{"id":193185,"date":"2026-04-07T08:51:39","date_gmt":"2026-04-07T13:51:39","guid":{"rendered":"https:\/\/www.artofmanliness.com\/?p=193185"},"modified":"2026-05-01T09:22:30","modified_gmt":"2026-05-01T14:22:30","slug":"podcast-1112-youve-been-pooping-wrong-heres-how-to-do-it-better","status":"publish","type":"post","link":"https:\/\/www.artofmanliness.com\/health-fitness\/health\/podcast-1112-youve-been-pooping-wrong-heres-how-to-do-it-better\/","title":{"rendered":"Podcast #1,112: You\u2019ve Been Pooping Wrong \u2014 Here\u2019s How to Do It Better"},"content":{"rendered":"<div class=\"art19-web-player awp-medium awp-theme-dark-blue\" data-episode-id=\"8436cf16-39dc-4b80-b088-5cbda859a010\">&nbsp;<\/div>\n<p>Pooping. Everybody does it, but a lot of people are embarrassed to talk about it. That&#8217;s a shame, my guest says, not only because your digestive health is incredibly linked to your overall health, but simply for the fact that there is much happiness to be found in an easy, worry-free constitutional.<\/p>\n<p>Harvard gastroenterologist Dr. Trisha Pasricha is the author of <a href=\"https:\/\/amzn.to\/4vhnGCR\"><em>You&#8217;ve Been Pooping All Wrong: How to Make Your Bowel Movements a Joy<\/em><\/a>. Today on the show, Trisha and I have a fun and frank conversation about the art and science of bowel movements, including the color of healthy stools, how often you should be pooping, if laxatives are safe to use, the food to eat that&#8217;s even better than prunes for getting things going, why you feel the urge to go poop at Barnes and Noble, the wonders of the bidet, the danger of using your smartphone on the toilet, how to get more comfortable pooping in a public restroom, and more.<\/p>\n<h3>Resources Related to the Podcast<\/h3>\n<ul>\n<li><a href=\"https:\/\/www.artofmanliness.com\/living\/reading\/top-10-toilet-books\/\" target=\"_blank\" rel=\"noopener\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/www.artofmanliness.com\/living\/reading\/top-10-toilet-books\/&amp;source=gmail&amp;ust=1775061779379000&amp;usg=AOvVaw1WhnPw4yBZ4iyIaTch7Jlr\">AoM Article: The Top 10 Toilet Books<\/a><\/li>\n<li><a href=\"https:\/\/www.artofmanliness.com\/health-fitness\/health\/be-a-regular-guy-tips-for-improving-your-daily-constitutional\/\" target=\"_blank\" rel=\"noopener\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/www.artofmanliness.com\/health-fitness\/health\/be-a-regular-guy-tips-for-improving-your-daily-constitutional\/&amp;source=gmail&amp;ust=1775061779379000&amp;usg=AOvVaw3qSXXiu9aLJFNjvwaf3Sff\">AoM Article: Be a \u201cRegular\u201d Guy \u2014 Tips for Improving Your Daily Constitutional<\/a><\/li>\n<li><a href=\"https:\/\/amzn.to\/4sSaMsZ\" target=\"_blank\" rel=\"noopener\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/amzn.to\/4sSaMsZ&amp;source=gmail&amp;ust=1775061779379000&amp;usg=AOvVaw2b67lVTqRUzux3Np_nYMiB\">The Squatty Potty<\/a><\/li>\n<li><a href=\"https:\/\/en.wikipedia.org\/wiki\/Mariko_Aoki_phenomenon\" target=\"_blank\" rel=\"noopener\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/en.wikipedia.org\/wiki\/Mariko_Aoki_phenomenon&amp;source=gmail&amp;ust=1775061779379000&amp;usg=AOvVaw0MWY8FbRGM-GLtTzNGuhLt\">&#8220;Mariko Aoki phenomenon&#8221; \u2014 where individuals feel an urgent need to use the bathroom when entering a bookstore<\/a><\/li>\n<li><a href=\"https:\/\/www.artofmanliness.com\/health-fitness\/health\/you-need-to-eat-more-fiber\/\" target=\"_blank\" rel=\"noopener\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/www.artofmanliness.com\/health-fitness\/health\/you-need-to-eat-more-fiber\/&amp;source=gmail&amp;ust=1775061779379000&amp;usg=AOvVaw1cqbjF3D_JT___JLl4J70n\">AoM Article: You Need to Eat More Fiber<\/a><\/li>\n<\/ul>\n<h3><b>Connect With&nbsp;Trisha Pasricha<\/b><\/h3>\n<ul>\n<li><a href=\"https:\/\/www.trishapasricha.com\/\" target=\"_blank\" rel=\"noopener\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/www.trishapasricha.com\/&amp;source=gmail&amp;ust=1775061779380000&amp;usg=AOvVaw0mhokgrkln-COv5itRhJsz\">Trisha&#8217;s website<\/a><\/li>\n<li><a href=\"https:\/\/www.instagram.com\/trishapasrichamd\/?hl=en\" target=\"_blank\" rel=\"noopener\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/www.instagram.com\/trishapasrichamd\/?hl%3Den&amp;source=gmail&amp;ust=1775061779380000&amp;usg=AOvVaw27j-3E4Cn7sLasE62yrGdy\">Trisha on IG<\/a><\/li>\n<\/ul>\n<p><a href=\"https:\/\/amzn.to\/4vhnGCR\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-193187\" src=\"https:\/\/content.artofmanliness.com\/uploads\/2026\/03\/717fnrW6zQL._SL1500_.jpg\" alt=\"\" width=\"325\" height=\"491\" srcset=\"https:\/\/content.artofmanliness.com\/uploads\/2026\/03\/717fnrW6zQL._SL1500_.jpg 325w, https:\/\/content.artofmanliness.com\/uploads\/2026\/03\/717fnrW6zQL._SL1500_-320x483.jpg 320w\" sizes=\"auto, (max-width: 325px) 100vw, 325px\" \/><\/a><\/p>\n<h3>Listen to the Podcast! (And don\u2019t forget to leave us a review!)