“Doctor, I wake up feeling fine. But by late afternoon, my stomach looks and feels swollen no matter what I eat.”That line shows up in clinic more often than you’d think. Sometimes it comes with gas, sometimes cramping, and sometimes constipation for weeks followed by sudden loose stools—or a frustrating mix of both. Many people have already tried cutting gluten, dairy, or whole food groups. A few feel better briefly. Others are told their tests are normal and start wondering