GHAPPcast

This medication review explores the role of stable pharmacokinetics (PK) in achieving continuous inflammatory control in inflammatory bowel disease (IBD), with a focus on subcutaneous infliximab therapy for Crohn’s disease and ulcerative colitis. Kim Orleck, PA-C, from Atlanta Gastroenterology Associates and United Digestive, reviews how subcutaneous infliximab provides more stable and sustained drug exposure compared with traditional intravenous (IV) infliximab dosing. By minimizing peak-to-trough fluctuations and maintaining higher trough concentrations, subcutaneous infliximab may help support continuous TNF inhibition, reduce immunogenicity risk, and improve long-term disease control in patients with moderate to severe IBD. The discussion highlights key clinical data from studies including REMSWITCH, LIBERTY Crohn’s, and LIBERTY UC, demonstrating that subcutaneous infliximab delivers durable remission, stable safety outcomes, and consistent therapeutic drug levels through long-term follow-up. Learn how transitioning from IV to subcutaneous infliximab may improve patient convenience, maintain clinical and endoscopic remission, and support treat-to-target goals in IBD management. The review also examines which patients may require closer monitoring or dose escalation strategies following the switch from IV biologic therapy. For more educational content visit the GHAPP Digital Hub and the GHAPP ACE app.

Thank you to J&J for the support of this Journal Club Review Module. In this journal club video, Sharon Dudley Brown, CRNP, PhD, from the IBD Center at Johns Hopkins University, reviews the ASTRO trial published in The Lancet, which evaluated subcutaneous guselkumab for the treatment of moderate to severe ulcerative colitis. The discussion highlights how this IL-23 inhibitor was studied in patients with difficult-to-treat disease who had previously failed or were intolerant to standard therapies. The trial compared different dosing strategies of subcutaneous guselkumab versus placebo and assessed clinical remission, symptom improvement, and endoscopic outcomes over time.Results showed that patients receiving guselkumab had higher rates of remission and improved colon inflammation compared with placebo, with benefits seen early in treatment and sustained through follow-up. Safety outcomes were generally similar between groups, with no new safety concerns identified. Overall, the ASTRO trial supports subcutaneous guselkumab as an effective and well-tolerated option for patients with moderate to severe ulcerative colitis.

Thank you to AbbVie for the support of this Journal Club Review Module. This journal club review episode explores the benefit–risk profile of Upadacitinib for patients with moderately to severely active Ulcerative Colitis and Crohn’s Disease, based on a post hoc analysis of phase 2b/3 clinical trials. Featuring expert insights from Sally Bowa, APNP, FNP-C and Jennifer Labas, MSN, in both community and academic settings, this discussion breaks down real-world considerations including efficacy, safety outcomes, and long-term disease management. Key topics include rapid symptom relief, induction and maintenance of remission, and how upadacitinib compares to other advanced therapies in IBD treatment sequencing. The episode also highlights important safety considerations such as herpes zoster risk, cardiovascular events, and thrombosis, along with practical strategies like vaccination protocols, lab monitoring, and patient selection. Designed for gastroenterology and hepatology advanced practice providers, this episode provides actionable guidance on balancing risks and benefits, optimizing treatment decisions, and improving patient outcomes in complex IBD care. For more educational content, visit the GHAPP Digital Hub and the GHAPP ACE app.

Learn how to effectively support patients starting treatment for MASH with this practical, clinician-focused discussion featuring expert advanced practice providers. In this episode, hepatology specialists Robin Soto and Alison Moe break down how to set realistic expectations, define meaningful treatment goals beyond the scale, and guide patients through long-term lifestyle and pharmacologic management. Discover why success in MASH care extends beyond weight loss to include improvements in A1C, lipid profiles, energy levels, sleep, and overall metabolic health, and how shifting the conversation away from numbers can improve patient motivation and adherence. This episode also explores how to structure patient journeys through the first 30, 60, and 90 days of treatment, navigate common challenges with compliance, and reinforce sustainable behavior change. Gain insights into emerging therapies, including newly approved medications targeting liver fat and fibrosis, as well as GLP-1 receptor agonists that support both metabolic health and liver outcomes. The discussion highlights how to personalize treatment plans, manage side effects, and empower patients to take control of their disease while preventing progression to cirrhosis and liver-related complications.

