What gastroparesis is, and why testing comes first
Gastroparesis is delayed stomach emptying without a physical blockage. The stomach muscle contracts too weakly or too slowly, so food sits for hours. That produces nausea, vomiting of undigested food, early fullness, bloating, upper abdominal pain, weight loss, and often severe acid reflux (GERD). The cause is frequently unknown (idiopathic, sometimes after a viral illness), sometimes a complication of diabetes, sometimes the result of prior surgery, and sometimes a side effect of medications like opioids.
Testing matters more here than patients realize. According to the American College of Gastroenterology’s gastroparesis guideline, the gold standard for diagnosis is a 4-hour gastric emptying study that measures the percentage of a labeled meal still in the stomach at four hours. Two findings from that guideline change how a careful specialist proceeds. First, the severity of delayed emptying doesn’t reliably match how bad someone feels. Second, symptoms overlap heavily with functional dyspepsia, where patients have identical complaints but normal emptying. Operating on the pylorus in someone whose emptying is actually normal won’t help. That’s why objective testing comes before any talk of a procedure, and why symptoms alone are never enough. Gastroparesis symptoms can also mimic other motility disorders such as achalasia, which needs an entirely different treatment.

What results look like, and the honest limits
G-POEM is not a cure. No current gastroparesis treatment is. It’s aimed at reducing symptoms and improving emptying, and for many carefully selected patients it does both. Here’s what the published evidence shows, so your expectations match reality.
Technical success (completing the myotomy as intended) consistently runs above 95%. Short-term symptom improvement is reported in roughly 70 to 80% of patients. Durability is more nuanced: a 2024 systematic review and meta-analysis of 952 patients found clinical success around 72% at one year, holding in the majority through about three years, and tapering over longer follow-up. Serious complications are uncommon, pooled at roughly 8%. Response also varies by cause and by how long you’ve had the disease, which is one more reason patient selection drives the result. The takeaway isn’t that G-POEM is unreliable. It’s that it works well for the right person and disappoints when it’s used on the wrong one.
Who G-POEM helps, and who it doesn’t
A good candidate has delayed emptying confirmed on a gastric emptying study, symptoms that stayed severe despite diet changes and medication, and no mechanical blockage. G-POEM is a step you reach after first-line care falls short, not a first move, though it’s increasingly considered earlier in patients whose testing clearly points to the pylorus.
It’s a poor fit in a few situations. Patients whose emptying study is normal (functional dyspepsia) won’t benefit, because the pylorus isn’t the driver. Patients with severe malnutrition or dangerous weight loss may need nutritional support first, before any definitive procedure is safe. And G-POEM isn’t the only option. Depending on the case, gastric electrical stimulation (an implanted device for persistent nausea and vomiting), robotic or laparoscopic pyloroplasty, a feeding tube for nutritional stabilization, or rarely surgery to remove most of the stomach in severe unresponsive disease may fit better. A specialist who can offer more than one of these is in a position to recommend the one that fits your anatomy, rather than the only one they perform.
What’s changing in gastroparesis care in 2026
Why Clearwater patients travel to this practice
Dr. Grandhige is one of only a handful of physicians in the Tampa Bay area who performs G-POEM, and his practice focuses solely on the foregut: the esophagus, stomach, and diaphragm. That means conditions like silent reflux (LPR), hiatal hernias, achalasia, and gastroparesis, not general surgery. The defining habit is restraint. He confirms the problem with objective testing, tells patients plainly which symptoms a procedure will and won’t fix, and declines to operate when surgery is unlikely to help.
Continuity is built in. He performs every procedure at HCA South Tampa Hospital with the same operating-room team and a dedicated physician assistant who’s present for the surgery and reachable afterward, so patients aren’t handed to unfamiliar providers during recovery. More on Dr. Grandhige’s training and background is on the practice site, and you can verify his standing independently through the American Board of Surgery and the Florida Department of Health license lookup. His credentials include a foregut and minimally invasive surgery fellowship at Yale New Haven Hospital, board certification in general surgery, and fellowship in the American College of Surgeons.
New patients are typically seen within two weeks, and always within four. If you’re coming from Clearwater, email your prior records (endoscopy reports, any gastric emptying study, imaging, and specialist notes) to info@tampareflux.com before your visit so the consultation starts with a real review instead of paperwork. For deeper reading on reflux and foregut topics, see the practice blog.
Tampa Bay Reflux Institute is at 1315 South Howard Avenue, Suite 101, Tampa, FL 33606, in the yellow brick building next to Sally O’Neill’s Pizza, with parking behind the restaurant. Office hours are 9am to 6pm, Monday through Friday.

Frequently asked questions
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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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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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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#nonsurgicalweightloss #ESG #gastricballoon #weightlossjourney #vsg #vsgjourney #spatz3 #orbera #orberaballoon #grandhige #DrG
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