Abigail Meyers, MPAS, PA-C, was 9 years old when a diagnosis of ulcerative colitis set the trajectory of her future career.
“There weren’t a lot of medical therapies available back then,” recalls Meyers, who had to undergo multiple hospitalizations and surgeries for her condition. Medical staff would say: “Oh I know how you feel,” then retract their words when Meyers would ask if they had ever experienced a nasogastric tube or ileostomy.
“I’m going to go into healthcare. I’m going to take care of patients with inflammatory bowel disease [IBD] and I will never say ‘I know how you feel’ unless I truly mean it,” Meyers vowed to her mother one night at the hospital.
And that’s exactly what she did. During her training as a physician assistant (PA), Meyers had the opportunity to do an adult colorectal surgery rotation and a pediatric gastroenterology rotation. Another bonus: she got to work with the gastroenterologist who treated her when she was a 9-year-old patient.
Meyers has never told a patient, “I know how you feel.” Instead, she might say: “This is really hard. This is something new. This is a challenging moment. You’re allowed to feel upset, you’re allowed to feel disappointed, you’re allowed to feel scared.”
A clinical expert in gastroenterology and colon and rectal surgery, Meyers spent 10 years at the Mayo Clinic as a PA in colon and rectal surgery and gastroenterology. She currently works as the assistant director of student success and development at the Medical College of Wisconsin in Milwaukee.
On days where things are hard and the grind of the day-to-day work in healthcare becomes too challenging, “I get to remind myself that I do make an impact,” said Meyers. If a patient ever asks her, “Have you ever had an ileostomy before?” Meyers can honestly answer that she has and then describe what it was like.
“I think that allows them to have a little bit of an ‘aha’ moment or a breakthrough in their recovery journey or their acceptance journey, whatever that looks like through this disease process,” she said.
In an interview, she discussed the work she’s done on multiple fronts to guide the careers of advanced practice providers (APPs), and the special connection she has with her patients.
Tell me about your preceptor work with the Crohn’s and Colitis Foundation’s APP Preceptorship program.
It is one of my proudest accomplishments, particularly in the preceptorship program. As a patient, the Crohn’s and Colitis Foundation provided a lot of education and resources when my family was going through a tough time. To be able to give back to the foundation, whether that’s resources for patients or providers, is really great. It’s helped me grow a lot professionally. I realized I enjoyed educating not just my patients, but also my peers. While I worked at Mayo Clinic, I had a wonderful opportunity at a tertiary IBD center for students and advanced practice providers to come and shadow me in colorectal surgery and managing IBD patients.
Michele Rubin, MSN, an advanced practice nurse and Maureen Kelly, MS, RN, CPNP, a nurse practitioner, started the foundation’s preceptor program and graciously took me under their wing.
Originally, there was just one site at the University of Chicago. When I joined, it expanded to the University of North Carolina at Chapel Hill for pediatric experience, and Mayo Clinic Rochester [Minnesota]. There are now seven participating host sites for the 2025 cycle.
The curriculum varies at each site based upon what resources are available. We really tried to tailor it to each individual preceptor. If there’s a nurse practitioner that used to be an ostomy nurse, maybe she’ll get time in the ostomy nurse area, but maybe she wants more time with the pharmacist or the radiologist.
If there is somebody who’s coming through that knows nothing about surgery, maybe they want a little bit more time in the surgical sphere. I tried to, when creating the curriculum for this, create a lot of options that existed for didactic learning as well as practical application.
You’re the assistant director of student success and development at the Medical College of Wisconsin, which launched a new Physician Associate Program. What’s happened with the program so far?
We do not have enrolled students yet. We are developing the program from the bottom up. I am one of four faculty, and then we have our founding director, Christine M. Everett, PhD, MPH, PA-C.
As we develop our program we are trying to keep a holistic approach in mind. We’re thinking about what a traditional student is vs a nontraditional student, and who we think will make great physician assistants. We pull from our own personal experiences as educators and experts in our field. As somebody who is academically minded, this program really spoke to me. Many PAs and nurse practitioners (NPs) fill a primary care role. But as we search to develop academically minded physician associates to join academic medical practices in an anticipated physician shortage, we want to hone in on some of these specialty care areas, recognizing that there is a place for us in academia and asking ‘what does that look like and how do we grow in those subspecialties?’
So, how can I help to foster that type of desire and growth and professional development in my students? That will be what we’re going to be tackling in our future cohorts.