<\/h3>\n<p><a href=\"https:\/\/podcasts.apple.com\/us\/podcast\/the-art-of-manliness\/id332516054?mt=2\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-111440 size-full\" src=\"https:\/\/content.artofmanliness.com\/uploads\/2020\/02\/listen-apple-podcasts.jpg\" alt=\"Apple Podcast.\" width=\"300\" height=\"77\"\/><\/a><\/p>\n<p><a href=\"https:\/\/youtube.com\/playlist?list=PLLIasrSrFGdQRgdfSoUfBx2Bt8O4LcpVD&amp;si=vlWpk0HXq82aR1Hi\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-191972\" src=\"https:\/\/content.artofmanliness.com\/uploads\/2025\/12\/YouTube.png\" alt=\"\" width=\"300\" height=\"76\"\/><\/a><\/p>\n<p><a href=\"https:\/\/overcast.fm\/itunes332516054\/the-art-of-manliness\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-111443 size-full\" src=\"https:\/\/content.artofmanliness.com\/uploads\/2020\/02\/overcast-1.png\" alt=\"Overcast.\" width=\"300\" height=\"79\"\/><\/a><\/p>\n<p><a href=\"https:\/\/open.spotify.com\/show\/2vJHmWhhcMQRXtTruuFWTJ\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-111444 size-full\" src=\"https:\/\/content.artofmanliness.com\/uploads\/2020\/02\/spotify.png\" alt=\"Spotify.\" width=\"300\" height=\"109\"\/><\/a><\/p>\n<p><a href=\"https:\/\/castro.fm\/podcast\/3c765314-b44c-410d-91c5-a36600abcca3\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-191297\" src=\"https:\/\/content.artofmanliness.com\/uploads\/2020\/08\/podcastcastro_orig.png\" alt=\"Listen on Castro button.\" width=\"300\" height=\"100\"\/><\/a><\/p>\n<p><a href=\"https:\/\/art19.com\/shows\/the-art-of-manliness\/episodes\/8436cf16-39dc-4b80-b088-5cbda859a010\">Listen to the episode on a separate page<\/a><\/p>\n<p><a href=\"https:\/\/rss.art19.com\/episodes\/8436cf16-39dc-4b80-b088-5cbda859a010.mp3\">Download this episode<\/a><\/p>\n<p><a href=\"https:\/\/rss.art19.com\/the-art-of-manliness\">Subscribe to the podcast in the media player of your choice<\/a><\/p>\n<h3>Transcript&nbsp;<\/h3>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Brett McKay here and welcome to another edition of the AoM podcast. Pooping: everybody does it, but a lot of people are embarrassed to talk about it. That&#8217;s a shame, my guest says. Not only because your digestive health is incredibly linked to your overall health, but simply for the fact that there&#8217;s much happiness to be found in an easy, worry-free constitutional. Harvard gastroenterologist, Dr. Trisha Pasricha, the author of <i>You\u2019ve Been Pooping All Wrong: How to Make Your Bowel Movements a Joy<\/i>. Today on the show, Trisha and I have a fun and frank conversation about the art and science of bowel movements, including the color of healthy stools, how often you should be pooping, if laxatives are safe to use, the food to eat that&#8217;s even better than prunes for getting things going, why you feel the urge to go poop at Barnes and Noble, the wonders of the bidet, the danger of using your smartphone on the toilet, how to get more comfortable pooping in a public restroom, and more. After the show&#8217;s over, check out our show notes at aom.is\/poop. All right, Dr. Trisha Pasricha, welcome to the show.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Thank you so much for having me, Brett. Glad to be here.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>So you are a medical professor of gastroenterology. That&#8217;s a hard word to say. I had to look up how to pronounce it. You specialize in gut health and a big part of your work involves researching and talking a lot about poop. How\u2019d you end up doing what you do?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Well, I am a second generation gastroenterologist. I grew up as the daughter of a gastroenterologist. When you grow up like that, you think that talking about poop every day is perfectly normal and you think that that&#8217;s what everyone else is doing. It was delightful. My father was, and still is a gastroenterologist, but he was also a researcher. He was just so excited to tell me and my siblings about the cool stuff he was discovering in his lab every day after he came home from work and he was describing how colonoscopies worked and all of this. I know now that sounds really bizarre, but at the time it was just what we talked about at the dinner table and how cool science was and specifically when it came to our gut. So I loved it and it was kind of what I grew up thinking was the coolest thing in the world.