What does a GI specialist wish primary care providers knew before sending a referral?
In this episode, I’m joined by family nurse practitioner Paige Sosebee, who has worked in gastroenterology since 2019 at a large academic medical center. We talk through some of the most common GI concerns we see in primary care—and what happens on the other side of the referral.
Paige shares practical pearls on H. pylori testing and treatment, GERD and PPI trials, evaluating abnormal liver tests, celiac testing, chronic constipation, SIBO and intestinal methanogen overgrowth (IMO), and how primary care can make GI referrals more useful for both the specialist and the patient.
We also talk about something that comes up constantly for newer NPs: How much of this am I actually supposed to manage myself, and when is it time to ask a specialist for help?
In this episode, we cover:
- H. pylori testing, treatment, and common pitfalls
- GERD management and when to consider EGD
- Elevated liver enzymes and what to do before referring
- Celiac testing and the importance of testing before going gluten-free
- Chronic constipation, red flags, and initial management
- SIBO and intestinal methanogen overgrowth (IMO)
- How to make GI referrals more useful—and when they’re truly urgent
Timestamps:
00:00 – Introduction
02:19 – Meet GI specialist Paige Sosebee, FNP
04:31 – H. pylori testing, treatment & referrals
13:20 – GERD, PPIs & when to consider endoscopy
20:06 – Alginate therapy for GERD
22:31 – Elevated liver tests & GI referrals
24:51 – Elevated alkaline phosphatase & imaging
30:00 – Celiac disease testing
41:10 – Chronic constipation
46:00 – SIBO & intestinal methanogen overgrowth (IMO)
52:50 – When to refer to a GI specialist
56:00 – Clinical resources for primary care NPs
For a full transcript and conversation chapters, visit the blog: http://www.realworldnp.com/blog/gi-specialist
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