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Wake Up Every Morning With A Rumbling Stomach. The "borborygmus"
Question: Wake up every morning with a rumbling stomach. The "borborygmus" noise. General Aching comes along with that. The main source of the pain and grumbling is between my rib cages and about three inches above my navel. The grumbling doesn't slow down until I've eaten breakfast. On my good days eating helps get rid of about 90% of the noises and 50% on the pain. I have a constant burnt out feeling in my stomach. Almost as if I drank a glass of battery acid the night prior. That is on a normal day. On a bad day (which I usually get 3x per month) these symptoms are multiplied. The pain becomes a ten. It feels like my stomach was just squeezed by a body builder for 8 hours and has finally been let go. It's a constant sore feeling. This exact pattern has been going on for 2 years. I feel horrible pretty much every day. I am an incredibly active 28 year old. I own 2 businesses, exercise constantly, and drug/alchohol/nicotine/caffeine free. The only time my symptoms completely go away is about 10 minutes into working out. It is a sure-fired solution. Now, that relief is only very temporary. About one hour after the workout is finished, the pain returns. The biggest issue I have been running into is feeling good enough to actually workout. But once I am there I have temporary relief. If I go 4-5+ hours without eating the symptoms get so incredibly unbearable and painful. I am physically tired and almost beat up/defeated. Some days I have absolutely no fight in me. No specific food makes it worse, no amount of stress changes it. It is a constant pain, and randomly will become debilitating. Also; I have no nausea, no problem eating, no problem pooping, and almost never get heartburn.
I also have blood work
HIGH MONOCYTE REL
HIGH EOSINOPHIL REL
HIGH MCV
I also have blood work
HIGH MONOCYTE REL
HIGH EOSINOPHIL REL
HIGH MCV
Brief Answer:
Thoroughly investigated but treatment is suboptimal.
Detailed Answer:
Hello and Welcome to 'Ask A Doctor' service.
I have reviewed your query and here is my advice.
You have been thoroughly tested and test results of endoscopy are clearly suggestive of severe gastritis(inflammation) in many areas.
As per treatment is concerned every time just a basic proton pump inhibitor is given that too in an optimal dose(usually used in patients with the mild acid peptic disorder).
As per me, the pain is not responding due to mild treatment.
In many of cases like you proton pump inhibitors should be given with prokinetic drugs.
In endoscopy, it's clearly written that esophagitis is there but no medication has been given to treat it.
Look, proton pump inhibitor prevents baseline as well as excessive secretion of acid in the stomach(work finished) but prokinetic drug helps to prevent the reflux of this acid into the esophagus hence preventing recurrent injury(missing in your case).
Secondly, it's not necessary that every patient responds to oral medication. In such patients initially, intravenous therapy is used followed by oral therapy.
Acotiamide a new drug is also very helpful in patients not responding to normal treatment.
When you don't eat for a few hours your stomach gets empty now the baseline acid secreted by parietal cells irritates the mucosa hence causing pain.
You have been extensively investigated but as per me the part lacking is proper treatment.
Discuss this answer with your treating gastro and please ask why no prokinetic medicine is used and when you are not responding to oral antacids why parenteral therapy was not used.
Just take a print out and discuss it with him in the mail or in-person and reply to me what he says.
If possible follow this also,
You should also take a walk after meals.
-You should take small portions of food every 2 hours.
-Avoid heavy and large fatty meals.
-Drink sufficient water.
-chew your food slowly and properly.
Follow up after your Doctor's reply.
Hope I was helpful,
Thank you!
Thoroughly investigated but treatment is suboptimal.
Detailed Answer:
Hello and Welcome to 'Ask A Doctor' service.
I have reviewed your query and here is my advice.
You have been thoroughly tested and test results of endoscopy are clearly suggestive of severe gastritis(inflammation) in many areas.
As per treatment is concerned every time just a basic proton pump inhibitor is given that too in an optimal dose(usually used in patients with the mild acid peptic disorder).
As per me, the pain is not responding due to mild treatment.
In many of cases like you proton pump inhibitors should be given with prokinetic drugs.
In endoscopy, it's clearly written that esophagitis is there but no medication has been given to treat it.
Look, proton pump inhibitor prevents baseline as well as excessive secretion of acid in the stomach(work finished) but prokinetic drug helps to prevent the reflux of this acid into the esophagus hence preventing recurrent injury(missing in your case).
Secondly, it's not necessary that every patient responds to oral medication. In such patients initially, intravenous therapy is used followed by oral therapy.
Acotiamide a new drug is also very helpful in patients not responding to normal treatment.
When you don't eat for a few hours your stomach gets empty now the baseline acid secreted by parietal cells irritates the mucosa hence causing pain.
You have been extensively investigated but as per me the part lacking is proper treatment.
Discuss this answer with your treating gastro and please ask why no prokinetic medicine is used and when you are not responding to oral antacids why parenteral therapy was not used.
Just take a print out and discuss it with him in the mail or in-person and reply to me what he says.
If possible follow this also,
You should also take a walk after meals.
-You should take small portions of food every 2 hours.
-Avoid heavy and large fatty meals.
-Drink sufficient water.
-chew your food slowly and properly.
Follow up after your Doctor's reply.
Hope I was helpful,
Thank you!
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you so much for taking the time to help me! Is there any way you could tell me which of these medicines are available in the USA and if you could prescribe it to me?
Brief Answer:
Follow up.
Detailed Answer:
Hi my dear,
Thank you for follow up,
All these medicines are available in states but on the prescription of your doctor.
I am extremely sorry but online prescription can't be provided (hope you can understand we have to abide by rules).
Acotiamide I think is not available in some states of the USA but could easily be availed from Mexico.
Doses are 100mg thrice for 3 months.
As said above firstly take a print of my answer and discuss that with your treating doctor (Don't worry all medicines are available but I don't know why they are just doing investigations after investigation and treating you with just optimal/low doses).
Discuss that with your Gastro and let me know what s/he says.
Hope to hear from you soon.
Thank you!
Follow up.
Detailed Answer:
Hi my dear,
Thank you for follow up,
All these medicines are available in states but on the prescription of your doctor.
I am extremely sorry but online prescription can't be provided (hope you can understand we have to abide by rules).
Acotiamide I think is not available in some states of the USA but could easily be availed from Mexico.
Doses are 100mg thrice for 3 months.
As said above firstly take a print of my answer and discuss that with your treating doctor (Don't worry all medicines are available but I don't know why they are just doing investigations after investigation and treating you with just optimal/low doses).
Discuss that with your Gastro and let me know what s/he says.
Hope to hear from you soon.
Thank you!
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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