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July 2025
In this informative session, Jennifer Geremia, PA-C, a seasoned gastroenterology physician assistant in tertiary care Boston, addresses some of the most common questions primary care providers have about identifying and managing patients with fatty liver disease, MASLD (Metabolic dysfunction-associated steatotic liver disease), and MASH (Metabolic-associated steatohepatitis). Jennifer highlights the importance of using FIB-4 as a first-line non-invasive test (NIT) in high-risk patients with diabetes, obesity, or other metabolic conditions—noting how easily this tool can be integrated into routine labs via the EMR. She underscores that the liver is often overlooked in chronic disease management and makes a strong case for routine fibrosis screening alongside cardiovascular and diabetes evaluations. The talk also dives into actionable next steps after FIB-4 testing, including elastography, ELF testing, and referrals to GI when needed. Jennifer closes by discussing realistic lifestyle intervention goals—especially the importance of 7–10% weight loss for meaningful reductions in steatosis and fibrosis risk. This session is a must-watch for PCPs, APPs, and clinicians managing metabolic comorbidities and seeking practical, evidence-based strategies for early MASH detection and management.
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APP Insight: Misconceptions About Liver Health
June 2025
In this video, Anthony Derencius, PA-C at Pinnacle Clinical Research, clears up some of the most common misconceptions about liver health—offering valuable insights for both patients and healthcare providers. With extensive experience in hepatology, Anthony emphasizes that liver disease is often silent and asymptomatic, meaning many individuals may feel completely fine while living with a significant liver issue. He cautions against relying on a single lab result or imaging test to determine liver status, especially when assessing for conditions like cirrhosis, and stresses the importance of confirming findings through multiple diagnostic tools over time. Anthony also highlights the need for proactive screening, particularly in patients with risk factors such as obesity, diabetes, or a family history of liver disease. Early detection is key, and he encourages patients to advocate for their liver health by seeking evaluation—even if their provider hasn’t suggested it. This is a must-watch for anyone aiming to better understand the complexities of liver disease and the importance of early and accurate diagnosis.
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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 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 informative episode, Emily Przybyl, PA-C at Erie County Medical Center in Buffalo, NY, answers two of the most common questions primary care providers have about MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis): When should I refer to hepatology? and Is it safe to prescribe statins in patients with fatty liver disease? Emily explains that any history of hepatic steatosis on imaging or elevated liver enzymes (LFTs) is reason enough to initiate referral for further workup, including non-invasive testing like FIB-4 or FibroScan®. She also debunks the common myth that statins should be avoided in this population, emphasizing that statins are not contraindicated and are critical for managing cardiometabolic risk factors that drive liver disease progression. This episode is a must-watch for clinicians navigating MASLD/MASH in primary care, with practical guidance that supports early intervention and evidence-based management.
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APP Insight: Common Questions from Patients About MASH
June 2025
In this episode, Jordan Mayberry, MPAS, PA-C, a seasoned hepatology provider at UT Southwestern in Dallas, Texas, 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). With over 12 years of clinical experience, Jordan explains the root causes of MASLD/MASH, including key cardiometabolic risk factors like obesity, diabetes, hypertension, and hyperlipidemia, as well as genetic predispositions—particularly in Hispanic populations. He emphasizes the importance of fibrosis assessment in guiding treatment decisions, explaining that patients with early-stage disease should focus on lifestyle changes, while those with more advanced fibrosis (stages F2–F3) may be candidates for pharmacologic therapy such as resmetirom (Rezdiffra). Jordan also explores how prognosis depends on fibrosis stage and long-term management of comorbidities, making early intervention and risk stratification essential. This episode offers practical insights for clinicians aiming to improve conversations and care strategies for patients living with MASLD or MASH.
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Misconceptions About Liver Health
July 2025
In this short and informative video, Miu Lai Ng, a nurse practitioner at Tufts Medical Center, debunks two of the most common myths about liver health. First, she sets the record straight on liver cleanses and detox teas—explaining that your liver already detoxifies your body daily and doesn’t need fad diets or trendy supplements. Instead, what your liver needs is support through sustainable habits like reducing alcohol intake, cutting back on processed sugars, and maintaining a healthy weight. She also highlights a critical point: liver disease is often silent, and many people with significant liver damage have no symptoms until it’s advanced. If you're at risk due to metabolic syndrome, alcohol use, or other factors, Miu Lai urges you to talk to your healthcare provider about screening options like FIB-4 or FibroScan®. Your liver works hard for you—this video is a reminder to return the favor with real, lasting care.
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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 Community GI About MASH
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 Community GI About MASH
July 2025
In this insightful video, Christie Morrison, a local advanced practice provider with the GHAPP MASLD/MASH Community Network, answers two of the most frequently asked questions from community GI providers: when to refer patients with MASH to a transplant center and how to evaluate liver fibrosis when FibroScan® isn’t accessible. Christy emphasizes the importance of using non-invasive testing (NITs)—including FIB-4 and ELF (Enhanced Liver Fibrosis) scores—to help identify patients with F3 fibrosis, who are at higher risk for rapid progression to cirrhosis and hepatocellular carcinoma (HCC). She encourages early referral to transplant hepatology to avoid delays in care, especially given long wait times and the value of multidisciplinary support teams at transplant centers. For clinicians without access to FibroScan, Christy shares practical alternatives such as ordering reflex testing to ELF via major labs and leveraging easy-to-use digital tools like MDCalc for FIB-4 calculation. This episode is a valuable resource for GI providers looking to optimize liver care pathways and prevent late-stage complications in MASLD and MASH patients.
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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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