GI Specialist Interview: H. pylori, GERD, Celiac, Constipation & When to Refer

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

______________________________

© 2026 Real World NP. For educational and informational purposes only, see https://www.realworldnp.com/disclaimer for full details.

Hosted on Acast. See acast.com/privacy for more information.