OR WAIT null SECS
Optimizing Care Pathways in Gastrointestinal Bleeding, With Jessica Gandhi, PA
Gandhi describes the crucial role APPs play in GI bleeding care and the importance of collaborative management of these patients.
Gastrointestinal bleeding remains a major cause of hospital admissions and a critical challenge for providers across care settings. Effective management requires not only swift medical decision-making but also seamless coordination across providers and services.
Advanced practice providers (APPs) are increasingly at the center of this process, frequently serving as the first point of contact and shaping the initial evaluation and management plan. Their role extends beyond triage, driving collaboration among specialties and ensuring patients receive timely, coordinated care, as highlighted at the 2025 Gastroenterology & Hepatology Advanced Practice Providers (GHAPP) conference by Jessica Gandhi, PA, a physician assistant at Capital Digestive Care.
“It's really important for APPs to understand our roles and how important it is,” Gandhi told HCPLive. “We're not just the person just answering the phone. We're actually triaging, evaluating, ordering those tests, ordering imaging, setting up procedures, sort of outlining the rest of that hospital course for that patient. So our role is really tremendous in that regard.”
In her session at GHAPP, Gandhi says a primary focus was the importance of spending time with patients to gather a detailed history before extensive testing begins. APPs often excel at taking those extra minutes to listen to the patient’s story—how symptoms started, how they’ve progressed, and what the patient’s overall condition looks like. She says this approach not only aids in identifying the source and severity of bleeding but also helps stratify risk and guide the urgency of interventions while reducing confusion, improving communication, and ensuring patients feel reassured about their care pathway.
Collaboration is another cornerstone of effective GI bleed management. Beyond the GI team, Gandhi explains how APPs work closely with emergency room staff, ICU providers, endoscopy teams, nurses, and sometimes cardiology, depending on comorbidities.
As a practical clinical pearl, Gandhi underscores the importance of performing a rectal exam in every patient presenting with suspected GI bleeding. Despite being underutilized, she says this step can provide invaluable information that may not align with patient history or lab results and should not be overlooked.