Has the program generated a lot of interest?
Most PAs train in the region they are from and end up practicing there. So, our community and institution are very excited. There’s a lot of work in creating the program and making sure that the goals we have in mind will continue to grow with the profession. One of my neighbors who just started college reached out to me and said she wants to be a PA. We get emails regularly asking what people should do to prepare for PA school, and what are we looking for. PAs and NPs are growing professions. Both are on the top five list of best jobs ranked by U.S. News & World Report right now.
You’re the co-chair of AGA’s NPPA Task Force. What are the goals of this task force, specifically for 2025?
This is a new task force. We’re really excited about it, and we feel very supported by AGA. Specifically, we are focusing on content review and optimization. We’re working through and consulting on different proposals, such as how to have an NP/PA voice within AGA, or how certain proposals can be of interest to APPs or applicable to an APP practice.
One of our other goals is to grow our APP community opportunities, to find ways that we can all communicate with each other, share in our professional accomplishments, and be mentors and sponsors to each other to open the doors for professional growth within the GI space.
We are trying to create a sense of community within all the societies that APPs are involved in, and recognize everyone’s professional development and goals. We want to create a space to connect at some of our primary conferences and touchpoints, regardless of where your society home is.
We’ve also been asked to be a representative in helping to select the AGA-Pfizer Beacon of Hope Awards for Gender and Health Equity award recipients. We’re really proud that one of our task force members is going to be sitting on that committee to help select recipients of this award.
As a clinical expert in gastroenterology and colon and rectal surgery, you often present to national organizations like AGA, the Crohn’s and Colitis Foundation, and the American Society of Colon & Rectal Surgeons. What topics do you discuss and why?
It’s always been IBD because of my background. But I’ve also grown more in the colon/rectal surgery sphere, both in the inpatient, outpatient, and operating room setting. I enjoy presenting on topics like: What could you do right before you send a patient off to a tertiary IBD referral? I talk about complex disease management, especially the surgical realm of perianal Crohn’s disease. One of my colleagues jokes that one of her favorite talks I’ve ever given is how to perform a perianal examination. It’s a sensitive exam. I feel like I’m pretty good at it!
I also think it’s important to share information on how to write papers and how to present at conferences, because there are a lot of really smart NPs and PAs in GI and colorectal surgery who — for whatever reason — don’t know how to get their foot in the door for these types of opportunities. I love to be the person that opens that door. Do you want to be involved in a professional society? In what capacity? Making that information broadly available to everyone is something that I really love doing.
Describe a memorable patient encounter that helped shape your career.
I know this will sound so cliché, that there isn’t just one, but it’s true. There is a connection that I create with each and every one of my patients. I listen to their stories. They have whole lives outside of their disease, and I am honored that they open up to me — whether that is ongoing communication and check-ins with a patient’s family member a year after they’ve passed away, or every year receiving a Christmas card from a patient who is expanding their family because they’re finally in remission from their disease. These are the types of things that are so impactful and memorable.
Describe how you would spend a free Saturday afternoon.
I’m a mom to 7-year-old boy twins, and so I often don’t have a free Saturday. If I did, it would be sunny. I would go for a long run and then I would go out for brunch with my husband and then come home and read with my kids in a cozy blanket all day.
Lightning Round
What would you be if you weren’t a GI?
First grade teacher.
Last movie you watched?
Mufasa: The Lion King.
Best Halloween costume?
Velma from Scooby Doo.
Favorite sport?
To play – Tennis.
To watch – NBA basketball, “Go Timberwolves!”
Place you most want to travel to?
Greece
Favorite movie genre?
Rom-com.
Cat person or dog person?
Cat.
Favorite city besides the one you live in?
Manhattan.
Favorite season
Fall.
Favorite junk food?
Salty snack mix.
How many cups of coffee do you drink per day?
Three.
Summary content
7 Key Takeaways
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1
Developed a paper-based colorimetric sensor array for chemical threat detection.
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Can detect 12 chemical agents, including industrial toxins.
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Production cost is under 20 cents per chip.
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Utilizes dye-loaded silica particles on self-adhesive paper.
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Provides rapid, simultaneous identification through image analysis.
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Inspired by the mammalian olfactory system for pattern recognition.
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Future developments include a machine learning-enabled reader device.
The guidelines emphasize four-hour gastric emptying studies over two-hour testing. How do you see this affecting diagnostic workflows in practice?
