Gastroparesis New Treatment In Clearwater, FL

The newest gastroparesis treatments available to Clearwater patients in 2026 split into two groups: one procedure you can have now, and several drugs that are still in trials. G-POEM, an endoscopic procedure that opens the tight valve at the stomach outlet, is available today and is performed by board-certified foregut surgeon Dr. Gopal Grandhige, about 35 minutes from Clearwater over the Courtney Campbell Causeway. The drugs generating headlines, naronapride and deudomperidone, cannot be prescribed for gastroparesis yet. What decides which path applies to you is objective testing, not how bad your symptoms feel.

What is actually new in gastroparesis treatment in 2026

Three drugs are in the news for gastroparesis right now. None of them can be prescribed for it today. Here is where each one stands.

Naronapride posted the strongest results. In the global Phase 2b MOVE-IT trial announced on May 4, 2026, 328 adults with moderate-to-severe idiopathic or diabetic gastroparesis and objective evidence of delayed emptying were randomized against placebo for 12 weeks. The 20 mg and 40 mg three-times-daily doses met the primary endpoint on the ANMS GCSI-DD core symptom score. Nausea, early satiety, post-prandial fullness, and upper abdominal pain all improved. The developers have said they are moving toward registration studies. That means Phase 3 has to run before any application reaches the FDA, so this is a multi-year timeline, not a next-year one.

Deudomperidone (CIN-102) is the one with a direct Clearwater connection, and the status has changed. The envision3D Phase 2 study (NCT05832151) enrolled roughly 400 adults with diabetic gastroparesis across multiple sites, including one in Clearwater. Enrollment closed in September 2025 and the study completed on December 12, 2025. If you found a Clearwater diabetic gastroparesis trial page while searching, that study is finished and is no longer taking patients. The science behind it is worth knowing anyway: deudomperidone is a deuterated reformulation of domperidone, engineered to reduce the cardiac rhythm concern that has kept domperidone off the US market.

Tradipitant is the one that confuses people most, and the confusion is understandable. The FDA approved it on December 30, 2025 under the brand name NEREUS, the first new drug for motion sickness in more than forty years. It is not approved for gastroparesis. The FDA issued a complete response letter on that indication in September 2024, and in March 2026 published its decision on the manufacturer’s hearing request. Same molecule, different indication, and a pharmacy cannot fill it for delayed gastric emptying. It remains in development for gastroparesis and for GLP-1-related nausea.

The practical takeaway: if a Clearwater patient is waiting for a pill before considering anything else, the wait is longer than the headlines suggest.

What the 2025 AGA guideline says about the order of treatment

The American Gastroenterological Association published its gastroparesis guideline in September 2025, and the part that matters most before any procedure is sequence, not novelty. The panel issued 12 conditional recommendations. Five of them change what a patient should ask for.

Testing should use the 4-hour gastric emptying protocol, and the guideline recommends against the 2-hour version. This one detail matters more than it sounds. Plenty of patients arrive having been diagnosed or ruled out on a shortened scan, and a 2-hour study can miss delayed emptying that shows up at four hours.

Metoclopramide and erythromycin are the suggested medications. The panel recommended against domperidone, prucalopride, aprepitant, nortriptyline, buspirone, and cannabidiol as first-line therapy.

G-POEM and gastric electrical stimulation are both recommended against as routine initial treatment, and reserved for patients whose symptoms are refractory to medical therapy. Botulinum toxin injection into the pylorus is also not recommended for routine use.

On surgical pyloromyotomy and surgical pyloroplasty, the panel gave no recommendation at all, citing gaps in the evidence.

Every one of these is conditional, which is the guideline panel’s way of saying the evidence base is thin and reasonable clinicians will differ. That honesty is the point. It also describes how Dr. Grandhige already practices: diet and medication are worked through first, testing confirms the mechanism, and a procedure is offered only when the results support it.

The treatment available now, and how candidacy is decided

G-POEM, also called gastric per-oral endoscopic myotomy or endoscopic pyloromyotomy, is the procedure available today for refractory gastroparesis. It divides the pyloric muscle from the inside through an endoscope passed down the mouth, with no abdominal incisions. The step-by-step technique, recovery, and published success and durability figures are covered in depth on our St. Petersburg gastroparesis surgery page, and the condition itself is explained on the gastroparesis overview. What follows is the selection question, which is where most of the outcome is actually determined.

Confirming delayed emptying is only the first step. The second is deciding whether the pylorus is the reason. In selected cases the valve is measured directly with EndoFLIP, the same catheter-based technology used to tailor treatment for achalasia, which gauges how easily the pylorus opens rather than inferring it from symptoms. A tight, poorly opening pylorus is the finding that a myotomy can address. A normal one usually is not.

Cause changes the plan. Gastroparesis is most often diabetic, idiopathic, or post-surgical from vagus nerve injury during earlier esophageal or stomach surgery. Some patients develop slow emptying while taking GLP-1 medications such as semaglutide, and when a drug is driving it, adjusting the drug comes before any procedure. Mechanical contributors get ruled out as well. A large hiatal hernia can produce the same picture, and in Dr. Grandhige’s experience the larger the hernia, the more likely the stomach has become atonic, which may or may not recover after the hernia is repaired. Symptoms also overlap heavily with acid reflux, which is why the two are evaluated together rather than in isolation.

All procedures are performed at HCA Florida South Tampa Hospital with the same operating room team.

