You need to tell them. You are very unwell. Most certainly it’s frustrating that they can’t find proper treatment but I believe you can make it worse by not telling. Another IP might not be a bad option. Plus I thought you wanted to go IP, just didn’t qualify for it

Pantaprosole is supposed to work when you eat. That’s why you take it half an hour before meal. My GI actually recommends it not in the morning but before larger meal like dinner for example. But if you don’t eat, it just doesn’t do what it is supposed to do.