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August 2025
In this educational video, HoChong Gilles, NP—Clinical Program Director at the Central Virginia VA Healthcare System—breaks down practical, non-invasive strategies for evaluating liver fibrosis in community GI and primary care settings. With over 25 years of hepatology experience, she walks through the importance of calculating the FIB-4 score using just four parameters: age, ALT, AST, and platelet count. Learn how to interpret FIB-4 score cutoffs to determine low, indeterminate, or high risk of advanced fibrosis and explore alternative tools like the ELF (Enhanced Liver Fibrosis) test when imaging options are limited. Whether you're a hepatology specialist or a frontline provider, this video offers actionable insights to help bridge the gap in liver care access using guideline-supported lab-based methods.
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Misconceptions About Liver Health
July 2025
In this quick myth-busting session, Elizabeth Alqueza, PA-C from Beth Israel Deaconess Medical Center in Boston, addresses two of the most common misconceptions in hepatology related to steatotic liver disease (MASLD/MASH). First, she explains that liver disease is not always fixed or irreversible—and with proper management and elimination of the underlying cause, liver fibrosis can improve over time, a trend often monitored through FibroScan®. Second, she clarifies that significant liver improvement does not require extreme weight loss. In fact, a modest 5–10% reduction in total body weight—sometimes as little as 10–20 pounds—can lead to measurable improvements in liver inflammation and fibrosis. This video is ideal for providers and patients seeking a clearer understanding of how lifestyle changes can reverse liver disease and why timely, targeted interventions matter.
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Common Questions From Patients About MASH
August 2025
Discover practical insights into managing fatty liver disease from Melissa Franco, PA, a hepatology expert at the University of Miami. In this MASLD Community Network episode, Melissa answers one of the most common questions from patients: what causes fatty liver and how to improve it. She explains the multiple factors that can lead to fatty liver, including lifestyle, diet, genetics, alcohol use, and certain medications, and emphasizes the critical role of dietary modifications and regular exercise—often recommending the Mediterranean diet. Melissa also addresses alcohol use in patients with fatty liver, sharing why she discourages it entirely due to its potential to accelerate fibrosis progression, even at mild intake levels. Learn why personalized nutrition, physical activity, and avoiding alcohol are key steps in slowing disease progression and protecting liver health. Whether you’re a patient, caregiver, or healthcare professional, this video offers clear, evidence-based guidance on managing fatty liver disease effectively.
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Misconceptions About Liver Health
August 2025
Elizabeth Goacher, PA-C at Duke University in Durham, North Carolina, addresses a common misconception about Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)—that it’s a “death sentence.” While early screening and awareness are critical, Elizabeth emphasizes the importance of balanced messaging: most patients with MASLD, especially those without advanced fibrosis, will not experience liver failure or require a transplant. Instead, their greatest health risks are often from cardiovascular disease and all-cause malignancy, making lifestyle changes, metabolic health management, and cardiovascular risk reduction key priorities. This discussion encourages both patients and referring providers to focus on evidence-based care, clear communication, and realistic risk assessment, ensuring that awareness doesn’t translate into unnecessary fear.
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Common Questions From Community GI About MASH
August 2025
In this MASLD Community Network episode, Valerie Shin, NP with UCLA Health Hepatology, addresses frequently asked questions from community GI providers about noninvasive tests (NITs) for assessing steatosis and fibrosis in MASLD and MASH. She reviews the benefits and key limitations of the FIB-4 score—highlighting the risk of false negatives in patients with normal AST/ALT levels, false positives in older patients, and inaccuracy when thrombocytopenia is unrelated to liver disease. Valerie explains when to consider second-line NITs, including transient elastography (FibroScan®), ELF score, and MR elastography, detailing their strengths, availability challenges, and technical limitations such as operator dependence, BMI restrictions, and insurance coverage issues. She also clarifies the rare but important role of liver biopsy when NITs produce conflicting or inconclusive results. Whether you’re a healthcare provider seeking practical diagnostic guidance or a patient wanting to understand your testing options, this video offers expert insights into selecting and interpreting noninvasive liver tests for MASLD and MASH.
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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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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 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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Common Questions From Community GI About MASH
July 2025
In this session, Lavinia Iordache, PA-C, from the University of Miami, draws on a decade of experience in inpatient and outpatient hepatology to address common management questions related to MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis). She provides practical guidance for gastroenterology providers navigating when to monitor versus refer patients with fibrosis, how to interpret and time non-invasive testing (NITs) such as FIB-4, and when liver biopsy may still play a role—particularly in cases with persistently elevated liver enzymes despite lifestyle improvement. Lavinia also dives into the referral criteria for hepatology, the evolving role of resmetirom in stage 2–3 fibrosis, and the critical topic of HCC screening. While current AASLD guidelines limit HCC surveillance to cirrhosis, Lavinia highlights emerging evidence and EASL recommendations supporting imaging in patients with F3 fibrosis based on individualized risk factors like diabetes, genetics, and obesity. She also explains why CT or MRI is often preferred over ultrasound in MASLD patients due to obesity-related imaging limitations. This is a must-watch for hepatology and GI teams managing liver fibrosis in metabolic disease.
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Common Questions From Primary Care Providers About MASH
August 2025
In this MASLD Community Network episode, Edith Johannes, NP at UCLA Health, shares evidence-based guidance on one of the most important questions in managing Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction–Associated Steatohepatitis (MASH): how much weight loss is needed to improve liver health. Drawing on years of experience in hepatology and liver transplant care, Edith explains how weight loss can reduce liver fat (steatosis), decrease inflammation, improve or even reverse fibrosis, and support better overall metabolic health. Research shows that achieving more than 10% weight loss can result in 100% improvement in steatosis, MASH resolution in 90% of patients, and fibrosis regression in over 80%. Even smaller amounts of weight loss—5% to 10%—provide significant liver and metabolic benefits, while exercise and dietary changes can help improve liver function even without weight loss. Edith also discusses when additional treatments like GLP-1s, bariatric surgery, or resmetirom may be needed. This video is essential for healthcare providers, patients, and caregivers seeking practical, science-backed strategies to manage MASLD and MASH effectively.
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Common Questions From Patients About MASH
July 2025
In this informative video, Ellie Gonyeau, a nurse practitioner in general gastroenterology at Beth Israel in Boston, answers some of the most common questions she hears from patients about MASLD (Metabolic dysfunction-Associated Steatotic Liver Disease). With compassion and clarity, Ellie addresses concerns about the seriousness of the condition, explaining that while MASLD can progress to advanced liver disease, early intervention can make a significant difference. She emphasizes the importance of not delaying care and encourages patients to take manageable steps—like losing just 5–10% of their body weight—to reduce liver inflammation and slow disease progression. Nutrition, exercise, and proactive conversations are central to her patient-centered approach. Whether you're newly diagnosed or seeking guidance, this episode offers valuable, practical insights for anyone navigating MASLD. #MASLD #FattyLiver #LiverHealth #GIcare #BethIsrael #NursePractitioner #Gastroenterology #PatientEducation #LiverDisease #WeightLossSupport
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