When gastroparesis needs more than diet and medication
Endoscopic pyloromyotomy (G-POEM), the procedure Dr. Grandhige performs
Endoscopic pyloromyotomy, also called gastric per-oral endoscopic myotomy (G-POEM), is an incisionless procedure that cuts the pyloric muscle from the inside so the stomach can empty more easily. The pylorus is the muscular valve between the stomach and the small intestine. In many people with gastroparesis it fails to relax, so food backs up. Dr. Grandhige reaches the pylorus with an endoscope passed through the mouth and divides the muscle, with no incisions on the abdomen. Most patients go home the same day.
The procedure itself is reliable to perform: technical success rates consistently exceed 95%. Symptom results depend heavily on picking the right patients. In carefully selected patients, published long-term data show meaningful symptom improvement in roughly 70% at one year, and up to about 80% at six months. Dr. Grandhige is one of the few surgeons in the Tampa Bay area who performs G-POEM.
Be clear-eyed about durability. The benefit isn’t always permanent. Long-term studies show sustained improvement in roughly 50% to 77% of patients at three to four years, and response varies by cause: diabetic and post-surgical gastroparesis tend to respond better than idiopathic gastroparesis, which has no identified cause. That’s exactly why the evaluation before the procedure matters as much as the procedure.
G-POEM compared with the gastric pacer and other options
For refractory gastroparesis, the three procedural options you’re most likely to hear about are endoscopic pyloromyotomy (G-POEM), gastric electrical stimulation (a surgically implanted device often called a “pacer,” such as Enterra), and Botox injection of the pylorus. They are not interchangeable.
G-POEM is incisionless, takes less time, and usually allows same-day discharge. Comparative data suggest it offers better durability than Botox, whose effect tends to be short-lived, and results that are comparable to or better than the implanted stimulator in appropriately selected patients, with fewer complications than open surgical pyloroplasty. The gastric stimulator is a device implanted during surgery and can suit certain patients, particularly when nausea and vomiting are the dominant symptoms. No single option works for everyone, and the right choice depends on the cause of your gastroparesis, your testing, and your goals. Dr. Grandhige walks through the trade-offs rather than defaulting to one procedure.
Who is a candidate, and who is not
A good candidate for G-POEM has gastroparesis that hasn’t responded to optimized diet and medication, objectively confirmed delayed gastric emptying, and symptoms driven by the pylorus rather than another cause. If those boxes are checked, the procedure has a reasonable chance of helping.
Some people are not candidates, and saying so protects them. If you haven’t yet tried optimized medical therapy, that usually comes first. Opioid medications slow the gut and can both mimic and worsen gastroparesis, which changes the calculus. Mechanical blockage has to be ruled out. Idiopathic cases respond less reliably than diabetic or post-surgical ones, so expectations have to be set honestly. Dr. Grandhige is known for telling patients when a procedure is unlikely to help, and some people leave the consultation with a clear explanation and a non-surgical plan instead of an operation. For the right patient, that’s the right outcome.
Serving Clearwater and Pinellas County
The practice is in South Tampa, about a 30-minute drive from most of Clearwater and Pinellas County. Tampa Bay Reflux Institute is located at 1315 South Howard Avenue, Suite 101, Tampa, FL 33606. The office phone is 813.922.2920, and hours are 9 AM to 6 PM, Monday through Friday. Procedures are performed at HCA South Tampa Hospital.
Traveling from across the bay doesn’t have to mean multiple trips. The office staff, many of whom have been with Dr. Grandhige for over a decade, help consolidate testing and, when possible, arrange studies closer to your home so your visits to Tampa are efficient. Before your consultation, send your prior records, including any endoscopy reports, gastric emptying study, imaging, and notes from your gastroenterologist, so Dr. Grandhige can review everything ahead of time and use your visit for answers rather than paperwork.
FAQS
About the surgeon
This page was reviewed by Dr. Gopal Grandhige, MD, a board-certified general surgeon who is fellowship-trained in foregut and minimally invasive surgery at Yale New Haven Hospital. He earned his medical degree at the University of Michigan and completed his general surgery residency at Yale New Haven, and he has focused on foregut disease in the Tampa Bay area since 2009. He is a Fellow of the American College of Surgeons, a member of the Society of American Gastrointestinal and Endoscopic Surgeons, and a founding member of the American Foregut Society. Across his foregut practice he has performed more than 600 fundoplications, more than 600 LINX procedures, and more than 200 TIF procedures, and his patients come largely through physician referrals. You can read more about Dr. Grandhige and his training, and verify his credentials through the American Board of Surgery, the American College of Surgeons directory, and the Florida Department of Health license lookup.
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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#nonsurgicalweightloss #ESG #gastricballoon #weightlossjourney #vsg #vsgjourney #spatz3 #orbera #orberaballoon #grandhige #DrG
#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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#chronicheartburn #gerdsymptoms #heartburnrelief #reflux #PPIs #heartburn #LINX #fundoplication #TIF #GERD#tampaheartburn #linx #TIF #fundoplication #tampabayreflux #GERD #acidreflux #acidrefluxsurgery #stopreflux
#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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#letushelpyou #medsnotworking #reflux #PPIs #heartburn #LINX #fundoplication #TIF #GERD#tampaheartburn #linx #TIF #fundoplication #tampabayreflux #GERD #acidreflux #acidrefluxsurgery #stopreflux
#nonsurgicalweightloss #ESG #gastricballoon #weightlossjourney #vsg #vsgjourney #spatz3 #orbera #orberaballoon #grandhige #DrG
#tampabayrefluxinstitute #guthealth #roboticsurgery
#heartburn #stopreflux #hiatalherniarepair #severeheartburn #reflux #tampabayreflux #acidrefluxsurgery #tampaheartburn #GERD #PPIs #achalasia #LINX #TIF #tampareflux #fundoplication #stomach #digestivehealth #ESG #obesity #overweight #weightlossjourney #gastricballoon
