This book was designed to help gastroenterologists take care of their patients with challenging problems. Every day in practice we face patients with issues that are not simple to master. Oftentimes we search out some guidance from “the experts,� and, if they are available, we will curbside them, either by phone or in person.   This text is written from the standpoint of a community gastroenterologist curbsiding his academic cohorts with his challenging cases. We present a patient with a difficult GI problem and ask the academic expert how he, or she, would manage the case. We have provided over a hundred examples of problem cases and asked the experts at the Medical College of Wisconsin (MCW) for help in their management. These cases run the gamut, including general GI, motility disorders, inflammatory bowel disease, advanced therapeutics, hepatology and functional GI disorders.  The main objective of this book is to compile the most clinically useful questions, present them to experts who frequently deal with these problems, and then wrap up their knowledge within one clinically useful text. If a community gastroenterologist had endless access to an academic panel of GI experts, these are the questions they might ask. There are hundreds of useful clinical pearls between the pages of this book which should help anyone taking care of patients with GI problems.   While the text may be targeted particularly toward practicing community gastroenterologists, it certainly can be of benefit to GI fellows in training, academic gastroenterologists, and general internists and surgeons with a strong interest in gastroenterology as well as APPs.