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When G-POEM is the wrong answer

A meaningful share of consultations end without a procedure, and that is by design. Dr. Grandhige’s stated view is that the most important skill in foregut surgery is knowing when not to operate, and which operation not to do.

The clearest mismatches are these. Patients whose dominant complaint is abdominal pain rather than nausea and vomiting tend to respond less well than patients with the nausea-forward pattern. Rumination syndrome, functional dyspepsia, and esophageal hypersensitivity all mimic gastroparesis and none of them improve with a myotomy. If severe weight loss or malnutrition is the pressing problem, nutrition is stabilized before anything else is considered. If a medication or uncontrolled blood sugar is driving the delay, that gets addressed first. And if the testing does not point to the pylorus, no amount of symptom severity changes the recommendation.

Patients told no are often the least happy people to leave the office. They are also the ones spared a procedure that would not have worked, and referring gastroenterologists across Tampa Bay send patients here specifically because that line holds.

For refractory nausea and vomiting where a myotomy is not appropriate, gastric electrical stimulation is performed in Pinellas County. Worth knowing before you pursue it: the Enterra system is authorized as a humanitarian use device for chronic drug-refractory nausea and vomiting from diabetic or idiopathic gastroparesis in adults aged 18 to 70, and the manufacturer’s own labeling states that effectiveness for this use has not been demonstrated. It tends to help nausea and vomiting more than it speeds emptying.

Getting evaluated from Clearwater

The office is at 1315 South Howard Avenue, Suite 101, Tampa, FL 33606, in a yellow brick building next to Sally O’Neill’s Pizza, with parking behind the restaurant. From most of Clearwater the drive is roughly 30 to 40 minutes over the Courtney Campbell Causeway, which is a different and usually easier route than the Gandy or Howard Frankland approach used by patients coming from St. Petersburg.

You will not be driving over for every step. The team coordinates gastric emptying studies and other workup close to home in Pinellas County whenever it can, and reserves the Tampa trips for the consultation and, if it is appropriate, the procedure.

Before your visit, email prior records to info@tampareflux.com: upper endoscopy reports, gastric emptying study results (note the number of hours it ran), any imaging, a current medication list, prior surgical history, and notes from your gastroenterologist or primary care doctor. Dr. Grandhige reviews all of it personally before you arrive, which turns the first visit into a diagnostic conversation instead of a data-collection appointment.

New patients are typically seen within two weeks and always within four. When testing is already complete, one consultation is usually enough and the procedure can often be scheduled around four weeks out. When testing is still needed, plan on two visits roughly four weeks apart and about eight weeks total. Insurance authorization is handled entirely by the office staff and runs in parallel so it does not add to that timeline.

Office hours are 9am to 6pm, Monday through Friday. Phone: 813.922.2920.

About Dr. Gopal Grandhige

Dr. Grandhige profile photo

Dr. Grandhige is a board-certified general surgeon whose practice is limited to foregut surgery, meaning benign conditions of the esophagus, diaphragm, and stomach. He has practiced in Tampa Bay since 2009 and is the founder and medical director of Tampa Bay Reflux Institute.

He completed his undergraduate degree at Johns Hopkins University and his medical degree at the University of Michigan, Ann Arbor, followed by general surgery residency at Yale New Haven Hospital and fellowship training in foregut and minimally invasive surgery there. 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. His full training and credentials can be reviewed independently through the American Board of Surgery physician lookup and the Florida Department of Health license verification tool.

Within his foregut practice he has performed more than 600 fundoplications, more than 600 LINX procedures, and more than 200 TIF procedures, and he is one of only a handful of surgeons performing per-oral pyloromyotomy in the Tampa Bay area.

Two things patients raise most often. The first is continuity: the same dedicated physician assistant assists in every case and is reachable during recovery, Dr. Grandhige takes after-hours calls himself, and several medical assistants have been with the practice for over a decade. The second is the explaining. He draws your anatomy by hand during the visit and shows you what is happening and why a given step does or does not fit your situation.

Common questions from Clearwater patients

No. Naronapride and deudomperidone are both still in trials, and the drug approved in December 2025 under the name NEREUS was approved for motion sickness, not for gastroparesis. Metoclopramide and erythromycin remain the medications supported by current guidelines.

It can matter a great deal. The 2025 AGA guideline recommends the 4-hour protocol and recommends against the 2-hour version, because delayed emptying can be missed on the shorter scan. Send your report and we will tell you whether it needs repeating.

Yes, if you fit the reserved category. The recommendation is against routine initial use, not against the procedure. It is intended for patients whose symptoms have not responded to diet changes and medication, and whose testing points to the pylorus as the problem.

Usually, yes. Gastric emptying studies and much of the workup can be coordinated in Pinellas County so the Tampa trips are limited to the consultation and the procedure. Send your existing records first so nothing gets repeated unnecessarily.

New patients are seen within two weeks and always within four. If your testing is complete, the procedure is often about four weeks after the first visit. If testing is still needed, plan on roughly eight weeks total.

Possibly not, and you should hear that early rather than after a procedure. Patients whose dominant symptom is abdominal pain respond less predictably to a myotomy than patients whose dominant symptoms are nausea and vomiting. Testing and a careful history sort this out before anything is scheduled.

The diabetic gastroparesis study that ran in Clearwater completed in December 2025 and is closed. Trial availability changes, so confirm current status directly with any research site and with your gastroenterologist before making plans around it.

No. Many patients come through their gastroenterologist or primary care doctor, but you can contact the office directly to schedule.

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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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NOT increased acid production

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