GHAPPcast

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.

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 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

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 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 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 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.

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 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.

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.

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.

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.

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.

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.