Stay up to date on MASH and MASLD with expert insights from nurse practitioners Sarah Dawkins of Duke University Medical Center and Edith Johannes of UCLA Health. This episode focuses on best practices for identifying at-risk patients, including those with steatosis on imaging, cardiometabolic risk factors, and elevated BMI—highlighting why early screening is critical to preventing progression to cirrhosis and liver transplant. Learn how to apply practical, non-invasive tools like FIB-4 and FibroScan to assess fibrosis risk, when to refer patients, and how to navigate common challenges such as intermediate scores and normal liver labs. With MASH becoming a leading cause of liver disease, this discussion provides actionable strategies for advanced practice providers and primary care clinicians to improve early detection and patient outcomes. Visit the GHAPP Digital Hub and GHAPP ACE app for more educational content.

In this episode of RhAPPcast, host Amanda Mixon, PA-C, is joined by Christina Hanson, NP, to explore the growing intersection between rheumatology and gastroenterology, focusing on shared immune pathways and the evolving role of subcutaneous biologic therapies in immune-mediated inflammatory diseases (IMIDs). The conversation highlights how advances in subcutaneous (subQ) biologics for inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, are improving patient convenience, adherence, and quality of life while offering comparable efficacy to traditional IV infusions. This expert discussion dives into key clinical considerations such as induction versus maintenance strategies, patient selection, safety, and real-world implementation of SubQ therapies. The episode also emphasizes the importance of multidisciplinary collaboration between rheumatology and GI providers, especially when managing patients with overlapping conditions like psoriatic arthritis and axial spondyloarthritis. Listeners will gain practical insights on optimizing treatment decisions, enhancing patient education, and leveraging a shared “toolbox” of therapies to better manage complex, multi-system disease. For more expert-driven education and cross-specialty insights, visit the RhAPP Content Rheum, GHAPP Digital Hub & both GHAPP & RhAPP ACE apps.

Thank you to Johnson & Johnson for the support of this FAQ Video Module. In this FAQ video module, Tedra Gray, a gastroenterology nurse practitioner at Sinai Chicago, breaks down the key differences between treat-through and randomized withdrawal clinical trial designs in inflammatory bowel disease (IBD). This educational overview explains how these two study designs impact the evaluation of new IBD therapies, including their role in assessing safety, efficacy, and long-term patient outcomes. Viewers will learn how treat-through trials randomize patients at baseline to receive either active treatment or placebo throughout the study, offering insights into real-world effectiveness from induction through maintenance. In contrast, randomized withdrawal designs focus on patients who initially respond to therapy, re-randomizing them to continue treatment or switch to placebo—allowing for more efficient study design, reduced placebo exposure, and a focus on maintenance of response. This video also explores key considerations such as population selection, ethical implications, study objectives, and how these designs are applied in major Phase 3 IBD trials like ASTRO, GRAVITI, GALAXY, and QUASAR. Ideal for gastroenterology providers and advanced practice providers, this content provides practical insights into interpreting clinical trial data and optimizing treatment strategies in IBD. For more expert-driven GI education, visit the GHAPP Digital Hub and GHAPP ACE app.

In this medication review video module, Kimberly Orleck, PA-C, reviews the long-term efficacy and safety of guselkumab in the treatment of Crohn’s disease, highlighting results from the Phase 3 GALAXI-2, GALAXI-3, and GRAVITI clinical trials and their long-term extension (LTE) data through week 96. The discussion examines outcomes following intravenous (IV) or subcutaneous (SC) induction therapy followed by SC maintenance dosing, demonstrating sustained clinical remission, endoscopic response, endoscopic remission, and deep remission across study populations. The module also reviews steroid-free outcomes and emphasizes the durability of response observed over two years of treatment, with high rates of patients maintaining remission. Safety data across the LTE studies showed a stable safety profile with no new safety signals and low rates of serious adverse events and infections, consistent with the known safety profile of guselkumab. This expert overview provides clinicians and advanced practice providers with important insights into long-term treatment outcomes and real-world implications for managing moderate-to-severe Crohn’s disease with IL-23 pathway inhibition.For more gastroenterology and hepatology educational content, visit the GHAPP Digital Hub and GHAPP ACE app.

