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.

Thank you AbbVie for your support on this podcast episode.

In this episode, Kim Orleck, PA-C, and Kristina Skarbinski, NP, dive into the critical topic of setting patient expectations when initiating therapy for IBS-C (Irritable Bowel Syndrome with Constipation). Building on their previous discussion around diagnosing IBS with confidence using a positive diagnostic strategy, Kim and Kristina now focus on how to effectively transition patients from over-the-counter options to prescription therapies. They emphasize the importance of shared decision-making, clear communication, and addressing common patient concerns, such as fears about medication dependence, side effects like diarrhea, and long-term treatment timelines. The episode explores how to guide patients through symptom tracking, establish realistic goals for bowel movement improvements versus pain or bloating, and use resources like the Rome IV criteria, ACG guidelines, and bowel diaries to improve adherence and outcomes. Listeners will learn how to proactively address discontinuation risks, personalize follow-up plans, and empower patients to be active partners in managing their IBS-C. Whether you’re a seasoned APP or new to GI care, this discussion offers practical tools to enhance medication adherence, improve patient satisfaction, and support long-term success in IBS-C management.

Discover more resources and educational tools at GHAPP.org and on the GHAPP ACE App.

In addition to GHAPP's IBS educational resources, please see essentialsofibs.com for more.

#PatientExpectations #NewTherapy #TreatmentInitiation #PatientEducation #SharedDecisionMaking #ChronicDiseaseManagement #HealthcareCommunication #TherapyOutcomes #ClinicalPractice #MedicalEducation #ProviderTips

Thank you AbbVie for your support on this podcast episode.

In this episode, Kim Orleck, PA-C, and Kristina Skarbinski, NP, share a practical, guideline-based approach to diagnosing irritable bowel syndrome (IBS) with confidence. Drawing on years of clinical experience in GI, they highlight the importance of applying the Rome IV criteria and shifting from outdated diagnostic strategies to a positive diagnostic approach that relies on patient history, absence of alarm symptoms, and minimal lab testing. The conversation explores how to effectively rule out red flags like anemia, rectal bleeding, weight loss, and family history of IBD or colon cancer, while avoiding unnecessary colonoscopies in low-risk patients. Listeners will learn how to implement ACG and AGA guidelines, optimize limited diagnostic workups (CBC, CRP, celiac panel, fecal calprotectin), and build trust with patients through shared decision-making. Kim and Kristina also offer tips for advanced practice providers (APPs) on improving patient engagement—like using tools such as the Bristol Stool Scale and symptom tracking to increase diagnostic clarity and treatment adherence. Whether you're a new or experienced GI provider, this episode reinforces how to diagnose IBS with clinical confidence and reduce diagnostic overuse, while keeping patient education and communication at the center of care.

Access more resources at GHAPP.org or download the GHAPP ACE App to stay updated on evidence-based GI practice.

In addition to GHAPP's IBS educational resources, please see essentialsofibs.com for more.

#IBS #IrritableBowelSyndrome #IBSDiagnosis #DigestiveHealth #FunctionalGI #Gastroenterology #RomeCriteria #ChronicGIConditions #PatientCare #MedicalEducation #GIHealth #ConfidentDiagnosis

Thank you AbbVie for your support on this podcast episode.

In this episode, Carol Antequera, DMSc, PA-C, and Jennifer Geremia, PA-C, dive into the clinical nuances of diagnosing and managing exocrine pancreatic insufficiency (EPI). Guided by AGA best practices, they explore how to recognize hallmark symptoms such as chronic diarrhea, steatorrhea, weight loss, and fatigue, even in patients without overt pancreatic disease. From identifying key risk factors—including chronic pancreatitis, cystic fibrosis, pancreatic cancer, diabetes, and post-surgical anatomy—to the appropriate use of diagnostic tools like fecal elastase testing, this conversation provides a clear roadmap for providers managing suspected EPI in both tertiary and community care settings. The discussion emphasizes practical guidance for initiating pancreatic enzyme replacement therapy (PERT), determining optimal dosing, addressing challenges with adherence, and monitoring nutritional deficiencies and vitamin absorption. Carol and Jennifer also highlight the importance of dietary counseling, managing psychosocial factors, and the long-term safety of empiric therapy, even when diagnostic certainty is limited. Whether you're new to managing EPI or seeking tips for improving outcomes in complex cases, this episode offers actionable, evidence-based strategies to enhance your GI practice.

Learn more or access related resources via the GHAPP ACE App and GHAPP.org.

In addition to GHAPP's IBS educational resources, please see essentialsofibs.com for more.

#EPI #ExocrinePancreaticInsufficiency #PERT #PancreaticEnzymes #Gastroenterology #DigestiveHealth #EPIDiagnosis #PERTDosing #FatMalabsorption #ChronicGIConditions #MedicalEducation #GIHealth