Gastroparesis Doctor In Wesley Chapel, FL

Endoscopic pyloromyotomy, also called G-POEM or POP, is performed through the mouth with a flexible endoscope. A small tunnel is created under the pyloric muscle, then the muscle is divided with an endoscopic knife to reduce resistance at the stomach outlet. There are no abdominal incisions. Dr. Grandhige is one of only a handful of physicians performing this procedure in Tampa Bay.

It is not the only option, and that matters. A robotic or laparoscopic pyloroplasty divides the pyloric sphincter through small abdominal incisions and reshapes the valve for longer-term effect. The honest trade-off: permanently opening the pylorus can let small intestine contents reflux back into the stomach, or cause diarrhea with certain meals. For patients who arrive with severe weight loss and malnutrition, venting and feeding procedures come first so nutrition is safe enough to consider anything definitive. Subtotal gastrectomy is reserved for rare cases with severe disease unresponsive to everything else. A surgeon who performs only one of these has one answer for every patient.

Four checks have to clear before Dr. Grandhige recommends a pyloromyotomy:

1. Delayed emptying is documented on a four-hour study, not assumed from symptoms.
2. Symptoms correlate with the delay rather than simply coexisting with it.
3. Mimics are ruled out. Motility disorders on manometry, anatomy on endoscopy and imaging, medications reviewed, hiatal hernia measured.
4. Expectations are set in advance. Which symptoms are expected to improve, which are not, and which may improve only partially.

If a patient does not clear all four, he says so. In his own words: “Unfortunately, the patients that I choose not to operate on are often the unhappiest as they are frustrated. But these are the same patients that would be even unhappier if unnecessary surgery is performed and the symptoms remain.”

One more thing patients should hear before booking anything. Gastroparesis procedures are aimed at improving symptoms, not at curing the disease. Nobody at this practice will tell you otherwise.

Two visits at most, and roughly four to eight weeks from first consultation to procedure when one is indicated.

New patients are usually seen within two weeks and always within four.

Send your records to info@tampareflux.com before the visit: prior upper endoscopy and pathology reports, gastric emptying study results, esophageal manometry, barium swallow or other imaging, office notes from your gastroenterologist and from any ENT, pulmonary or allergy physicians, a list of current and prior medications, and a list of prior surgeries. Studies from years ago still count, because they show how the disease has moved. Signed record releases get sent too, but they are slow and often come back incomplete, so patients who bring their own records get a far more definitive visit. This is what makes a single trip from Wesley Chapel productive instead of preliminary.

From there the path splits. If your testing is already complete, one consultation is usually enough and a procedure can be scheduled as early as four weeks out. If testing is missing, the first visit covers record review and test planning, a second visit about four weeks later covers the results and the decision, and the procedure follows at roughly eight weeks. Authorization paperwork is handled by the office and runs in parallel, though it can take four to six weeks on its own.

For patients driving in, the office groups testing onto the fewest days possible and arranges studies closer to home when that is workable.

Every procedure is performed at HCA South Tampa Hospital. Dr. Grandhige holds privileges at St. Joseph’s Main, St. Joseph’s South and HCA Brandon as well, and deliberately consolidated all surgery to one facility so the anesthesia team, nursing staff and equipment are the same every time. His own physician assistant assists in every case, knows your anatomy and your operation, and is reachable during office hours. After hours, patients reach Dr. Grandhige directly.

Tampa Bay Reflux Institute 1315 South Howard Ave., Suite 101 Tampa, FL 33606 Phone: 813.922.2920 Fax: 813.742.0711 Hours: 9 a.m. to 6 p.m., Monday through Friday

The drive is I-75 south to I-275, then east toward the Howard Avenue and Hyde Park area, roughly 30 to 40 minutes depending on traffic. The office is in a yellow brick building next to Sally O’Neill’s Pizza. Parking is behind the restaurant, not on Howard Avenue.

Patients also come from South Tampa, Hyde Park, Palma Ceia, Bayshore, Westchase, Carrollwood, Brandon, Riverview, Clearwater and St. Petersburg, and travel in from Orlando, Sarasota, Naples, Fort Myers, Miami, Jacksonville and the Panhandle.

Bring your records, get a straight answer about whether a procedure will help, and leave understanding what is actually causing your symptoms. That is the goal of the visit, whether or not surgery ends up on the table.