Best Practices for Assessing Minimally Elevated Liver Tests

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Sarah Cogle, PharmD, BCNSP, FASPEN Concerns over the inflammatory effects of traditional soybean-based lipid emulsions have prompted interest in alternatives like SMOFlipid—a four-oil blend designed to support hepatic function and reduce inflammation in parenteral nutrition. Joining Dr. Charles Turck to examine the clinical advantages, safety data, and key implementation strategies for SMOFlipid in adult patients is Dr. Sarah Cogle. Dr. Cogle is a Clinical Pharmacist Specialist at Vanderbilt University Medical Center in Nashville.

Host: Brian P. McDonough, MD, FAAFP Guest: Phil Ayers, PharmD, BCNSP, FMSHP, FASHP With the potential to reduce infection risk, improve operational efficiency, and enhance safety through standardization, multi-chamber bags are increasingly being used as an alternative to traditional compounded parenteral nutrition. To explore this approach and how it can be implemented in hospital and home care settings, Dr. Brian McDonough speaks with Dr. George Phillip Ayers. He's an Associate Clinical Professor at the University of Mississippi School of Pharmacy as well as the Chief of Clinical Pharmacy Services in the Department of Pharmacy at the Mississippi Baptist Medical Center in Jackson.

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Paul Adams, MD Hemochromatosis, a genetic condition that causes the body to absorb too much iron from food, often goes unrecognized despite its prevalance. With unique diagnostic and management challenges, it's crucial to understand how it presents, which testing strategies are most effective, and what treatment options are available. Tune in to hear Dr. Peter Buch and Dr. Paul Adams, Professor in the Division of Gastroenterology at the Western University in London, Canada, discuss the latest on hemochromatosis.

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Charles Kahi, MD Computer-aided detection systems (CADe) are transforming adenoma detection and enhancing colonoscopy quality. Dr. Peter Buch sits down with Dr. Charles Kahi to unpack the latest American Gastroenterological Association (AGA) guideline, evidence from randomized controlled trials, and the practical implications of integrating AI tools into clinical practice. Dr. Kahi is a Professor of Medicine at Indiana University School of Medicine, and he helped develop the AGA Living Clinical Practice Guideline on Computer-Aided Detection-Assisted Colonoscopy, which was published in Gastroenterology in 2025.

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Alexa Weingarden, MD PhD Probiotic use in gastroenterology remains a complex and evolving topic, shaped by variable evidence and growing patient demand. Dr. Peter Buch sits down with Dr. Alexa Weingarden to review current data, discuss distinctions between probiotic-related therapies, and explore the clinical utility of microbiome testing. Dr. Weingarden is an Assistant Professor of Gastroenterology, Hepatology, and Nutrition at the University of Minnesota Medical School.

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: David Levinthal, MD, PhD Cyclic vomiting syndrome (CVS) is often underdiagnosed in adults due to its episodic nature and symptom overlap with other conditions. Dr. David Levinthal joins Dr. Peter Buch to explore key diagnostic criteria, key differences between CVS and cannabinoid hyperemesis syndrome (CHS), and evidence-based treatment strategies. Dr. Levinthal is the Director of the UPMC Neurogastroenterology and Motility Center and an Associate Professor of Medicine at the University of Pittsburgh School of Medicine.

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Yinghong Wang, MD, PhD, MS Immune checkpoint inhibitor (ICI) colitis comes with unique diagnostic and treatment challenges, which means that recognizing and managing it effectively is key to the best outcomes. Joining Dr. Peter Buch to share her insights on caring for patients with this complex condition is Dr. Yinghong Wang. Dr. Wang is a Professor in the Department of Gastroenterology, Hepatology, and Nutrition at MD Anderson Cancer Center in Houston, Texas, as well as Director of the Oncology-GI Toxicity Program, Director of Fecal Microbiota Transplantation, Deputy Division Head of Research in the Division of Internal Medicine, and Chair of the MD Anderson Cancer Center Immunotherapy Toxicity Working Group.

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Nabil Mansour, MD Artificial intelligence, simulation platforms, augmented reality, and other technological innovations are transforming our approach to GI training. In this expert-led discussion, Dr. Peter Buch sits down with Dr. Nabil Mansour to discuss how we can integrate cutting-edge tools into colonoscopy training while preserving core competencies. Dr. Mansour is an Associate Professor and the Director of the McNair General GI Clinic at Baylor College of Medicine in Houston.

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Paul Kwo, MD While sometimes overlooked, minimally elevated liver tests may signal early liver disease or non-hepatic conditions like thyroid dysfunction. As a result, interpreting ALT and AST thresholds, assessing metabolic risk, and reviewing lifestyle factors can help shape a focused diagnostic approach and reduce liver-related complications. Joining Dr. Peter Buch to provide insights into the evaluation of minimally elevated liver tests is Dr. Paul Kwo, who’s a Professor of Medicine and Director of Hepatology at Stanford University.

Guest: Francis Farraye, MD Host: Peter Buch, MD, FACG, AGAF, FACP A 2025 update to the American College of Gastroenterology (ACG)'s guideline on preventive care in inflammatory bowel disease (IBD) includes key changes impacting vaccine recommendations, dermatologic screening, and care coordination. Dr. Peter Buch sits down with Dr. Francis Farraye, lead author of this guideline, to highlight what clinicians need to know. Dr. Farraye is a Professor of Medicine and the Director of the Inflammatory Bowel Disease Center at the Mayo Clinic in Jacksonville, Florida