Gastroparesis Treatment In St. Petersburg, FL

Stop managing symptoms and start fixing the cause with a dedicated reflux and foregut specialist.

If gastroparesis medications have stopped working, the next real option is a procedure that targets the pylorus, the muscular valve at the stomach’s exit. Dr. Gopal Grandhige is one of only a handful of surgeons in the Tampa Bay area who performs endoscopic pyloromyotomy (G-POEM/POP) for gastroparesis, and St. Petersburg patients are a regular part of his practice. He confirms gastroparesis with objective testing first, then matches treatment to what the testing actually shows.

Tampa Bay Reflux Institute is in South Tampa at 1315 South Howard Avenue, Suite 101, a short drive across the bay from St. Pete. To start, you can schedule a consultation or call 813.922.2920.

Where St. Petersburg Patients Go for Advanced Gastroparesis Care

St. Petersburg sits across the bay from one of the few foregut-focused surgical practices in the region. Most gastroparesis care in Pinellas and Hillsborough is medical management handled by a general gastroenterologist: diet changes and prokinetic drugs. That helps some people. When it stops working, the question becomes who locally can offer a procedure, and that list is short.

Dr. Grandhige built Tampa Bay Reflux Institute around benign diseases of the esophagus, stomach, and diaphragm, including gastroparesis. He performs endoscopic pyloromyotomy (also called G-POEM or POP), an incision-free procedure done through the mouth that divides the pyloric muscle to ease stomach emptying. On his own account he is one of only a handful of physicians performing it in Tampa Bay. For St. Pete patients, that means the procedure is roughly 20 to 30 minutes away rather than a flight to a national center.

This page is specifically for people in St. Petersburg and the surrounding Pinellas communities who have already tried the basics and want to know what comes next. For the full clinical overview of the condition, see the main gastroparesis treatment page.

Dr. Grandhige profile photo

What Gastroparesis Is, in Plain Terms

Gastroparesis means the stomach empties too slowly even though nothing is physically blocking it. The stomach muscle that should push food forward is sluggish or uncoordinated, so food sits too long. That is what drives the nausea, bloating, early fullness, and vomiting of undigested food hours after eating.

It often has no clear cause. In some people it follows diabetes, prior surgery, or nerve injury, and certain medications (opioid pain relievers, some antidepressants, some blood pressure and allergy drugs) slow emptying and can make existing gastroparesis worse. Because these symptoms overlap with reflux, rumination, and functional dyspepsia, the first job is to confirm gastroparesis rather than assume it.

How Dr. Grandhige Confirms Gastroparesis Before Any Treatment

Treatment decisions start with proving the diagnosis, not guessing from symptoms. The most useful test is a gastric emptying study, and Dr. Grandhige reviews it personally before your visit when it already exists.

The Gastric Emptying Study

You eat a light standardized meal (typically eggs and toast or oatmeal) containing a small amount of tracer. A scanner over the abdomen tracks how fast the meal leaves the stomach, and the study follows that for four hours. Slow clearance over those four hours is what objectively defines delayed emptying.

Upper Endoscopy

Endoscopy is not used to diagnose gastroparesis directly. It rules out a mechanical blockage or inflammation that could mimic it. One practical clue shows up here: if food is still in the stomach during an endoscopy after the patient has not eaten for many hours, gastroparesis is suspected.

When the picture is unclear, additional motility testing is added so that other disorders, such as achalasia, are not mistaken for gastroparesis. The point of all of this is simple: confirm the problem, locate it, and only then talk about treatment.

The Gastroparesis Treatment Ladder: From Diet to Procedure

Gastroparesis cannot be cured, so treatment aims at controlling symptoms, and it is escalated step by step only as far as each patient needs. Here is the full ladder Dr. Grandhige works through, from least to most involved.

Step 1: Diet and Nutrition

The first goal is keeping nutrition adequate. Smaller, more frequent meals, well-chewed and well-cooked food, lower-fat choices, and avoiding carbonation, alcohol, and smoking all reduce the load on a slow stomach. The practice can refer you to a dietitian. For many patients this alone produces meaningful improvement.