<\/p>\n<p>So I knew I wanted to be a gastroenterologist since I was a little girl. I had never imagined wanting to be anything else. But then when I came to medical school and then I started doing my own training, I really started to realize what a weird gap there was between what other people seem to have learned about poop and their bowel movements and how their gut works and what I learned. And people, for the most part, it seems like, didn&#8217;t really talk about their guts and their poop after they turned three or four, and it was something everyone just stopped bringing up at the dinner table. And so I kind of went on this mission and it just started with me talking to my patients about trying to normalize these conversations and having them out loud. And ultimately that led to writing the book. But I really do think that people need to have conversations more loudly because 40% of Americans are suffering from bowel habits that disrupt their daily lives. But you wouldn&#8217;t know that because we&#8217;re so quiet about them.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Yeah, I mean, unlike you, we didn&#8217;t talk about poop at the dinner table. I don&#8217;t even remember having conversations about my bowel movements with my family. And that carries over, I think, for a lot of Americans to how they approach talking about it with their doctor. As you said, a lot of Americans have bowel problems and it can cause a lot of discomfort, a lot of inconvenience in their life, and a lot of it is preventable. Well, let&#8217;s talk about this. I think one of the reasons why people have a hard time talking about it is they don&#8217;t know how to talk about poop. So when they go to the doctor saying, I got this problem with my bowel movements, I mean, what should they call it? You&#8217;re always like, do I call it bowel movement? Do I get scientific and call it stool or feces, human soil, what do you call it?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah, liquidating your assets, whatever you want. I have found that I use the word poop usually unless somebody leads with another word that they find more comfortable. And the reason I do that is when I was in medical training, the kind of formal word that all doctors use is bowel movement. And so that&#8217;s what I was trained to start saying, and I certainly started saying that. And I had one professor who was a gastroenterologist and he was my research mentor in medical school, and I shadowed him. And he was the first guy I had ever seen, this doctor, this middle-aged gentleman. And this young patient came in and he was like, so tell me what your poop looks like. And I looked at this guy and I was like, this is so weird. You&#8217;re this doctor, this white coat. That&#8217;s the weirdest, I&#8217;ve never seen a doctor say that like that in a clinic before.<\/p>\n<p>But when he said it, this young patient in his twenties suddenly smiled for the very first time and just the whole atmosphere in the room changed. And this guy just totally shared exactly what was going on with him. And you could just tell it broke the ice, it made it comfortable. And after that, I never looked back because I know oftentimes when I tell people, oh, tell me about your bowel movements, everyone stiffens up a little bit. And they too try to match my level of medicalization. And if you could just tell me what&#8217;s bothering you, I want to use whatever words make you comfortable. So I think someone should lead with the words they want to use that allows you to talk about it most freely. And my hope is that your doctor&#8217;s going to meet you right there.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Okay, that&#8217;s great. It&#8217;s funny, bowel movement. So my name&#8217;s Brett McKay. This is sort of a tangent. So when we had the initial things, it started when I was in middle school, I got really self-conscious about it, those initials BM. Oh my gosh. And I had some kid be like, oh, BM poop. And so now, ever since then I do BHM. That&#8217;s my middle initial.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Oh my gosh. Now you should embrace it. I&#8217;ve embraced TP as a gastroenterologist.