In this podcast, host Amanda Mixon, PA-C, leads a 2026 Fireside Chat exploring the intersection of rheumatology and gastroenterology. Joined by Kim Orleck, PA-C (GI APP), and Wendy Simmons, PA-C (Rheumatology APP), the panel discusses the shared inflammatory pathways linking Crohn’s disease, ulcerative colitis, psoriatic arthritis, and ankylosing spondylitis, with a focus on the gut–joint–skin axis and the IL-23, IL-17, and TNF pathways. The conversation highlights early screening for overlapping immune-mediated inflammatory diseases (IMIDs), recognizing subclinical gut inflammation, and selecting cross-indication therapies such as JAK inhibitors and IL-23 inhibitors based on disease severity, comorbidities, and cardiovascular risk. Listeners will gain practical insights into biomarker use (including fecal calprotectin), second-line treatment strategies after TNF failure, and the importance of real-time collaboration between rheumatology and GI providers to optimize patient outcomes. For more educational content, visit the GHAPP Digital Hub or GHAPP ACE app.

Thank you to AbbVie for the support of this Journal Club Review Video Module. In this journal club review, Kimberly Orleck, PA-C, discusses the long-term efficacy and safety of risankizumab, an IL-23 p19 inhibitor, in moderate to severely active Crohn’s disease, highlighting results from the FORTIFY maintenance trial and its open-label extension. Data show strong Week 52 clinical remission and endoscopic response and remission rates in both biologic-naïve and biologic-experienced patients, many with prior biologic failure, reinforcing the importance of treat-to-target goals and STRIDE-II recommendations. Long-term findings out to 276 weeks demonstrate sustained clinical and endoscopic outcomes with a favorable safety profile and no new safety signals over four years. The review also covers updated 2025 ACG and AGA guideline positioning and real-world U.S. claims data showing lower treatment switch rates and healthcare utilization with risankizumab compared to other advanced therapies, underscoring its role in evolving Crohn’s disease management. For more educational content, visit the GHAPP digital hub and GHAPP ACE app.

Thank you to AbbVie for the support of this podcast episode. In this GHAPP podcast episode, Brooke Hodnik, PA, and Jamie Brogan, APRN, discuss the October 10, 2025 FDA label update for upadacitinib in adults with moderate to severe ulcerative colitis and Crohn’s disease. They break down what the expanded indication means in practice, including how clinicians should interpret terms like “clinically inadvisable” and “approved systemic therapy,” and how this update allows for more individualized treatment decisions beyond mandatory prior TNF exposure in certain scenarios. The conversation highlights key considerations such as high inflammatory burden in IBD, steroid-refractory disease, low albumin, immunogenicity concerns, and real-world barriers to biologic therapy. Brooke and Jamie emphasize the importance of clinical judgment, earlier access to appropriate advanced therapy when needed, and the goal of reducing hospitalizations, surgery risk, and long-term complications—ultimately improving quality of life for patients with moderate to severe IBD. For more educational content visit GHAPP.org, the GHAPP Digital Hub or the GHAPP ACE app.

Thank you to Fujifilm for their support of this FAQ Video Module. In this FAQ video module, Patrick Horne, NP, President of GHAPP and nurse practitioner at the University of Florida, provides a clear, practical overview of FDA-cleared biomarkers used in the detection and risk assessment of hepatocellular carcinoma (HCC). This discussion walks through key blood-based tests including AFP-L3, des-gamma-carboxy prothrombin (DCP), and how these markers—when combined with patient age and sex—are used to calculate the GALAD score to estimate the probability of HCC. The video also introduces newer diagnostic approaches such as the HelioLiver LDT, which evaluates tumor-associated DNA methylation patterns, and the Oncoguard-Liver test, a multi-target liquid biopsy analyzing both protein biomarkers and cancer-associated DNA. Designed for clinicians involved in liver disease management, this module highlights how FDA-cleared biomarkers can support earlier detection, improved risk stratification, and informed clinical decision-making in patients at risk for liver cancer. Visit GHAPP.org, the GHAPP Digital Hub, and the GHAPP ACE app for additional gastroenterology and hepatology education and resources.

Thank you to AbbVie for their support on this FAQ Video Module. In this FAQ video module, Brooke Hodnick, PA-C, breaks down key updates to the expanded upadacitinib label for adults with moderate to severe ulcerative colitis and Crohn’s disease, effective October 10, 2025. The discussion focuses on what qualifies as an “approved systemic therapy” in the context of patients who have had an inadequate response to prior treatments or for whom TNF inhibitors are clinically inadvisable. Viewers will gain clarity on FDA-approved systemic therapies for induction and maintenance of remission, including TNF inhibitors, anti-integrins, IL-12/23 and IL-23 inhibitors, JAK inhibitors, and S1P modulators, as well as important distinctions around therapies such as steroids and immunomodulators that are commonly used but not FDA-approved as systemic maintenance options. The conversation also highlights the role of clinical judgment, individualized risk–benefit assessment, and current guidance from organizations such as the American College of Gastroenterology and the American Gastroenterological Association. For more educational information, please visit GHAPP.org, the GHAPP Digital Hub or the GHAPP ACE app.

Thank you to AbbVie for their support on this FAQ Video Module.In this FAQ video module, Jamie Brogan, APRN from the IBD Center at Northwestern Medicine, breaks down the October 2025 FDA label expansion for upadacitinib in adult patients with moderate to severely active ulcerative colitis and Crohn’s disease. The discussion focuses on the updated indication for patients with an inadequate response or intolerance to TNF inhibitors—and importantly, the newly emphasized language around when TNF therapy may be considered “clinically inadvisable.” Jamie explores what this term means in real-world clinical practice, including patient-specific factors such as contraindications to TNF agents, need for rapid onset of action, prior treatment exposure, comorbidities, and access or adherence challenges. She shares practical insights on how this label expansion has impacted IBD management, increased treatment access, and supported individualized, risk-benefit decision-making between providers and patients.

Thank you to Madrigal for their support on this FAQ Video Module.In this FAQ video, Allysa Saggese, NP, reviews how clinicians can balance systemic and liver-directed therapies in the treatment of metabolic dysfunction–associated steatohepatitis (MASH) and shares insights on the evolving role of combination therapy. The discussion explores current guideline-aligned options, including GLP-1–based systemic therapies and liver-directed agents, and emphasizes individualized treatment decisions based on fibrosis stage, metabolic comorbidities, patient preferences, and access considerations. Designed for APPs and clinicians, this overview highlights why multimodal therapy—alongside lifestyle interventions like diet and exercise—is likely the future of MASH management.

Thank you to Madrigal for their support on this FAQ Video Module.In this FAQ video, Alison Moe, PA-C, discusses how alcohol consumption impacts the evaluation and progression of metabolic dysfunction–associated steatohepatitis (MASH) and why accurate assessment is critical in clinical practice. The discussion reviews the synergistic effects of alcohol and metabolic liver disease on fibrosis progression, explains current alcohol intake thresholds associated with increased risk, and outlines how biomarkers such as phosphatidylethanol (PEth) can provide objective insight into recent alcohol use. Designed for APPs and clinicians, this practical overview highlights how to differentiate MASH, alcohol-related liver disease (ALD), and MetALD to ensure accurate diagnosis, documentation, and treatment decisions.

Thank you to Madrigal for their support of this Medication Review Video Module.In this medication review module, Michelle Barnett, PA-C, provides an in-depth overview of resmetirom, the first FDA-approved liver-directed thyroid hormone receptor beta (THR-β) agonist for adults with non-cirrhotic metabolic dysfunction–associated steatohepatitis (MASH) and moderate to advanced fibrosis (F2–F3). The discussion reviews MASH risk factors, resmetirom’s mechanism of action, dosing considerations, and key findings from the phase 3 MAESTRO-NASH trial, including improvements in liver histology and lipid parameters. Designed for APPs and clinicians, this concise review highlights how resmetirom fits into contemporary MASH management alongside lifestyle interventions such as diet and exercise.

In this expert-led podcast discussion on hepatitis B management, Elizabeth Goacher, PA-C, from Duke University Medical Center and Allison Moser, NP, from RUSH University Medical Center break down what’s new in chronic hepatitis B care and how evolving guidelines are shaping real-world clinical decision-making. Recorded onsite at GHAPP National, the conversation explores updated treatment thresholds from European Association for the Study of the Liver compared with American Association for the Study of Liver Diseases, including when to initiate antiviral therapy regardless of HBeAg status, the role of HBV DNA and ALT levels, and special considerations such as pregnancy, renal and bone health, adherence, and HIV co-infection. The episode also highlights practical antiviral selection, patient-centered counseling, risks of treatment interruption, and emerging therapies aimed at functional cure. This discussion offers timely, practice-focused insights for APPs and clinicians caring for patients with hepatitis B.

This in-depth conversation explores how advanced practice providers navigate some of the most challenging discussions in the care of patients living with chronic hepatitis B. Drawing from years of real-world hepatology and transplant experience, Jennifer Geremia, PA-C, and Andrea Keller, PA, discuss culturally sensitive communication, addressing stigma, improving health literacy, and building trust with patients and families affected by hepatitis B. The discussion highlights practical strategies for long-term disease management, medication adherence, family screening and vaccination, perinatal transmission counseling, and the importance of regular monitoring to prevent cirrhosis, hepatocellular carcinoma, and end-stage liver disease. The speakers also address common misconceptions, language barriers, and shared decision-making, offering actionable insights for APPs and clinicians caring for diverse hepatitis B populations. #Hepatology #LiverDisease #ChronicHepatitisB #AdvancedPracticeProviders #GHAPP #TransplantHepatology #PatientCommunication #CulturalCompetency #HealthLiteracy #LiverCare #ChronicDiseaseManagement

In this expert-led podcast discussion, Patrick Horne and HoChong Gilles explore the complex management of comorbidities in patients with chronic viral hepatitis, with a focus on hepatitis B, hepatitis C, and HIV co-infection. The conversation highlights practical strategies for treatment sequencing, preventing hepatitis B reactivation during DAA therapy, managing drug–drug interactions, and optimizing long-term liver and systemic outcomes. The episode also examines the growing impact of metabolic dysfunction–associated steatotic liver disease (MASLD/MASH) on fibrosis progression and hepatocellular carcinoma (HCC) risk, along with current surveillance approaches including ultrasound and AFP. Additional insights address renal and bone health considerations with long-term hepatitis B antiviral therapy and the importance of multidisciplinary, whole-patient care when managing cardiovascular, metabolic, and renal co-morbidities in this high-risk population. Visit the GHAPP Digital Hub, Hep B Health Hub or GHAPP ACE app for more educational content.

Thank you to Madrigal for your support on this FAQ Video Module.In this short FAQ video module, Patrick Horne, President of GHAPP and a nurse practitioner at the University of Florida, discusses the critical role of noninvasive tests (NITs) in risk stratification and patient selection for patients with metabolic dysfunction–associated steatohepatitis (MASH). He explains how serum biomarkers and imaging help establish baseline fibrosis, clarify disease severity, and guide clinical decision-making in a condition with variable and non-linear progression. This overview emphasizes the importance of integrating NITs with a thorough patient history and physical exam to better understand fibrosis stage and optimize patient evaluation.Visit the GHAPP Digital Hub or GHAPP ACE 2.0 app for more gastroenterology and hepatology education.

Thank you to Madrigal for your support on this Journal Club Review video module.This journal club review explores the 2025 focused recommendations for the management of metabolic dysfunction–associated steatohepatitis (MASH) developed by advanced practice providers (APPs) across the United States and published in the Journal of Clinical Gastroenterology. Brian Lam, PA-C, reviews the evolving role of APPs in MASH care, key epidemiology insights, risk stratification using non-invasive tests, and practical guidance on identifying and treating at-risk patients with F2–F3 fibrosis. The discussion highlights real-world use of ELF, FibroScan, and FIB-4, an overview of resmetirom therapy, monitoring strategies, and a look ahead at emerging therapies shaping the future of MASH management.

Thank you to Madrigal for your support of this Medication Review Video Module.Discover how Resmetirom is reshaping the treatment landscape for metabolic dysfunction–associated steatohepatitis (MASH) in this expert-led medication review with HoChong Gilles, DNP. This short medication review breaks down the therapy’s mechanism of action, pivotal MAESTRO-NASH trial data, fibrosis and steatohepatitis endpoints, ideal patient selection (F2–F3 disease), and key safety considerations. Learn how this first-in-class THR-β agonist delivers meaningful improvements in fibrosis and steatohepatitis without worsening disease, and why 2024 marked a turning point in MASH care. Perfect for APPs and clinicians looking to stay ahead in the rapidly evolving world of liver disease management.

Thank you to Madrigal for your support on this FAQ Video Module.In this episode, Christina Hanson, NP, breaks down the key functional and prognostic differences between fibrosis stage F3 and F4, explaining how liver architecture, portal hypertension, and risk of decompensation shape patient outcomes. Learn how staging impacts mortality risk in MASLD/MASH, why accurate identification of advanced fibrosis is critical, and how management strategies differ for patients with severe fibrosis versus cirrhosis. Christina reviews how clinicians can intervene early, slow progression, and monitor for complications such as variceal bleeding, ascites, and hepatic encephalopathy, while emphasizing the importance of addressing underlying liver disease to improve long-term survival.#Fibrosis #LiverDisease #MASLD #MASH #Cirrhosis #F3Fibrosis #F4Fibrosis #LiverHealth #Hepatology #AdvancedFibrosis #LiverCare #NAFLD #NASH #PortalHypertension #LiverTransplant

In this final episode of our RhAPP, MAPP, GHAPP, and SDPA crosscast series, expert APPs from dermatology, gastroenterology, rheumatology, and obesity medicine break down the most important conversation of all—how to talk to patients about obesity and immune-mediated inflammatory diseases (IMIDs). This discussion focuses on real-world communication strategies, reducing stigma, motivational interviewing, shared decision-making, and setting small, achievable goals that improve outcomes. Learn how to approach sensitive weight-related conversations with empathy, build trust, and empower patients to better manage obesity and chronic inflammation in everyday practice.

In this cross-specialty episode of our RhAPP, GHAPP, MAPP and SDPA collaborative series, leading APPs from dermatology, gastroenterology, rheumatology, and metabolic medicine break down real-world strategies to improve outcomes for patients living with both obesity and immune-mediated inflammatory diseases (IMIDs). Building on earlier discussions about epidemiology and pathophysiology, this conversation focuses on practical, clinic-ready approaches—from shared decision-making and compassionate patient communication to interdisciplinary coordination, GLP-1 utilization, and lifestyle guidance. Learn how APPs across specialties are uniting to reduce systemic inflammation, personalize care, and translate education into meaningful action for patients with obesity and IMIDs.

Thank you to AbbVie for your support on this podcast episode.Navigating pregnancy with inflammatory bowel disease (IBD) can bring unique questions, concerns, and misconceptions—especially for women of childbearing age. In this expert-led episode, Janette Villalon, PA and Angelina Collins, MSN, ANP-BC, two dedicated IBD specialists break down the latest evidence and global consensus recommendations on pregnancy and IBD. Together, they explore fertility considerations, preconception counseling, voluntary childlessness, medication safety during pregnancy and breastfeeding, the impact of disease activity on maternal and fetal outcomes, and how to debunk persistent myths around IBD and pregnancy. Learn why remission at conception is critical, how to approach family planning conversations in the clinic, which therapies—including biologics and biosimilars—can be safely continued, and when to involve maternal–fetal medicine or colorectal surgery. The hosts also discuss managing flares during pregnancy, monitoring strategies such as fecal calprotectin each trimester, and when C-section may be recommended. This conversation provides timely, practical guidance to help clinicians counsel women with Crohn’s disease or ulcerative colitis with confidence, reduce fears, and support healthy pregnancies and postpartum outcomes for IBD patients.

In this episode of our crosscast series shared across RhAPPcast, GHAPPcast, and Dermcast, we explore the hidden costs of obesity in immune-mediated inflammatory diseases (IMIDs) and how excess adiposity drives poorer outcomes, reduced treatment response, and increased healthcare burden. Hosted by Amanda Mixon, PA-C, president of RhAPP, this discussion brings together expert APPs from rheumatology, dermatology, gastroenterology, and metabolic health to unpack the pathophysiologic link between obesity and IMID progression. Our panel breaks down how adipose tissue fuels systemic inflammation, why cytokines like TNF-α and IL-6 worsen disease activity in psoriasis, psoriatic arthritis, and IBD, and how obesity accelerates drug clearance and impacts biologic efficacy. We also examine clinical misconceptions, challenges with pharmacokinetics, and the real-world cycle of flares, surgeries, and increased healthcare utilization seen in this high-risk population. APPs will gain practical insight into addressing weight as part of comprehensive IMID care, improving patient conversations, and leveraging collaborative, cross-specialty management strategies. Stream this episode and the full series on RhAPPcast, GHAPPcast, and Dermcast, or access every installment through the RhAPP ACE 2.0 and GHAPP ACE 2.0 mobile apps for on-the-go learning. Stay tuned for our next episode, where we shift from mechanisms to action and discuss practical strategies APPs can use to improve outcomes for patients living with both obesity and IMIDs.

Thank you to AbbVie for your support on this FAQ Video Module.In this GHAPP FAQ Video Module, Christie Morrison, from Oshi Health and Texas Digestive Disease Consultants, explains how to discuss clinical remission with patients living with inflammatory bowel disease (IBD), including both Crohn’s disease and ulcerative colitis. She breaks down the different types of remission—clinical, biochemical, endoscopic, and steroid-free—and offers clear, practical ways for APPs and healthcare providers to communicate these concepts during patient visits. Christie discusses how to use objective markers such as CRP, ESR, fecal calprotectin, and lactoferrin, and how endoscopic scoring tools like the SES-CD and Mayo score can help track improvement and long-term disease control. She also emphasizes setting realistic expectations, the importance of treat-to-target goals, and the ultimate aim of achieving deep remission while minimizing steroid use. Watch to gain actionable strategies to educate your IBD patients about their treatment journey and the steps toward sustained remission.#IBD #CrohnsDisease #UlcerativeColitis #ClinicalRemission #GHAPP #IBDTreatment #APPeducation #TreatToTarget #IBDManagement

Thank you to AbbVie for your support on this podcast.In this episode of the GHAPP Podcast, Alison Krustapentus, NP-C and Christie Morrison, NP, join for an open discussion on mental and sexual health in inflammatory bowel disease (IBD). Together they explore the often-overlooked psychological and relational challenges that accompany chronic conditions like Crohn’s disease and ulcerative colitis—covering strategies to normalize sensitive conversations, screen for anxiety and depression using PHQ-2, PHQ-9, and GAD tools, and incorporate behavioral-health collaboration into routine care. The conversation also highlights practical ways to integrate IBD mental-health screening, sexual-wellness counseling, vaccine and health-maintenance checklists, and patient-partner communication into everyday gastroenterology practice. This episode underscores the importance of whole-person care in IBD management and offers real-world insights for APPs and healthcare professionals supporting patients living with chronic inflammatory disease.#IBD #CrohnsDisease #UlcerativeColitis #MentalHealth #SexualHealth #Gastroenterology #InflammatoryBowelDisease #AdvancedPracticeProviders #GHAPPodcast #IBDCare

Welcome to the first episode in our special cross-platform podcast collaboration on IMIDs and Obesity, shared across RhAPPcast, GHAPPcast, and Dermcast—the official podcasts of RhAPP, GHAPP, and SDPA. Hosted by Amanda Mixon, PA-C, President of RhAPP, this conversation titled “Obesity and IMIDs: Unpacking the Epidemic and Its Far-Reaching Impacts” explores one of the most under recognized yet clinically significant intersections in modern medicine—the link between obesity and immune-mediated inflammatory diseases. Joined by Laura Bush, PA-C, Erin Darguzas, NP, and Jennifer Hernandez Parra, APRN, the episode delves into the evidence behind obesity’s role in disease onset and progression across rheumatology, gastroenterology, dermatology, and metabolic health. Together, these experts examine how obesity influences inflammation, treatment response, and patient quality of life while highlighting the importance of multidisciplinary care and open communication between providers and patients. Tune in to gain practical insights on how advanced practice providers can better address obesity as a key driver of IMID burden, and stay tuned for upcoming episodes exploring pathophysiologic mechanisms and clinical management strategies.