Step 2: Medications

Two jobs here. Prokinetics speed the stomach up: metoclopramide (Reglan) and erythromycin are the common ones, though metoclopramide can have significant side effects that limit long-term use and erythromycin tends to lose effect over time. Domperidone has fewer side effects but is harder to access. Separately, anti-nausea medications such as ondansetron (Zofran), prochlorperazine (Compazine), and diphenhydramine (Benadryl) control nausea and vomiting.

Step 3: Endoscopic pyloromyotomy (G-POEM/POP)

When diet and medication are not enough, this is usually the next step, and it is the procedure that brings most out-of-town patients to the practice. Using a flexible endoscope through the mouth, Dr. Grandhige creates a small tunnel under the pyloric muscle and divides it with an endoscopic knife, lowering the resistance that holds food in the stomach. No external incisions. He notes he is one of only a handful of surgeons performing it in Tampa Bay.

Step 4: Robotic or laparoscopic pyloroplasty

A surgical alternative to the endoscopic approach. Through small abdominal incisions, the pyloric muscle is divided and the valve reshaped to widen the opening for the long term. Because the valve is opened permanently, some patients notice effects like reflux of intestinal contents back into the stomach or diarrhea with certain meals.

Step 5: Feeding Tube or Venting (Severe Cases)

Some patients arrive with severe weight loss and malnutrition that make them poor candidates for a definitive procedure. A tube that vents the stomach and allows feeding directly into the intestine can stabilize nutrition first, so a more permanent option can be considered safely later.

Step 6: Subtotal Gastrectomy (Rare, Last Resort)

Reserved for the small number of people whose disease is severe and unresponsive to everything else, with weight loss, repeated ER visits, and major disruption to life. As a life-saving measure, most of the stomach is removed and the intestine connected to a small remaining pouch.

Not everyone needs a procedure, and not every gastroparesis patient benefits from a pyloromyotomy. Patient selection matters: it is recommended when testing shows the pylorus is a real contributor and symptoms line up with the findings. That restraint is the point of the ladder.

Who Is a Candidate for G-POEM, and Who Is Not

Endoscopic pyloromyotomy helps most when objective testing confirms that pyloric dysfunction is driving delayed emptying and your symptoms correlate with those findings. It is not a fit for everyone.

  • A reasonable candidate: confirmed delayed gastric emptying, symptoms that track with the testing, and inadequate relief from diet and medication.
  • Better served by another step first: severe malnutrition or weight loss, where stabilizing nutrition comes before any definitive procedure.
  • Often not reflux or gastroparesis at all: symptoms actually caused by rumination, functional dyspepsia, or a motility disorder like achalasia, which need different treatment.

Telling these apart is exactly why the testing comes first. Operating on the wrong diagnosis is how patients end up disappointed, and avoiding that is part of the job.

Person with heartburn wondering

Why a Foregut Specialist, Not a Generalist

Gastroparesis decisions improve with focus and volume in foregut disease, not occasional exposure. Dr. Grandhige has practiced foregut surgery in Tampa Bay since 2009 and treats the esophagus, stomach, and diaphragm almost exclusively.

His verifiable background:

  • Gopal Grandhige, MD — board-certified general surgeon; Founder and Medical Director, Tampa Bay Reflux Institute.
  • Training: biology at Johns Hopkins University, medical degree at the University of Michigan, general surgery residency and fellowships in foregut/minimally invasive surgery and in burn/critical care at Yale–New Haven Hospital.
  • Memberships: Founding Member of the American Foregut Society, member of SAGES, and Fellow of the American College of Surgeons (FACS).
  • Procedure volume across foregut surgery: more than 600 fundoplications, more than 600 LINX procedures, and more than 200 TIF procedures.

You can verify board certification through the American Board of Surgery and the American College of Surgeons directory, and active licensure through the Florida Department of Health license lookup. For background on the procedure itself, the American Gastroenterological Association is an authoritative reference.

