
Wake Up Every Morning With A Rumbling Stomach. The "borborygmus"

I also have blood work
HIGH MONOCYTE REL
HIGH EOSINOPHIL REL
HIGH MCV
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!


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!

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