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July 2025
In this practical and timely video, Erin Tanner, NP at Gastro Health in Birmingham, Alabama, shares expert insights on how community gastroenterology providers should approach incidental findings of fatty liver (MASLD/MASH) on abdominal imaging. With over 14 years of experience in GI and hepatology, Erin emphasizes that fatty liver can no longer be ignored, even when discovered during workups for unrelated GI symptoms like reflux or diarrhea. She walks through the step-by-step use of the FIB-4 index to risk-stratify patients and explains when to follow up with further non-invasive testing such as FibroScan® or ultrasound elastography. For patients with F3 fibrosis, Erin outlines next steps including lifestyle interventions, the use of Resmetirom, and the promise of GLP-1 therapies for future treatment. This is a must-watch for GI clinicians aiming to improve outcomes by proactively managing fatty liver disease in everyday practice.
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Common Questions from Patients About MASH
July 2025
In this impactful episode, Sherona Bau, NP from UCLA, addresses the most frequent and pressing questions patients ask after being diagnosed with MASLD (Metabolic dysfunction-associated steatotic liver disease) or MASH (Metabolic-associated steatohepatitis)—including concerns about life expectancy, risk of liver failure, liver cancer, and genetic impact on family members. She emphasizes the importance of risk stratification using non-invasive testing, particularly FibroScan®, to determine the extent of fat accumulation and liver fibrosis. Sherona explains that early identification of stage 2 or 3 fibrosis is critical, as treatment options are now available for these stages, offering hope for patients. She also stresses that MASLD is not just a liver disease—it's a systemic, metabolic condition—and encourages coordinated care with endocrinologists, cardiologists, and dietitians. Additionally, she discusses the hereditary nature of fatty liver and the importance of family screening, especially for children of affected individuals. This video offers clear, compassionate guidance for patients and providers navigating the complexities of fatty liver disease.
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APP Insight: Common Questions from Patients About MASH
June 2025
In this insightful video, Patrick Horne, NP, from the University of Florida, addresses some of the most frequently asked questions from patients diagnosed with MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction–Associated Steatohepatitis). Drawing from his clinical experience, he answers common concerns such as: “How did I get fatty liver if I don’t drink alcohol?”, clarifying that alcohol is not a necessary factor in developing these conditions—rather, metabolic risk factors like obesity, diabetes, hypertension, and genetic predisposition play a significant role. Patrick also dives into lifestyle recommendations, including the importance of adopting a mediterranean diet, engaging in regular physical activity, and setting realistic weight loss goals. Additionally, he tackles the nuanced question of alcohol consumption in patients with MASLD/MASH, emphasizing individualized care depending on the stage of liver disease. This session is a must-watch for both patients and providers seeking practical, evidence-based guidance on managing metabolic liver disease.
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APP Insight: Common Questions from Community GI About MASH
June 2025
In this informative video, Janet Gripshover, DNP, FNP-BC, and nurse manager for the liver transplant program at Cedars-Sinai, answers key questions about managing MASH (Metabolic Dysfunction–Associated Steatohepatitis) and navigating non-invasive testing. She addresses a common clinical challenge—what to do when FIB-4 and FibroScan results are discordant. Janet explains that while non-invasive tests are useful, they're not foolproof, and when results are unclear—especially in patients with significant metabolic risk factors—liver biopsy remains the gold standard for accurate diagnosis. She also shares expert recommendations on dietary changes for patients with fatty liver disease, emphasizing alcohol avoidance, high-protein, low-fat, and lower-carb diets, as well as achievable weight loss goals (around 5% of body weight). Janet highlights when to escalate care beyond lifestyle interventions—typically after 3 to 6 months if there’s no improvement—and discusses options such as pharmacologic therapy or bariatric surgery. This video provides practical, evidence-based guidance for healthcare providers managing the complexities of MASLD and MASH.
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APP Insight: Misconceptions About Liver Health
June 2025
In this video, Scott Springer, PA-C, from Erie County Medical Center in Buffalo, NY, addresses one of the most common misconceptions in liver health—trusting over-the-counter supplements and detox products to improve liver function. Drawing from his experience in both hepatology and addiction medicine, Scott emphasizes that many non-prescribed products marketed for liver support are not only ineffective but can actually cause liver harm. He cautions against relying on unregulated supplements and urges patients to consult medical professionals before taking anything for liver health. One surprising and evidence-based recommendation he makes: drink coffee. Filtered coffee, in particular, has been shown to support liver health and may reduce the risk of liver disease progression. Scott recommends two to three cups per day, without added sugar or excess dairy—especially for patients with MASLD or MASH. This video offers practical, research-backed advice for patients and providers alike, highlighting what truly helps (and what may harm) the liver.