Dr. Staller: Moving to a four-hour solid-meal scintigraphy will actually simplify decision-making. The two-hour reads miss a meaningful proportion of delayed emptying; standardizing on four hours reduces false negatives and the “maybe gastroparesis” purgatory that leads to repeat testing. Practically, it means closer coordination with nuclear medicine (longer slots, consistent standardized meal), updating order sets to default to a four-hour protocol, and educating front-line teams so patients arrive appropriately prepped. The payoff is fewer equivocal studies and more confident treatment plans.
Metoclopramide and erythromycin are the only agents conditionally recommended for initial therapy. How does this align with what is being currently prescribed?
Dr. Staller: This largely mirrors real-world practice. Metoclopramide remains the only FDA-approved prokinetic for gastroparesis, and short “pulsed” erythromycin courses are familiar to many of us—recognizing tachyphylaxis limits durability. Our recommendation is “conditional” because the underlying evidence is modest and patient responses are heterogeneous, but it formalizes what many clinicians already do: start with metoclopramide (lowest effective dose, limited duration, counsel on neurologic adverse effects) and reserve erythromycin for targeted use (exacerbations, bridging).
Several agents, including domperidone and prucalopride, received recommendations against first-line use. How will that influence discussions with patients who ask about these therapies?
Dr. Staller: Two points I share with patients: evidence and access/safety. For domperidone, the data quality is mixed, and US access is through an FDA IND mechanism; you’re committing patients to EKG monitoring and a non-trivial administrative lift. For prucalopride, the gastroparesis-specific evidence isn’t strong enough yet to justify first-line use. So, our stance is not “never,” it’s just “not first.” If someone fails or cannot tolerate initial therapy, we can revisit these options through shared decision-making, setting expectations about benefit, monitoring, and off-label use. The guideline language helps clinicians have a transparent, evidence-based conversation at the first visit.
The guidelines suggest reserving procedures like G-POEM and gastric electrical stimulation for refractory cases. In your practice, how do you decide when a patient is “refractory” to medical therapy?
Dr. Staller: I define “refractory” with three anchors.
1. Adequate trials of foundational care: dietary optimization and glycemic control; an antiemetic; and at least one prokinetic at appropriate dose/duration (with intolerance documented if stopped early).
2. Persistent, function-limiting symptoms: ongoing nausea/vomiting, weight loss, dehydration, ER visits/hospitalizations, or malnutrition despite the above—ideally tracked with a validated instrument (e.g., GCSI) plus nutritional metrics.
3. Objective correlation: delayed emptying on a standardized 4-hour solid-meal study that aligns with the clinical picture (and medications that slow emptying addressed).
At that point, referral to a center with procedural expertise for G-POEM or consideration of gastric electrical stimulation becomes appropriate, with multidisciplinary evaluation (GI, nutrition, psychology, and, when needed, surgery).
What role do you see dietary modification and glycemic control playing alongside pharmacologic therapy in light of these recommendations?
Dr. Staller: They’re the bedrock. A small-particle, lower-fat, calorie-dense diet—often leaning on nutrient-rich liquids—can meaningfully reduce symptom burden. Partnering with dietitians early pays dividends. For diabetes, tighter glycemic control can improve gastric emptying and symptoms; I explicitly review medications that can slow emptying (e.g., opioids; consider timing/necessity of GLP-1 receptor agonists) and encourage continuous glucose monitor-informed adjustments. Pharmacotherapy sits on top of those pillars; without them, medications will likely underperform.
The guideline notes “considerable unmet need” in gastroparesis treatment. Where do you think future therapies or research are most urgently needed?
Dr. Staller: I see three major areas.
1. Truly durable prokinetics: agents that improve emptying and symptoms over months, with better safety than legacy options (e.g., next-gen motilin/ghrelin agonists, better-studied 5-HT4 strategies).
2. Endotyping and biomarkers: we need to stop treating all gastroparesis as one disease. Clinical, physiologic, and microbiome/omic signatures that predict who benefits from which therapy (drug vs G-POEM vs GES) would transform care.
3. Patient-centered trials: larger, longer RCTs that prioritize validated symptom and quality-of-life outcomes, include nutritional endpoints, and reflect real-world medication confounders.
Our guideline intentionally highlights these gaps to hopefully catalyze better trials and smarter referral pathways.
Dr. Staller is with the Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston.