Silent reflux (LPR): symptoms in your throat, not your chest
Silent reflux is reflux that reaches your throat and voice box, and many people who have it never get classic heartburn.
The signs look like other things: chronic throat clearing, hoarseness, a nagging cough, post-nasal drip, or the feeling of a lump in your throat. Because the symptoms sit up high, patients usually cycle through ENT, allergy, and asthma work-ups first, then get told their reflux test was normal. The catch is that standard reflux testing only looks low, above the stomach valve. It doesn’t check whether reflux is reaching the throat. The throat is far more sensitive than the esophagus. The esophagus can shrug off dozens of reflux episodes a day, while the throat can react to a single one.
Dr. Grandhige uses a customized 24-hour pH-impedance probe that measures reflux at two levels, above the lower valve and above the upper one, including non-acid reflux like bile and pepsin that standard tests miss. That precision changes outcomes. With ordinary testing, surgery for throat-based reflux helps about half of patients. By selecting candidates with dual-channel testing, the practice reports improvement closer to 80%, and it means turning down patients who wouldn’t benefit. You can read more about how the practice approaches silent reflux (LPR).
Your treatment options, matched to your anatomy
There’s no single best reflux operation. The right one depends on your anatomy, how well your esophagus works, and what matters to you.
Dr. Grandhige performs all four anti-reflux procedures, which is unusual. He’s the only surgeon in the region who does, and the volume backs it up: more than 600 fundoplications, more than 600 LINX procedures, and more than 200 TIF procedures, plus the newest option, RefluxStop. For patients who are carefully selected on testing, the practice reports that more than 90% of appropriate candidates get lasting symptom relief and stop daily reflux medication. Those numbers depend on selection, which is exactly why the testing comes first.
In plain terms, the procedures work differently. Fundoplication wraps the upper stomach around the lower esophagus to rebuild the barrier. It’s the most durable choice, handles large hiatal hernias, and can be adjusted for a weak esophagus, but depending on the wrap it can limit burping and vomiting. LINX is a ring of magnetic beads around the valve. It usually preserves the ability to burp and vomit, tends to cause less bloating, is removable, and is compatible with MRI up to 1.5 Tesla, but it needs good esophageal strength. TIF is done through the mouth with no incisions and has an easy recovery, but it can’t repair a hiatal hernia and it’s the least durable. Dr. Grandhige is direct that it’s the best endoscopic option, not a permanent one, and quotes a failure rate around 2% per year. The point isn’t which procedure sounds best. It’s which one fits your body, and the testing decides that.
Sometimes the right answer isn’t surgery
Many reflux-like symptoms aren’t caused by reflux, and surgery won’t fix those.
Esophageal hypersensitivity, motility disorders like achalasia, functional chest pain, and non-reflux throat and lung conditions can all mimic GERD. Operating on them tends to make people worse, not better. This is why Dr. Grandhige performs fewer surgeries than practices that decide based on symptoms and medication history alone. He often tells patients surgery won’t help and points them toward the right non-surgical care instead. His own line: the most important skill in reflux surgery is knowing when not to operate, and which operation not to do. If you leave a consultation understanding your condition, even with no procedure scheduled, that counts as a good visit.
Meet your reflux surgeon: Dr. Gopal Grandhige, MD

Dr. Gopal Grandhige is a board-certified general surgeon who has focused only on foregut disease, the esophagus, diaphragm, and stomach, since 2009.
He earned his medical degree at the University of Michigan and completed his general surgery residency and a fellowship in foregut and minimally invasive surgery at Yale-New Haven Hospital. He’s a Fellow of the American College of Surgeons, a member of SAGES, and a founding member of the American Foregut Society. He performs all surgeries at HCA South Tampa Hospital, works with the same dedicated physician assistant in every case, and has an office team that has been with him for over a decade. You can verify his board certification through the American Board of Surgery and his license through the Florida Department of Health, and read more about his background and the practice.
What patients most often report is relief at finally having reflux explained, being listened to, not being pushed toward surgery, and the hand-drawn diagrams he uses to walk through their anatomy.
Common questions about acid reflux treatment
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.
#reflux #gerd #hiatalhernia #gastroparesis #linx
CALL US AT 813-922-2920
www.tampareflux.com
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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https://tampareflux.com/contact-us/
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#tampabayrefluxinstitute #guthealth #roboticsurgery
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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#nonsurgicalweightloss #ESG #gastricballoon #weightlossjourney #vsg #vsgjourney #spatz3 #orbera #orberaballoon #grandhige #DrG
#tampabayrefluxinstitute #guthealth #roboticsurgery
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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#nonsurgicalweightloss #ESG #gastricballoon #weightlossjourney #vsg #vsgjourney #spatz3 #orbera #orberaballoon #grandhige #DrG
#tampabayrefluxinstitute #guthealth #roboticsurgery
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