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APP Insight: Misconceptions About Liver Health
June 2025
In this video, Gabriella McCarty, NP-C, of Northshore Gastroenterology in Cleveland, Ohio, tackles common misconceptions surrounding fatty liver disease, also known as MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease). Drawing from her clinical experience, Gabriella highlights how fatty liver is often an incidental finding during routine GI visits, even when patients present for unrelated concerns like GERD or colon screenings. She emphasizes that MASLD is not caused by alcohol, but instead driven by metabolic risk factors such as obesity, diabetes, high cholesterol, and hypertension. Gabriella dispels the myth that normal liver enzymes indicate a healthy liver, explaining that liver markers are often unreliable in detecting advanced fibrosis or cirrhosis. She also warns against unregulated liver detox products and the outdated belief that fatty liver is harmless. With MASLD now the most common liver disease worldwide and increasing rates among younger populations, Gabriella stresses the importance of early screening, lifestyle modification, and patient education. This is a must-watch for anyone looking to better understand the silent progression of fatty liver disease and the tools available for timely intervention.
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Common Questions From Primary Care Providers About MASH
July 2025
In this insightful episode, Jessica Crimaldi, NP from the Cleveland Clinic, addresses two of the most frequently asked questions from primary care providers about MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis). First, she clarifies a common concern regarding statin use in patients with liver disease, emphasizing that statins are not only safe in most cases—including compensated cirrhosis—but also beneficial in managing cardiometabolic risk factors and slowing disease progression. She explains when statins are contraindicated and encourages collaboration with hepatology if there are concerns. Second, Jessica outlines a practical pre-referral workup for suspected MASLD/MASH patients. She details the labs needed to calculate FIB-4, suggests ordering an INR, and highlights the importance of screening for viral hepatitis, autoimmune liver disease, and common genetic liver disorders. This episode offers clear, actionable guidance for providers managing fatty liver disease in primary care and is a valuable resource for improving early diagnosis and coordinated care.
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APP Insight: Common Questions from Community GI About MASH
July 2025
In this episode, HoChong Gilles, DNP, FNP-BC, a seasoned hepatology expert and Clinical Program Director at the Central Virginia VA Health Care System, addresses a frequently asked question from primary care and community GI providers: How do you risk stratify patients without access to a FibroScan? Drawing on over 25 years of clinical experience, HoChong outlines practical strategies for assessing liver fibrosis using the FIB-4 score—a simple calculation based on patient age, ALT, AST, and platelet count. She also discusses how tools like the Enhanced Liver Fibrosis (ELF) test, available through Quest or Labcorp, can serve as valuable alternatives in the absence of elastography. Whether you're managing incidental hepatic steatosis or evaluating elevated liver enzymes, this episode offers step-by-step guidance for using non-invasive biomarkers to stratify liver disease risk and guide referrals effectively. Perfect for clinicians in primary care, GI, and hepatology seeking practical, accessible tools for early liver disease assessment.
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APP Insight: Common Questions from Patients About MASH
June 2025
In this video, Jonathan Yeh, PA, answers three of the most frequently asked questions about MASH—Metabolic Dysfunction–Associated Steatohepatitis—and offers practical advice for understanding and managing this progressive form of fatty liver disease. He begins by explaining what MASH is: an inflammatory, more advanced stage of MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease), driven by abnormal fat accumulation in the liver due to impaired fat transport. Jonathan then breaks down the treatment approach, emphasizing the importance of lifestyle modification—particularly diet and exercise. He highlights the benefits of a green Mediterranean diet, regular physical activity, and sustainable weight loss, which can improve or even reverse MASH in many patients. For individuals with more advanced fibrosis, pharmacologic treatment with resmetirom (Rezdiffra) may be indicated. This concise FAQ offers helpful guidance for patients and providers alike on tackling MASH with evidence-based strategies.
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Common Questions from Primary Care Providers About MASH
July 2025
In this FAQ session, Brian Lam, PA-C, breaks down a common question he receives from primary care providers, endocrinologists, and even other GI specialists: Which patients with fatty liver should be referred to hepatology or GI for further evaluation? Using a clear and practical approach, Brian explains how to apply FIB-4, a simple lab-based non-invasive test, to guide referrals. He emphasizes that patients with metabolic syndrome—especially those with diabetes—are at significantly higher risk for MASH (Metabolic dysfunction-associated steatohepatitis), with roughly 1 in 3 diabetic patients affected. If the FIB-4 is greater than 1.3, or greater than 2.0 in adults over 65, it's time to refer. Brian also highlights the utility of FIB-4 with reflex to ELF, now available through major labs like LabCorp and Quest, as an efficient two-step method to detect advanced fibrosis and at-risk MASH. This video is perfect for busy clinicians looking for a referral-friendly workflow to catch MASH early and improve liver health outcomes in high-risk populations.
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Common Questions From Primary Care Providers About MASH
July 2025
In this concise and practical discussion, Lindsay Pratt, PA-C from the University of Colorado’s Department of Hepatology and Liver Transplant, shares expert guidance on screening and managing patients with MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis). Speaking directly to the common questions she receives from primary care providers, Lindsay outlines when to screen for MASLD/MASH—emphasizing the importance of evaluating patients with elevated liver enzymes, hepatic steatosis on imaging, and cardiometabolic risk factors like diabetes, hypertension, hyperlipidemia, and sleep apnea. She breaks down the utility of FIB-4 as a first-line non-invasive test, when to use FibroScan®, and clears up a common misconception about statin use in liver disease—encouraging providers to continue or initiate statins when indicated. This session is ideal for clinicians managing metabolic syndrome and its liver manifestations and offers simple, evidence-based tools to identify at-risk patients early.
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