Gastroparesis Treatments In St. Petersburg, FL
If gastroparesis medications and diet changes have stopped controlling your symptoms, the next step is a procedure that targets the pylorus, the muscular valve at the stomach’s exit. Dr. Gopal Grandhige performs endoscopic pyloromyotomy (also called POP or G-POEM) for gastroparesis and is one of only a handful of physicians performing it in the Tampa Bay area. He confirms the diagnosis with objective testing before recommending any treatment, then matches the treatment to what the testing actually shows.
Where St. Petersburg Patients Go for Advanced Gastroparesis Care
Most gastroparesis care in the Tampa Bay area is medical management handled by a general gastroenterologist: diet changes and promotility drugs. That helps some people. When it stops working, the question becomes who locally can offer a procedure, and that list is short.
Dr. Grandhige built Tampa Bay Reflux Institute around benign diseases of the esophagus, stomach, and diaphragm, gastroparesis among them. He performs endoscopic pyloromyotomy (POP / G-POEM), an incision-free procedure done through the mouth that divides the pyloric muscle to improve stomach emptying. He is one of only a handful of physicians performing it in Tampa Bay. For St. Petersburg patients, that means the procedure is a drive across the bay rather than a trip to an out-of-state center.
This page is for people in St. Petersburg and the surrounding Pinellas communities who have already tried the basics and want to know what comes next. For the full clinical overview of the condition, see the main gastroparesis page.
What Gastroparesis Is, in Plain Terms
Gastroparesis means the stomach empties too slowly even though nothing is physically blocking it. The stomach muscle that should push food forward is sluggish or barely moving, so food sits too long. That is what drives the nausea, vomiting, bloating, early fullness, regurgitation of undigested food, and the severe reflux that often comes with it.
The cause is often unknown. In some people it follows diabetes or prior surgery. Certain medications also slow stomach emptying, including opioid pain relievers, some antidepressants, and some blood pressure and allergy drugs, and these can make existing gastroparesis worse. Because the symptoms overlap with reflux, IBS, and other conditions, gastroparesis is commonly misdiagnosed, which is why confirming it matters before any treatment.
Started After Ozempic or Wegovy? Your Case May Be Different
If your symptoms began shortly after starting a GLP-1 medication such as semaglutide (Ozempic, Wegovy) or tirzepatide (Mounjaro, Zepbound), it is worth flagging at your evaluation. These drugs slow stomach emptying on purpose, that is part of how they work, and in some people that tips into gastroparesis-type symptoms: persistent nausea, vomiting, and feeling full after a few bites.
This matters because it changes the conversation. The first step is not a procedure. It is a careful look at whether a medication is driving the picture and what should happen with that medication, done with your prescribing doctor, before anything more invasive is considered. Dr. Grandhige’s approach is to confirm what is actually happening with objective testing rather than treating every case the same way.
How Dr. Grandhige Confirms Gastroparesis Before Any Treatment
Treatment decisions start with proving the diagnosis, not guessing from symptoms. Many patients arrive having been told they “probably” have gastroparesis without the testing to back it up. Two studies do most of the work.
Gastric Emptying Study
This is the most useful test for gastroparesis. You eat a light standardized meal, usually eggs and toast or oatmeal, containing a small amount of tracer. A scanner over the abdomen measures how fast the meal leaves the stomach, and the study follows that for four hours. Slow clearance over those four hours is what objectively defines delayed emptying.
Upper Endoscopy
Endoscopy is not used to diagnose gastroparesis directly. It rules out a blockage or other problem that could mimic it. One practical clue shows up here: if food is still in the stomach during an endoscopy after the patient has gone many hours without eating, gastroparesis is suspected.
Dr. Grandhige personally reviews your prior studies before the visit when they already exist, so the consultation is spent on explanation and decisions instead of re-collecting paperwork.
Gastroparesis Treatment Options, From First Steps to Procedures
There is no cure for gastroparesis. Treatment is aimed at controlling symptoms and protecting nutrition, and it is usually escalated step by step until symptoms are adequately controlled. Procedures are reserved for patients who do not get enough relief from the earlier steps.
Diet And Nutrition
The first goal is keeping nutrition adequate. Smaller, more frequent meals, well-chewed and well-cooked food, lower-fat choices, and avoiding carbonation, alcohol, and smoking all help many patients. The practice can refer you to a dietitian to build a plan around foods your stomach handles better.
Medications
Two types are used. Promotility drugs that speed up the stomach include metoclopramide (Reglan) and erythromycin; metoclopramide can cause serious side effects that limit long-term use, and erythromycin tends to lose its effect over time. Domperidone has fewer side effects but is hard to access. Separately, anti-nausea medications such as ondansetron (Zofran), prochlorperazine (Compazine), and diphenhydramine (Benadryl) are used to control nausea and vomiting.
Endoscopic Pyloromyotomy (POP / G-POEM)
This is the incision-free procedure Dr. Grandhige is known for in the region. Using a flexible endoscope passed through the mouth, he creates a small tunnel under the pyloric muscle and divides it, which loosens the valve and lets the stomach empty more easily. There are no abdominal incisions. It is increasingly used as an early procedural option for the right patients, and he is one of only a handful of physicians performing it in Tampa Bay.
Robotic or Laparoscopic Pyloroplasty
Done under general anesthesia through small abdominal incisions, this divides the pyloric sphincter muscle and reshapes the valve so it stays open longer-term. Because the valve is opened permanently, some patients notice effects like reflux of intestinal contents back into the stomach or diarrhea with certain meals.
When the Disease is Severe
A small number of patients arrive with severe weight loss and malnutrition that make them poor candidates for a definitive procedure. In those cases, feeding tubes can vent the stomach and deliver nutrition directly into the intestine to stabilize a patient enough to consider other options. Rarely, in patients whose lives are severely affected and who have not responded to anything else, removing most of the stomach (subtotal gastrectomy) is considered as a life-saving step.
Who Is a Candidate, and Who Is Not
Not everyone with gastroparesis should have a procedure, and being honest about that upfront is part of the point. A procedure on the pylorus tends to help most when the dominant symptoms are nausea and vomiting and the diagnosis is confirmed by testing. It is a weaker fit when pain is the dominant complaint, because pain is less predictable in how it responds.
Patients whose symptoms appear to be driven by a medication, including GLP-1 drugs, are usually better served by addressing that first. And gastroparesis frequently travels with other foregut problems, particularly severe reflux. Because Dr. Grandhige treats the full range of foregut conditions, he can identify and address more than one contributing factor during a single evaluation instead of sending you to several separate specialists. You can read more about his approach on the about the practice page.
Why Patients Choose Tampa Bay Reflux Institute
Dr. Grandhige focuses only on foregut surgery, the esophagus, stomach, and diaphragm. He earned his medical degree at the University of Michigan and completed his general surgery residency and his fellowship in foregut and minimally invasive surgery at Yale–New Haven Hospital, after an undergraduate degree at Johns Hopkins University. He has practiced in Tampa Bay since 2009, founding Tampa Bay Reflux Center that year and evolving it into Tampa Bay Reflux Institute in 2022.
He is a Fellow of the American College of Surgeons (FACS), a member of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), and a founding member of the American Foregut Society. All of his surgeries are performed at HCA South Tampa Hospital, with a dedicated physician assistant who assists in every case and stays available for questions during recovery. Many of his office staff have worked with him for over a decade.
You see the same physician from consultation through treatment and follow-up. That continuity is harder to get at larger systems where care is split across rotating providers.
FAQS
Take the Next Step
Gastroparesis affects every meal and every day, but you do not have to accept symptoms that medications are no longer controlling. The first step is a clear diagnosis and an honest read on whether a procedure would actually help you.
Dr. Grandhige and his team will review your history, confirm what is happening with objective testing, and walk you through every option, including the ones that are not surgery. Schedule a consultation or call 813.922.2920.
An endoscopy cannot tell you if you have reflux. It can only tell you if you have complications of GERD.
If you are unhappy with your reflux symptoms, come in and we can discuss testing and treatments that can accurately diagnose your problem.
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If you have a hiatal hernia and fit one of these categories, you should know your options.
Dr. Grandhige is an expert in his field and performs 200 of these surgeries a year. He is the only surgeon in the Tampa Bay Area who offers all surgical options - LINX, Fundoplications, TIF and will be one of 20 surgeons in America introducing the latest procedure RefluxStop in 2026.
We accept most insurances but will verify yours before you come in. These procedures are considered medically necessary and covered by your insurance. You can expect to pay your in-network deductibles and nothing else.
#hiatalhernia #reflux #GERD #LINX #refluxstop
What causes reflux ?
1. Weak lower esophageal sphincter
2. Hiatal hernia
3. Flattening of the Angle of His
4. Poor esophageal motility
5. Gastroparesis (slow stomach)
NOT increased acid production
Don’t let GERD get in the way of living your life. Request your appointment with us today on the link below.
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https://tampareflux.com/contact-us/
Anyone can be victim to GERD and though weight loss can help reduce GERD symptoms. Many athletes with high impact workouts may continue to have these symptoms. This may be a symptom of a hiatal hernia or other issue. We are more then happy to assist you in finding your solution, just click the link below.
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Heartburn may seem like an annoyance. But if you find yourself having symptoms on a daily basis, it may be time to to talk to Dr. Grandhige as it could be a symptom of something worse.
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If you are tired of avoiding your favorite foods or taking daily medications, we can help.
We are the Tampa experts in reflux ! With years of experience and thousands of patients treated successfully, we offer all FDA approved anti-reflux procedures.
Call 813-922-2920 to schedule your appointment
All major insurances accepted.
Not all patients need surgical intervention. Many patients are living a heartburn free life with their PPIs. However 40% of patients taking PPIs are not getting the relief they need. If you are one of those, you have options! Come in and find out more.
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