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Alright, so if you can do that, I can go back to BM. I&#8217;m going to embrace the BM.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>A hundred percent.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>So you describe this idea of euphoria in your book. What is euphoria?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah, euphoria. It is a state that I want everyone to reach. And that is where having a bowel movement is the absolute least of your daily concerns. It&#8217;s this easy, effortless thing that happens quickly without straining, and then you go about the rest of your day and live your best life. You&#8217;re not worried about feeling heavy for the rest of the morning or day because you didn&#8217;t have that window to go, or you&#8217;re worried, should I go out to brunch with my friends or should I even meet people for dinner because I&#8217;m so worried about the bathroom situation? I don&#8217;t want you to live like that. And tragically, I think a lot of people are right now. So euphoria is a state of mind and it&#8217;s a lifestyle that I think we can all reach \u2014 some of us with just a little bit more knowledge about our bowel habits that we just never got. Because the last time we talked about our bowel habits with another soul was usually when we were potty training with our mom and dad. And that was a long time ago. Most of us cannot remember that conversation.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>So a healthy bowel movement, you&#8217;re not even thinking about it, just not even on, you don&#8217;t have to worry about it at all.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah, you&#8217;re not obsessed about, I mean, there&#8217;s another end of the spectrum where people, I mean, and this can be quite understandable, but people fixate on their bowel movements all the time. They&#8217;re worried about, did I go yet today? If I don&#8217;t go, I feel off. And even if there&#8217;s someone who you might look from the outside and say, okay, they&#8217;re going once a day, they&#8217;re regular. But if you&#8217;re thinking about it all the time, you&#8217;re becoming paranoid. If you haven&#8217;t gone, that&#8217;s not euphoria either.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Well, let&#8217;s talk about what healthy poop looks like and hopefully we can answer some questions that people have always wondered about it. Let&#8217;s start with the color of poop. First off, why is poop usually brown?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah, the natural color is actually not brown. The natural color of our poop is like this whitish clay colored. And what gives it its beautiful brown color is bile. So our body produces this digestive juice and it has bilirubin in it, and that&#8217;s just this chemical that gives it that brown color. But if we were to take that away, it would actually look bizarrely whitish. And that is why if you ever see a pale, whitish creamy stool, that&#8217;s a problem. That&#8217;s an emergency. It means that that bile is somehow being blocked somewhere. Maybe it&#8217;s a gallstone, it could even be a cancer. But if you ever see that, that&#8217;s a big red flag. Go to the emergency room. But then other than that, the normal color should be some shade of brown. And then of course, everybody poops the rainbow from time to time.<\/p>\n<p>I get these kinds of DMs every week where someone&#8217;s like, I had a really weird purple poop, or my poop was kind of greenish. Is that normal? And it can be normal. A lot of times we eat things that we don&#8217;t put together could impact our poop. For example, a classic one is beets. If you&#8217;ve ever eaten beets, you are probably going to have a maroon poop the next day or maybe the next day or two. And that&#8217;s just the beets. That&#8217;s okay. But if you haven&#8217;t eaten those beets and you see anything that looks like red, that would be really worrisome for bleeding. So bright red, maroon, or even pitch black and shiny, that could all be blood.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Gotcha. So yeah, black poo, that could be okay. Sometimes it suggests there&#8217;s some sort of internal bleeding going on up your tract, but sometimes there&#8217;s, I think iron supplementation can cause black poo.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>You can have this real chicken and egg situation because sometimes people are taking iron because they&#8217;re having some bleeding and they&#8217;ve lost blood. But then you see black poop and you&#8217;re like, is this because you&#8217;re taking iron to treat bleeding? Or is it because you are bleeding?<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Yeah. And then I guess Pepto Bismol can also cause black poop.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah. I feel like we always forget to warn people about it can turn your tongue black, it can make your poop black, and then people are really horrified the next day. But that if you&#8217;ve taken Pepto Bismol, you&#8217;re allowed to have a few black poops.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>And another interesting fact about Pepto-Bismol that you put in the book is that if you don&#8217;t want your farts distinct before a date or something, take Pepto Bismol before and that will make your farts less stinky.&nbsp;<\/p>\n<p>Okay. So poop&#8217;s naturally clay color until it meets with bile. But this is one of those things that can freak me out because I mean, you hear if you have a clay colored stool, that can mean you have pancreatic cancer or a bile duct blockage. And I can be looking at a light poop thinking, is that clay color? I think there are different colors of clay, and I think, well clay&#8217;s maybe a light tan. So maybe my poop is looking like clay, but we&#8217;re talking about white clay. It has to be basically white.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah, I guess you&#8217;re right. There&#8217;s differences, there&#8217;s earthy tones of clay. This I&#8217;m talking about more like a whitish creamy color or kind of gray. And I would say when in doubt, I mean everyone&#8217;s poop is going to look a little different. If you have any doubts, I always tell my patients, picture or it didn&#8217;t happen. Take a picture of it and then send it through your electronic medical record and show your doctor and just have them lay eyes on it. A doctor will be able to tell you really quickly, am I worried or excited about this or not?<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Gotcha. And then red, if you haven&#8217;t eaten beets, if you see red, that&#8217;s another thing you want to go see your doctor about because it could be colon cancer, but it could be something as benign as a hemorrhoid or an anal fissure or something like that.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Totally. Yeah. And most of the time it is going to be something not worrisome, it&#8217;s going to be a hemorrhoid. But what I never want someone to do, especially in this stage in 2026 where we are seeing this really disturbing rise in early onset colorectal cancer, is for someone to see bleeding and brush it aside. I mean, this is the trend we&#8217;re seeing in studies and with this rising cases that young people, when they see blood, they&#8217;re like, this is just my hemorrhoid, or I&#8217;m pretty sure this is no big deal. It&#8217;s always better to just quickly let your doctor know and let your doctor reassure you and be like, oh yeah, we&#8217;ll just do a quick exam. We&#8217;ll make sure it&#8217;s your hemorrhoid. No problem. But make sure that someone&#8217;s taken a look and giving you that reassurance rather than just brush it off yourself.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Let&#8217;s talk about the shape and consistency. What does a healthy poop consistency and shape look like?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah, I think most people think that a perfect shape would be this nice smooth sausage shaped, and then you go and people really aim to get is wipe less, and that is wonderful. That is a nice consistency that a lot of people have. But there&#8217;s really such a range of what could be normal. And I would tell people that for the most part, if you start eating a lot more fiber, which a lot of us are not doing, like 95% of Americans are not meeting our fiber goals, if you start to do that, it actually becomes less and less likely that you&#8217;re going to have that smooth little sausage that everyone wants. You&#8217;re going to start to have fluffier and fluffier stool. You might even start to go more often. That&#8217;s perfectly normal. It can be totally normal. And people sometimes when they do that, they&#8217;re like, I have diarrhea.