"Why I woke up with a bloated stomach every morning — and what finally stopped it"

“Dr. Nedelya Shtonova reveals the root cause of chronic bloating in women and why standard solutions don't work”

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Dr. Nedelya Shtonova • Medical Specialist Neurologist • Sapphire Nutrition

I will start with something I hear almost every day — not just in my office, but outside of it as well:

“I’m fine in the morning. By noon, my stomach is bloated. In the evening, I feel heavy, tired, and irritable. And my test results are normal.”

This is not a rare case. This is a pattern.

Women who are active, intelligent, and health-conscious — yet living with chronic discomfort that is often underestimated.

The truth is more nuanced than simple explanations. And it deserves to be told accurately.

What really lies behind bloating?

Abdominal bloating is not a diagnosis. It is a symptom.

In modern medicine — including according to the criteria for Irritable Bowel Syndrome — the causes are almost always multifactorial:

• impaired intestinal motility
• visceral hypersensitivity (over-reactivity of the nervous system to normal processes)
• dietary triggers, including fermentable carbohydrates (FODMAPs)
• changes in the gut microbiome
• hormonal fluctuations
• stress and regulation of the brain-gut axis

The key here is something rarely stated clearly:

There is no single "root cause." There is a network of interactions between the brain, gut, and metabolism.

What is the role of the gut microbiome?

The term "dysbiosis" — an imbalance in the gut microbiome — is often used as a catch-all explanation. In reality, science has become much more precise in recent years.

Yes, the microbiome matters. But it is important to know what science supports and what it does not:

• there is no single "normal" microbiome valid for all people
• there is no universal test that can diagnose "dysbiosis" in a strictly clinical sense
• and there is no single solution that will "fix" it for everyone

The microbiome is nevertheless involved in numerous physiological processes:

• fermentation of dietary components
• production of short-chain fatty acids
• communication along the brain-gut axis
• modulation of the immune system

It is an important part of the system. But it is a part — not the sole cause.

The "second brain" — a metaphor with boundaries

You will often hear that the gut is the "second brain." This image comes from the enteric nervous system — a network of neurons in the digestive tract.

Yes, a large part of the body's serotonin is synthesized in the gut. But this does not mean that mood is "cured" with probiotics.

The truth is more interesting and more complex:

• the brain and gut are in constant two-way dialogue
• the nervous system regulates sensitivity, motility, and the perception of bloating
• stress can change how our body perceives completely normal digestive processes

That is why a symptom like bloating rarely has a single cause.

Why do standard solutions often fail?

Many women have already tried:

• elimination diets
• various probiotics
• enzymes
• herbal products

And often, the result is temporary or non-existent. Why?

Because one is seeking a single solution for a multifactorial problem.

1. Probiotics are not universal

Different strains have different effects. Some have data supporting symptomatic relief in functional bowel disorders, others do not.

• the effect is strain-specific
• dosage matters
• for some people, there is no noticeable effect — and that does not mean they are "doing something wrong"

2. "More" does not always mean "better"

There is often talk of "billions of bacteria," but science does not support a simple linear relationship between CFU counts and results:

• a higher dose does not automatically mean a better effect
• the key is in the right combination and context

3. Food and the nervous system are just as important

Without adjusting one's diet, working on the sensitivity of the nervous system, and managing stress, the effect of any supplement remains limited.

Where do supplements fit in?

Supplements can have a place — but only as part of a broader strategy.

Synbiotics (a combination of probiotics and prebiotics) are an interesting approach in modern formulations because they:

• combine selected bacterial strains with an "environment" for them
• potentially support the colonization of beneficial microorganisms
• work synergistically, rather than as separate components

But it is important to state clearly:

• they are not a cure
• they do not work the same for everyone
• the effect is moderate and individual

What we observe with functional bowel complaints

Some people report:

• a reduction in the sensation of bloating
• better tolerance to certain foods
• subjective improvement in post-meal comfort
• changes in overall energy and well-being

But scientifically, the effects are heterogeneous, require individual assessment, and are always part of a wider strategy. This is the truth — and I believe it is more useful than any promise.

What really works: a personalized approach

The modern approach to functional bowel complaints is multi-layered:

• nutritional strategy — not based on universal restrictions, but tailored to individual reactions
• working with the brain-gut axis
• sleep and circadian rhythms
• regular, moderate physical activity
• if needed — targeted supplements as part of comprehensive care

What people taking Microbiome 11 share

The testimonials below are personal impressions and do not constitute clinical data. We include them because they show the variety of individual reactions — something we talk about throughout this article:

"I noticed a change in my overall feeling of comfort. I get sick less often and have better control over my appetite." — Kalin K.

"I've had a sensitive stomach, bloating, and discomfort after meals for years. Over time, I felt an improvement in my daily comfort." — Yordanka M.

"For me, the most noticeable thing was a reduction in the feeling of heaviness and gas after meals. I felt more lightness throughout the day." — Zhivko A.

Questions I hear most often

"I've tried probiotics — they didn't work for me."

This is common. The reason is usually that different probiotics have different strains, dosages, and formulas. Modern approaches view the microbiome as an individual ecosystem that does not react the same way for everyone. Just because one product didn't produce results doesn't mean your problem is "unsolvable" — it means the approach needs to be different.

"How quickly can a change be felt?"

Some people notice a change in their sense of comfort within the first few days to weeks. It is important to emphasize that effects are individual and depend on many factors — diet, stress, physical activity, and the baseline state of the intestinal system. Do not expect a dramatic breakthrough in one day; look for sustainable changes over time.

"Is it safe for long-term use?"

The formula is created as a dietary supplement with quality standards (GMP production in the EU), gluten-free, and with no artificial preservatives. As with all probiotic and synbiotic products, it is important to use it in the context of your individual health condition and, if necessary, after consultation with a specialist, especially if you have a chronic illness, are pregnant, or are taking medication.

My message to you

I know that when one lives with discomfort for a long time, fatigue sets in — not just physical, but emotional. And one often starts to believe that "nothing helps."

The truth is more nuanced.

Modern science regarding the gut microbiome and the gut-brain axis shows that these conditions are multifactorial and require a comprehensive approach — not a one-size-fits-all solution.

My role as a neurologist is to help you understand these processes more clearly and to make informed choices for your own health.

The goal is not to promise a “perfect solution,” but to foster a better understanding of the body and its signals.

Free delivery over 50 EUR • Mon-Fri: 09:00–18:00 • office@sapphire.bg

Dr. Nedelya Shotova is a neurologist. This article is for educational purposes and does not replace medical consultation. If you have any concerns, please seek a specialist for an individual assessment.