Your gastroparesis treatment options, compared
No treatment cures gastroparesis. Every option manages symptoms, and care usually starts conservative and steps up only if it needs to. National guidance in 2025 moved toward stricter diagnosis and more careful use of procedures, in line with the American College of Gastroenterology’s clinical guideline. Treatment tends to move up a ladder, and each step fits a different patient.
Diet comes first for most people. Smaller, more frequent, low-fat, well-cooked meals are easier for a slow stomach, and skipping carbonation and alcohol helps. A dietitian keeps calories and nutrition up while you adjust.
Medications are the next step. Prokinetics like metoclopramide or erythromycin speed the stomach up, and domperidone is an option that is harder to get in the United States. Anti-nausea medicines such as ondansetron treat the symptom directly. These help some patients, with side effects and limits worth weighing.
Pylorus-directed procedures come in when diet and medication fall short. The pylorus is the muscular valve between the stomach and small intestine, and loosening it lets the stomach drain more easily. That can be done endoscopically with G-POEM, or surgically with a pyloroplasty.
A smaller group considers other paths. Some patients are candidates for gastric electrical stimulation, an implanted device that stimulates the stomach. Dr. Grandhige focuses on endoscopic and pyloric-directed treatment, and when a different approach fits better he says so and points you to the right specialist. For severe disease with malnutrition, a feeding tube protects nutrition, and in rare, life-threatening cases that resist everything else, removing most of the stomach is a last resort.
Even with standard treatment, only a minority of patients get real, lasting symptom relief, which is why matching the treatment to the right patient matters more than the procedure itself. Like achalasia, another motility disorder Dr. Grandhige treats, gastroparesis is managed, not cured, and the plan is built around what your testing actually shows.
Endoscopic pyloromyotomy (G-POEM): who it helps, and who it doesn’t
G-POEM, also called POP or per-oral pyloromyotomy, is an incisionless procedure done entirely through the mouth. Using a flexible endoscope, a small tunnel is made under the pyloric muscle, and the muscle is divided with an endoscopic knife so the stomach can empty. There are no abdominal cuts, it is usually outpatient, and recovery is generally quicker than open surgery. Dr. Grandhige is one of a few surgeons in the region who performs it.
It is for selected patients with confirmed, medication-resistant gastroparesis. That is the whole reason the testing above comes first. If delayed emptying is not what is driving your symptoms, loosening the pylorus will not fix them, so patients whose symptoms trace to functional dyspepsia or another cause are not candidates. Patients with severe weight loss may need their nutrition stabilized first. And it manages symptoms rather than curing the disease, so results vary from person to person.
The surgical alternative, pyloroplasty, divides the same muscle through small abdominal incisions and can be very effective, though opening the valve permanently sometimes brings side effects like bile reflux or looser stools with certain meals. Which one fits depends on your anatomy and your testing. Every procedure is done at HCA South Tampa Hospital with the same operating-room team and Dr. Grandhige’s own physician assistant, so the people in the room know the operation cold.
How the evaluation works, and how fast you can be seen
Before your first visit, Dr. Grandhige personally reviews your records. That means your endoscopy reports, any gastric emptying study, imaging, and notes from your gastroenterologist, primary care doctor, or other specialists. Reviewing it ahead of time means your appointment is spent on answers, not filling out forms or repeating your history again. Email your records to info@tampareflux.com before you come in.
New patients are usually seen within two weeks, and always within four. If your testing is already done, one visit is often enough to confirm the diagnosis and talk through options. If testing is still needed, a second visit about four weeks later reviews the results and settles the plan. When a procedure is the right call, the stretch from consultation to the procedure itself typically runs four to eight weeks, depending on testing and scheduling. Throughout, a dedicated physician assistant is part of every case and stays reachable during recovery, so you are not handed off to someone who has never met you.
Meet Dr. Gopal Grandhige
Dr. Gopal Grandhige is a board-certified general surgeon, fellowship-trained in foregut and minimally invasive surgery at Yale-New Haven Hospital. He earned his biology degree at Johns Hopkins University and his medical degree at the University of Michigan, then completed his surgical residency and fellowships at Yale. He is a Founding Member of the American Foregut Society, a Fellow of the American College of Surgeons, and a member of the Society of American Gastrointestinal and Endoscopic Surgeons.
He has focused only on benign foregut disease, meaning the esophagus, stomach, and diaphragm, since 2009, which is more than 16 years in Tampa Bay. That work also covers silent reflux (LPR), achalasia, and hiatal hernias. He has performed more than 600 fundoplications, more than 600 LINX procedures, and more than 200 TIF procedures for reflux, and all of his surgeries are done at HCA South Tampa Hospital. You can read more about Dr. Grandhige and the practice, and find plain-language articles on testing and treatment on our blog.
Patients and referring physicians, from gastroenterology, ENT, pulmonology, and primary care, consistently point to the same things: a thorough workup, clear explanations with drawings, and a surgeon who recommends a procedure only when it is likely to help. Many arrive expecting surgery and leave with a diagnosis and a non-surgical plan instead.

FAQS
Get a clear diagnosis
If your gastroparesis symptoms are not improving, the next step is a diagnosis you can trust. Request a consultation with Dr. Grandhige, or send your records to info@tampareflux.com to get started.
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
