New Treatments For Gastroparesis In Clearwater, FL

The 4-hour study is not a formality. The AGA specifically advises against 2-hour or shorter protocols, because emptying measured only at 2 hours misclassifies people whose delay appears later. Extending imaging to 4 hours raises the diagnostic yield substantially over shorter historical protocols. If your scan ended at 90 minutes or 2 hours, you do not yet have an answer.

Dr. Grandhige reviews every available study before you ever sit down: prior endoscopy and pathology, pH testing, manometry, imaging, operative reports, and the notes from your gastroenterologist, ENT, pulmonologist, or allergist. He explains where his reading agrees with theirs and where it does not, so you are not collecting one more opinion without context.

Two things get ruled out that generalist workups often skip.

A large hiatal hernia driving gastric atony. Delayed emptying does not always start at the pylorus. The larger a hiatal hernia becomes, the more likely an atonic stomach develops, and that stomach may or may not recover after the hernia is repaired. Gastroparesis also overlaps regularly with GERD and esophageal disorders, which is why the whole foregut gets evaluated rather than the stomach outlet alone.

A motility disorder wearing gastroparesis symptoms. Nausea, early satiety, and regurgitation appear in achalasia, esophageal spasm, rumination, and esophageal hypersensitivity. The practice uses EndoFLIP, an impedance planimetry catheter that measures how a valve actually opens under pressure, in its motility work. Manometry, barium esophagram, and endoscopy each answer a different question, and skipping one is how the wrong procedure gets chosen.

G-POEM is performed entirely through the mouth with an endoscope. No abdominal incisions. The pylorus, the muscle ring controlling the stomach outlet, is cut in a controlled way to lower resistance so the stomach empties more efficiently. Most patients go home the same day.

Here are the published numbers, stated plainly, because they are routinely oversold.

Technical success, meaning the myotomy is completed as intended, runs near 98 percent. Clinical success, meaning your symptoms actually improve, is a different number. A systematic review and meta-analysis of 13 studies covering 952 patients put pooled clinical success at roughly 72 percent one year after G-POEM. Longer-term series report sustained success in the range of 50 to 77 percent at three to four years, and the variation tracks with the underlying cause and disease progression.

Any practice quoting you a 95 percent symptom-relief figure for gastroparesis is quoting technical success, not clinical success. Ask which one they mean.

You are not a candidate if the diagnosis rests on a 2-hour scan, if symptoms have been present for less than 6 to 12 months, if medical therapy has not been given a fair trial, or if abdominal pain is your dominant symptom rather than nausea, vomiting, or fullness. Gastric electrical stimulation is a separate option that exists elsewhere in the Tampa Bay region. Dr. Grandhige does not implant it, and the AGA also reserves it for refractory patients.

After a procedure, the practice asks for six months before judging the result. At that point, remaining symptoms get addressed directly, including a referral to another specialist when they turn out not to be gastric in origin.

Dr. Grandhige is a board-certified general surgeon who has practiced foregut surgery in Tampa Bay since 2009. He founded Tampa Bay Reflux Center in 2009 and Tampa Bay Reflux Institute in 2022, where he serves as Medical Director.

He earned a Bachelor of Science in biology from Johns Hopkins University and his medical degree from the University of Michigan. He completed general surgery residency at Yale-New Haven Hospital, followed by two fellowships there: burn and critical care, and foregut surgery with minimally invasive surgery. He is certified by the American Board of Surgery, 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.

He holds privileges at St. Joseph’s Main Hospital, St. Joseph’s South Hospital, HCA Brandon Hospital, and HCA South Tampa Hospital. Board certification is verifiable through the American Board of Surgery physician lookup and the American College of Surgeons directory, and active Florida licensure through the Florida Department of Health Medical Quality Assurance license search. His practice covers benign foregut disease only, including gastroparesis, GERD, hiatal hernias, silent reflux and LPR, and achalasia. He does not treat esophageal or gastric cancer.

More on his background and the practice is on the about the practice page, and the condition overview lives on the main gastroparesis page.