Many St. Pete patients also come for related foregut problems that travel with gastroparesis, such as severe reflux or a hiatal hernia. Where it is safe and appropriate, addressing more than one issue together avoids repeat surgeries. You can read more about his approach on the about the practice page or browse the patient education blog.

Getting Care From St. Petersburg in 2026

The office is at 1315 South Howard Avenue, Suite 101, Tampa, FL 33606, in South Tampa near the Howard Avenue corridor, typically 20 to 30 minutes from St. Petersburg depending on bridge traffic. Hours are 9 a.m. to 6 p.m., Monday through Friday.

If you already have records, send them before your visit to info@tampareflux.com: prior endoscopy and pathology reports, any gastric emptying study, motility or pH testing, imaging, your medication list, and relevant office notes. Dr. Grandhige reviews everything beforehand, so the consultation is spent on explanation and decisions instead of re-collecting paperwork. Bringing your own records is often faster than waiting on transfers between systems.

As of 2026 the practice also offers RefluxStop, making Dr. Grandhige the only surgeon in the Tampa Bay area offering all four major anti-reflux procedures, which matters for the many gastroparesis patients who also have reflux. To begin, schedule a consultation or call 813.922.2920.

FAQS

Mainly with a gastric emptying study. You eat a light tracer-containing meal and a scanner measures how much remains in the stomach over four hours. Slow clearance confirms delayed emptying. Endoscopy is used alongside it to rule out a blockage, not to diagnose gastroparesis itself.

No. There is no cure today, so treatment is aimed at controlling symptoms and keeping nutrition adequate. The good news is that for many people the right combination of diet, medication, and, when needed, a pyloric procedure produces real day-to-day improvement.

It is an incision-free procedure done through the mouth. A flexible endoscope is used to tunnel under the pyloric muscle and divide it, easing stomach emptying. Dr. Grandhige performs it in South Tampa and reports being one of only a handful of surgeons doing it in the Tampa Bay area, about 20 to 30 minutes from St. Pete.

Both open the pyloric valve. G-POEM does it endoscopically through the mouth with no external incisions. Pyloroplasty does it surgically through small abdominal incisions and reshapes the valve. Because pyloroplasty opens the valve permanently, some patients notice effects such as reflux of intestinal contents or diarrhea with certain meals. The right choice depends on your testing and anatomy.

Tampa Bay Reflux Institute focuses on pyloric-directed treatment: endoscopic pyloromyotomy and pyloroplasty, with feeding-tube or venting support and, rarely, subtotal gastrectomy for the most severe cases. Gastric electrical stimulation (a gastric pacer) is a different procedure offered elsewhere. The honest answer is that the best step is the one your objective testing supports, which is decided at the consultation rather than from a list online.

Possibly something else. Reflux, rumination syndrome, functional dyspepsia, and motility disorders like achalasia can all look like gastroparesis. That overlap is why diagnosis starts with objective testing rather than assuming. Confirming the right condition protects you from the wrong treatment.

Email any prior endoscopy and pathology reports, gastric emptying study, motility or pH testing, imaging, your medication list, and relevant specialist notes to info@tampareflux.com. Dr. Grandhige reviews them in advance so your visit focuses on understanding your condition and your options.

Start With a Clear Diagnosis

You do not have to keep guessing why eating has become so hard. If medications have stopped working, there are real procedural options, and the first step is confirming what is actually going on. Dr. Grandhige will review your testing, explain what it shows in plain language, and tell you honestly which symptoms a procedure is likely to improve and which it will not.

Tampa Bay Reflux Institute, 1315 South Howard Avenue, Suite 101, Tampa, FL 33606. Phone 813.922.2920. Serving St. Petersburg and the greater Tampa Bay area. Schedule a consultation.

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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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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. 

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What causes reflux ?

1.  Weak lower esophageal sphincter
2.  Hiatal hernia
3.  Flattening of the Angle of His
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5.  Gastroparesis (slow stomach)

NOT increased acid production

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All major insurances accepted.

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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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