This educational overview offers a practical guide for primary care and GI professionals. Learn more by visiting the GHAPP website or the ACE App for additional clinical resources.

In this episode, physician assistant Alison Moe, P-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.

#HepatitisB #HBVCure #LiverHealth #HepatologyEducation #TherapeuticVaccines #FunctionalCure #ChronicHBV #LiverDiseaseAwareness #Gastroenterology #AdvancedPracticeProviders #GHAPP #MedicalResearch #HBVElimination #ViralHepatitis

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.

Thank you to Ardelyx for your support on this APP Insight video module.

Join Monica Nandwani, GI nurse practitioner in California, as she outlines key diagnostic strategies for identifying Irritable Bowel Syndrome (IBS), one of the most common functional gastrointestinal disorders. In this detailed overview, Monica explains how to recognize IBS using symptom-based criteria such as the Rome IV diagnostic guidelines, which focus on recurrent abdominal pain and changes in stool habits. She emphasizes the importance of a positive diagnostic strategy over exclusion-based testing, as supported by the 2020 ACG Clinical Guidelines. This video explores IBS subtypes—including IBS-C, IBS-D, IBS-M, and IBS-U—and explains when to consider additional testing such as serologic celiac panels, fecal calprotectin, CRP, and colonoscopy to rule out inflammatory bowel disease (IBD), microscopic colitis, or other conditions. Learn how to identify red flags that require further evaluation, and discover how tools like the Bristol Stool Form Scale and patient stool diaries can guide diagnosis. Whether you're a clinician or a patient seeking clarity on IBS, this evidence-based discussion provides practical insights for timely and accurate diagnosis. For more education, visit the GHAPP website or GHAPP ACE App.

Thank you to Ardelyx for your support on this APP Insight video module.

Join Kristina Skarbinski, a GI nurse practitioner with over a decade of experience, as she explains how to use the Bristol Stool Scale to monitor treatment response in patients with Irritable Bowel Syndrome (IBS). Based in Boston, Christina emphasizes the importance of tracking bowel patterns as a key component of patient-centered IBS management. This educational video highlights how the Bristol Stool Form Scale—ranging from Type 1 (hard pellets) to Type 7 (watery stool)—can empower patients to log stool consistency, identify trends, and stay engaged in their care. Christina shares how she uses stool diaries to adjust treatment plans over time and encourages regular check-ins to optimize outcomes between follow-up visits. Whether you're a provider looking to implement practical tools in clinical practice or a patient navigating IBS treatment, this video offers valuable insights on improving symptom tracking and communication. For more GI-focused education, visit the GHAPP website or download the ACE App.

Join physician assistants Helen Adams, Mount Sinai Medical Center, and Emily Przybyl, Erie County Medical Center, as they dive into the clinical complexities of chronic hepatitis B in this insightful discussion. With over 250 million people living with chronic hepatitis B worldwide, the episode emphasizes the urgency of early diagnosis, proper screening, and effective long-term monitoring to prevent progression to cirrhosis and hepatocellular carcinoma (HCC). Helen and Emily review the importance of comprehensive hepatitis B triple panel testing (surface antigen, surface antibody, core antibody), the nuances of interpreting serologies, and updated screening guidelines for high-risk populations—including pregnant women, individuals born in endemic regions, and immunocompromised patients. They also address the role of non-invasive tools like FibroScan in staging fibrosis, the risk of HBV reactivation in patients undergoing immunosuppressive therapy, and pitfalls with newer HIV regimens that lack HBV suppression. With practical advice, clinical anecdotes, and references to AASLD and AGA guidelines, this episode provides a must-hear overview for clinicians managing hepatitis B in diverse patient populations.

In this podcast episode, Future Directions in PBC Research and Management, Christina Hanson, FNP, South Denver Gastroenterology, and Patrick Horne, NP, University of Florida, explore the evolving landscape of Primary Biliary Cholangitis (PBC)—highlighting advances in biomarkers, treatment targets, and personalized care. The conversation addresses a shift in clinical thinking beyond alkaline phosphatase alone, emphasizing the role of additional markers like bilirubin, GGT, albumin, and fibrosis stage in risk stratification and treatment planning. The episode also underscores the importance of symptom assessment, especially for pruritus and fatigue, which are often underreported by patients but have a significant impact on quality of life. With the arrival of new second-line therapies and promising data from IBAT inhibitors and PARS agonists, the hosts highlight how emerging research is transforming patient management in PBC. This episode is a must-listen for clinicians seeking to optimize outcomes with a multimodal, symptom-driven approach and stay ahead of new developments in PBC treatment and clinical trials.

In this insightful discussion, nurse practitioners HoChong Gilles and Sarah Dawkins explore the critical role of multidisciplinary care in the management of Primary Biliary Cholangitis (PBC). As a complex autoimmune liver disease, PBC often requires more than hepatology alone—patients benefit from a collaborative approach that includes endocrinology for bone health, primary care for fatigue evaluation, dermatology for refractory pruritus, mental health specialists, pharmacists, social workers, cardiology, rheumatology, and registered dietitians. Gilles and Dawkins emphasize how coordinated care improves quality of life, supports symptom management, and addresses barriers to access such as medication affordability and social determinants of health. They also highlight the importance of patient advocacy groups and holistic strategies like exercise and nutritional support. This video is essential viewing for clinicians seeking to elevate outcomes and deliver patient-centered, team-based care for individuals living with chronic liver disease.

In this expert conversation, Andrea Gossard, NP, and Ann Moore, NP, share real-world strategies for managing Primary Biliary Cholangitis (PBC) with a strong focus on symptom control and quality of life. While PBC is a chronic autoimmune liver disease requiring long-term management, patients often struggle most with debilitating symptoms like pruritus (itching) and fatigue—which can significantly impact their day-to-day well-being. Gossard and Moore discuss stepwise treatment approaches for pruritus, including cholestryramine, rifampin, naltrexone, and off-label options, as well as non-pharmacologic interventions. They also explore the complex, often misunderstood nature of fatigue in PBC and the importance of patient education, support groups, and validated resources like the PBCers organization, American Liver Foundation, and GHAPP ACE app. This discussion emphasizes the need for patient-centered care, multidisciplinary collaboration, and holistic management that prioritizes both liver health and symptom relief. With new therapies and promising clinical trial data emerging, this is an encouraging time for clinicians and patients navigating the evolving landscape of PBC treatment.