Stubborn reflux is usually a mechanical problem, not an acid problem
Most reflux that will not quit is a valve-and-diaphragm problem, not acid overproduction. Roughly 1 in 5 U.S. adults live with GERD, and in most of them the stomach makes a normal amount of acid. The real issue is a weak lower esophageal sphincter, a hiatal hernia, or a diaphragm that no longer supports the reflux barrier. Acid-suppressing medication lowers the acidity of what refluxes. It does not strengthen the valve or repair the hernia, so reflux events keep happening, often at night, and non-acid contents like bile and pepsin can still reach the esophagus and throat.
This explains the misunderstanding Dr. Grandhige corrects most often. A normal upper endoscopy does not rule out GERD. Endoscopy looks for damage such as inflammation or Barrett’s esophagus. It does not measure whether reflux is occurring, how often, or why. Many people with significant reflux have a completely normal endoscopy, especially while taking a proton pump inhibitor. Being told “your scope is normal, nothing is wrong” is one of the main reasons patients stay stuck for years.
How Dr. Grandhige diagnoses reflux: testing before treatment
Every treatment decision starts with objective testing, not a symptom guess. Reflux surgery earns a poor reputation whenever it is done on the wrong diagnosis, so the point of testing is both to confirm reflux and to rule out conditions that only look like it, such as esophageal motility disorders, hypersensitivity, and functional chest pain.
Four tests do the work. pH monitoring is the gold standard, because it directly measures how often reflux happens, how long it lasts, and whether it lines up with your symptoms over 24 to 96 hours of normal activity. Esophageal manometry measures the strength and coordination of the esophagus, which decides whether a given procedure is safe and which type of repair fits. Upper endoscopy checks the anatomy and looks for complications. A barium swallow, used selectively, shows how the esophagus behaves during an actual swallow, and it often locates a problem the patient feels in the throat but that sits lower down. Where you feel food stick matches the true location only about 60% of the time.
Silent reflux gets a more precise test. Laryngopharyngeal reflux, or LPR, reaches the throat and voice box, where even one reflux episode a day can cause hoarseness, chronic throat clearing, or a cough, while standard testing that only looks above the lower esophageal sphincter misses it. Dr. Grandhige uses a customized 24-hour dual-channel pH-impedance probe that measures reflux above both the lower and the upper esophageal sphincter, including non-acid reflux like bile and pepsin. That precision changes outcomes. With careful patient selection based on this testing, symptom improvement for LPR runs around 80%, compared with roughly 50% at centers relying on less exact testing. He is also honest about the tradeoff: LPR symptoms usually take four to six months to improve, while typical heartburn often settles within days.
Four anti-reflux procedures, and how the right one gets chosen
About Dr. Gopal Grandhige

Dr. Gopal Grandhige is a board-certified general surgeon who has focused exclusively on foregut surgery since 2009. He earned a biology degree at Johns Hopkins University and his medical degree at the University of Michigan, then completed his general surgery residency and fellowships in foregut and minimally invasive surgery, and in burn and critical care, at Yale-New Haven Hospital. He founded Tampa Bay Reflux Center in 2009 and now practices as Tampa Bay Reflux Institute.
He is a founding member of the American Foregut Society, a member of the Society of American Gastrointestinal and Endoscopic Surgeons, and a Fellow of the American College of Surgeons. Patients can confirm his standing directly through the American Board of Surgery. All of his surgeries are performed at HCA South Tampa Hospital with the same operating room team and his own physician assistant, who assists in every case and stays involved through recovery, so patients are never handed to an unfamiliar provider. His office medical assistants have worked with him for over a decade. Most of his patients come from other physicians, gastroenterologists, ENTs, pulmonologists, allergists, and primary care doctors who refer specifically because their patients come back informed and are not pushed toward surgery.
Beyond the clinic, he supports local organizations including Feeding Tampa Bay and Meacham Urban Farm.
Getting care from Clearwater and Pinellas County
The office is at 1315 South Howard Avenue, Suite 101, in South Tampa, about 30 minutes from Clearwater across the Howard Frankland or Gandy Bridge. It sits in a yellow brick building next to Sally O’Neill’s Pizza, with parking behind the restaurant.
Before your visit, email prior records to info@tampareflux.com so Dr. Grandhige can review your endoscopy reports, any pH or manometry results, imaging, and notes from other physicians ahead of time. That turns the appointment into a diagnosis-and-decision visit instead of a data-gathering one. New patients are usually seen within two weeks and always within four. If your testing is already complete, one consultation is often enough, and surgery can be scheduled within about four weeks. If testing is still needed, the plan usually runs two visits about four weeks apart, with treatment inside roughly eight weeks. Patients from Clearwater, St. Petersburg, and elsewhere in Pinellas get the same evaluation as local patients, with testing coordinated to keep trips to a minimum. You can reach the office at 813.922.2920.
Common questions from Clearwater patients
Take the first step
You do not have to keep guessing about reflux that will not go away. Get objective answers about what is causing your symptoms and which treatments actually fit, from a surgeon who does this and only this.
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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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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