Gastroparesis Specialist In Clearwater, FL

The test that confirms gastroparesis is a four-hour gastric emptying study, and the four-hour part is not optional. You eat a standard labeled meal and a scanner measures how much is still in the stomach at one, two, and four hours. Retention of more than about 10% at four hours points to delayed emptying. Shorter one-hour or two-hour versions miss a large share of cases, so a normal early scan does not rule gastroparesis out.

Dr. Grandhige pairs the emptying study with an EndoFLIP measurement of the pylorus. EndoFLIP measures how well the pyloric valve actually opens, and that number helps predict whether a pylorus-directed procedure is likely to work. That is how candidacy is decided here: by physiology, not by symptoms alone. Upper endoscopy rules out a mechanical blockage and checks for reflux damage, and when heartburn or swallowing symptoms overlap, esophageal testing separates gastroparesis from GERD and from motility disorders that need a different treatment.

The point of this workup is to avoid the two most common mistakes in gastroparesis care: treating a stomach that is emptying normally, and missing a mimic that needs something other than a gastroparesis treatment.

Most people with gastroparesis do not need a procedure. Treatment is a ladder, and you start at the bottom.

Diet comes first: smaller and more frequent meals, lower fat and lower fiber, and more liquid calories when solids are hard to keep down. Next are prokinetics, the drugs that speed emptying such as metoclopramide, and in some patients domperidone or erythromycin, plus separate anti-nausea medication. These are usually managed by your GI or primary doctor. Dr. Grandhige coordinates with them rather than duplicating that care.

The medication picture shifted in 2026. An oral drug called naronapride, which acts on two gut-motility targets at once (a 5-HT4 agonist and a dopamine D2 antagonist), met its main goal in the global Phase 2b MOVE-IT trial of 328 adults with moderate-to-severe idiopathic or diabetic gastroparesis. It improved nausea, early fullness, post-meal fullness, and upper abdominal pain at the 20 mg and 40 mg three-times-daily doses. In June 2026 the developers announced they are moving it into late-stage Phase 3 studies toward an FDA filing. It is not approved or available yet, so no one can prescribe it today, but it is the most promising new gastroparesis drug in years and a fair thing to ask about.

When diet and medication fall short, the remaining options are Botox injected into the pylorus, gastric electrical stimulation, and G-POEM. Botox is worth flagging honestly: controlled trials found it no better than placebo, so it has largely fallen out of favor. Gastric electrical stimulation uses the Enterra device and is offered by a surgeon in Pinellas County. G-POEM is the pylorus procedure covered next.

The reason to drive to South Tampa is not the building. It is that reflux and foregut disease are all Dr. Grandhige does, and gastroparesis decisions turn on judgment more than on the procedure.

A surgeon who focuses only on the foregut sees these patients constantly, reads borderline emptying studies and EndoFLIP results accurately, and is comfortable choosing among procedures or choosing none. That last part is the difference. He turns away patients whose testing says a procedure will not help, even when they came in hoping for one. The patients he declines to operate on are sometimes the most frustrated, and he understands that. They would be far more frustrated after a procedure that could not fix their problem.

This lines up with what patients tell each other online. In gastroparesis forums, a recurring complaint is that many general gastroenterologists list the condition among what they treat but see few complex cases, and the repeated advice is to find a dedicated foregut or motility specialist rather than work down a directory. Depth of experience is the thing patients keep pointing to.

Continuity is built in. A dedicated physician assistant is in every case and is available to patients afterward, and much of the office staff has been with the practice for over a decade. Every procedure is done at one hospital, HCA South Tampa Hospital, with the same team, which is one of the quieter predictors of a smooth operation and recovery. Dr. Grandhige has practiced in Tampa Bay since 2009 and has performed over 600 fundoplications, over 600 LINX procedures, and over 200 TIF procedures across his foregut practice. You can read more about his training and background.