<\/p>\n<p>I&#8217;m going three times a day. And it&#8217;s so soft. That&#8217;s fine, as long as it&#8217;s not interfering with your social life. There&#8217;s a range of normal. And in fact, you should embrace that new you because it means you&#8217;re doing something healthy for yourself. And then on the flip side, sometimes when people are having these really, really tiny rabbit pellets, usually I say that that indicates that there&#8217;s an issue with constipation, but sometimes the fix can also be quite simple. It can be you need to hydrate more or you need to not hold it in. We do that as adults. We have this urge to go. Sometimes it&#8217;s like when we&#8217;re at work or we&#8217;re on a date at a restaurant and we say, no, no, no, I&#8217;m not going to go right now. I feel the urge I&#8217;m not going to go. And when you do that, you&#8217;re setting yourself up for failure because that stool is just going to dry up and become more hard so that when you decide you want to go later, it&#8217;s not the same one that you started with 12 hours ago. It&#8217;s a totally different one. It&#8217;s going to be more pebbly. So it&#8217;s better to try to go when your body tells you to, and you&#8217;re going to get a little bit closer to that median.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Gotcha. So what happens to our stool whenever we get diarrheas? Why does the body decide this stuff needs to be liquid and get out fast? What&#8217;s happening there?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah, there&#8217;s lots of different causes, but in terms of your anatomy, your small bowel, which is that first part of the tube after your stomach, the main point of your small bowel is to absorb all the nutrients and it&#8217;s sucking out everything that it wants and breaking it down. And then the stuff that it can&#8217;t break down, which is usually like the fiber, which we actually don&#8217;t possess the enzymes to break down. It makes its way to our microbiome in our colon. Well, the colon has several jobs. One of them is to suck water out of the stool as it passes through. And stool passes a little bit more slowly through the colon. So your colon has a lot of time to get that water up. But if something happens that triggers that poop to move forward, and sometimes it&#8217;s stress. Stress can cause our colon to suddenly start to contract.<\/p>\n<p>That means we haven&#8217;t had time to remove and absorb all the water out of it yet. So it&#8217;s going to gush out like diarrhea when we&#8217;re stressed, spicy food, does that spicy food sense this signal down to say, okay, evacuate everything we have. That too will make whatever comes out to be a little bit fiery, a little uncomfortable, and it&#8217;ll also be pretty liquidy. And then there&#8217;s other things like infections or just depending on how things are going with other aspects of your life&#8217;s travel and exercise, those things can also help speed things up. But before you&#8217;ve really had a chance to absorb all the water.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Gotcha. And constipation is just the reverse. It&#8217;s been in the colon too long, so all that water has been sucked out.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah, exactly. And there&#8217;s a ton of different reasons why we think slow down and why we can get constipated. And you&#8217;re right, the longer we sit there, the longer that stool is just your colon is going to keep doing its job and it&#8217;s going to keep making it harder and harder, which is why I sometimes think the most important thing people can do who are constipated is just as soon as they hear that call, feel that urge respond because it&#8217;s not going to be the same poop later on.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>What causes constipation? You said there&#8217;s lots of potential sources?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah. Well, when someone comes into my clinic and they have constipation, I try to explain the way the colon works in terms of trying to get toothpaste out of a toothpaste tube. So sometimes the issue is that we&#8217;re not squeezing that toothpaste tube, and that means that maybe there&#8217;s something that&#8217;s stopping the colon from contracting so much. We need to do that. We need to generate pressure in order to push the stool outwards. And maybe the problem is actually not that we&#8217;re not squeezing the tube, but that the toothpaste itself is rock solid. And sometimes that happens because maybe we&#8217;re not getting enough fiber, maybe we&#8217;re not drinking enough. Maybe there&#8217;s something else that&#8217;s making that stool really, really hard. But then the third, and I think most underappreciated part of the problem is that, yeah, we&#8217;re squeezing hard enough. The toothpaste is super soft, but we forget to take the cap off the toothpaste tube and then we&#8217;re just pressing up against this pelvic floor that is not cooperating.