Thank you to Ardelyx for your support on this APP Insight video module.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.#IBSC #IrritableBowelSyndrome #Gastroenterology #DigestiveHealth #GutHealth #GIHealth #IBSConstipation #IBSManagement #PatientEducation

Thank you to Ardelyx for your support on this podcast episode.In this podcast, Gabriella McCarty, NP, and Kimberly Orleck, PA-C, dive into the complexities of irritable bowel syndrome with constipation (IBS-C) and the wide range of therapies available to help patients. They discuss the importance of taking a thorough patient history to understand whether the primary symptom is constipation, bloating, abdominal pain, or overflow diarrhea—emphasizing that IBS-C treatment is not one-size-fits-all. Gabriella and Kim break down the differences between over-the-counter therapies like fiber and osmotic laxatives, which often help with bowel movements but do little for abdominal pain, and FDA-approved prescription options that also address visceral hypersensitivity, bloating, and global IBS symptoms. They explain how secretagogues and retenagogues work, set realistic expectations around therapy timelines, and highlight the importance of preparing patients for possible side effects such as diarrhea or nausea. By focusing on patient education, shared decision-making, and scheduled follow-up visits, they empower patients to better understand their condition and stay engaged in their care. This conversation provides practical guidance for both GI providers and patients navigating IBS-C management. For more educational resources, visit GHAPP.org and download the GHAPP ACE App.#IBSC #IrritableBowelSyndrome #Gastroenterology #DigestiveHealth #GutHealth #GIHealth #IBSManagement #IBSConstipation #PatientEducation #GHAPPcast

Thank you to Fujifilm for your support on this podcast episode.In this episode of GHAPPcast, the official podcast of Gastroenterology and Hepatology Advanced Practice Providers, host Samantha Ramirez, NP-C is joined by Tracy Licari, PA-C to explore the rise of biomarker-based algorithms like GALAD in the surveillance of hepatocellular carcinoma (HCC). With more than 25 years of hepatology experience, Tracy shares insights on how combining biomarkers such as AFP, AFP-L3, and DCP with demographic factors like age and gender can improve diagnostic accuracy, risk stratification, and early detection compared to AFP alone. The discussion highlights how GALAD has consistently demonstrated higher accuracy in retrospective studies, the importance of ongoing prospective validation, and the potential for these algorithms to reshape surveillance, treatment response monitoring, and post-transplant risk assessment. Samantha and Tracy also provide practical ways for clinicians to explain complex biomarker concepts to patients without overwhelming them, reinforcing the importance of education and shared decision-making in liver cancer care. This episode delivers actionable insights for APPs, hepatologists, and GI clinicians seeking to stay ahead in the evolving landscape of biomarker-driven surveillance.

Thank you to AbbVie for your support of this FAQ Video Module.In this educational discussion, Mikhail Alper, PA-C, from Fresno, California, highlights the critical role of biomarkers like fecal calprotectin and C-reactive protein (CRP) in managing inflammatory bowel disease (IBD), including ulcerative colitis and Crohn’s disease. He explains how these biomarkers provide objective measures of inflammation and treatment response—often revealing more than patient-reported symptoms alone. Michael outlines a practical monitoring timeline, recommending assessment at six weeks to gauge early symptom improvement, followed by biomarker testing at 12 weeks, and endoscopic evaluation at six months to confirm mucosal healing. He also notes the growing value of intestinal ultrasound, though access remains limited in some regions. This video underscores why integrating biomarker monitoring into IBD management is essential for optimizing therapy and improving patient outcomes.

Thank you to AbbVie for your support of this FAQ Video Module.In this educational video, Alison Krustapentus, NP-C from Beth Israel Deaconess Medical Center in Boston discusses how to approach persistent inflammation in patients with inflammatory bowel disease (IBD). She outlines a step-by-step process for confirming true disease activity using objective measures such as C-reactive protein (CRP), fecal calprotectin, cross-sectional imaging, and endoscopy.Alison also explains the role of therapeutic drug monitoring in optimizing anti-TNF therapy, including how to interpret trough levels and antibody testing to guide dose escalation or frequency adjustments. When drug levels are adequate but inflammation persists, she discusses switching mechanisms of action—from anti-TNF agents to IL-23 inhibitors, JAK inhibitors, or vedolizumab—to regain control of disease activity.This video helps clinicians distinguish between primary non-response and secondary loss of response, emphasizing the importance of tracking biomarkers and imaging over time to make informed treatment decisions.

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.

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

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

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

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

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

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