<\/p>\n<p>And that is very common. That happens to about one in three people who have constipation and who have tried different laxatives and different things than they&#8217;ve failed. And basically what that means is that our pelvic floor, which is this set of more than a dozen muscles sitting there at the bottom of our rectums, and they need to coordinate in this really highly orchestrated dance, some need to contract at the right time, some need to relax. And for a lot of people, the sphincters that are supposed to be relaxing actually contract. When we bear down, if you think about it, we&#8217;re generating all this pressure to try to push our poop out and people&#8217;s sphincters contract, and that&#8217;s very paradoxical. It&#8217;s not supposed to do that. So sometimes when you&#8217;ve tried everything, the most obvious answer is actually something that doesn&#8217;t involve anything related to your colon, but actually it&#8217;s all the muscles in your pelvis that\u2019s the problem.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>You just went through what you call the three Ps of a good poop. So propulsion, that&#8217;s that bearing down that vasalva maneuver, we kind of and get that thing going. Then the consistency, it&#8217;s the pliability, the softness, if it&#8217;s hard, it&#8217;s not going to come out. And that pelvic floor aspect, sort of the cap on the toothpaste.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>And I think for someone to reach euphoria and to have healthy effortless balance every day, you have to think about how you&#8217;re optimizing all three of those things. All three of those things need to be working at their best in order to have a bound move. If even just one of them is off, it&#8217;s going to be hard to overcome it with just the other two.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>With the pelvic floor piece, I think we think about that with just women because pelvic floor problems can result after childbirth, but men can have pelvic floor problems too. And you recommend that if you have a pelvic floor issue to go to a physical therapist who specializes in that. We&#8217;ll talk about something else you can do, tell your pelvic floor when you&#8217;re pooping later on in our conversation, going to the pliability part of the three Ps of a good poop, this is the consistency of the poop. Why does poop float sometimes?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah, a couple of different reasons. Sometimes if it&#8217;s just soft enough because it has enough soluble material, like enough fiber, it&#8217;ll float. Sometimes fat floats in poop. So it depends on what you&#8217;ve eaten and how well you&#8217;ve absorbed it. There are certain conditions where people do not absorb nutrients and the food that they eat as well as we&#8217;d like them to. And traditionally we think about those as resulting in really serious floaters. So there&#8217;s a range that could be normal, but if this is your consistent pattern and you have any other symptoms, like you get pain, bloating when you eat, if you have a lot of floaters in your stool, you should actually just run that by somebody and make sure that you don&#8217;t have an issue with absorption.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Gotcha. I mean, so this is always a concern for me. I read these articles like, oh, pancreatic cancer, colon cancer. And it&#8217;s like, oh, floating poop. And I&#8217;m like, okay, I&#8217;m going to be TMI here, but mine, regular floaters, but they look normal. They feel normal. I think I just eat a lot of fiber. I eat like 60 grams of fiber a day.&nbsp;<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Good for you<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>So I think that&#8217;s what it is. Am I right? Should I go see my doctor?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Well, you should always run anything by your doctor you&#8217;re concerned about. But what you&#8217;ve described sounds very, very typical for somebody who&#8217;s just eating a lot of fiber. Once we start eating a lot of fiber and 60 grams is like an A-plus amount of fiber, then people&#8217;s poop does change and people are really caught off guard by it. The reason people say that floating poop is a sign of pancreatic cancer is because the pancreas helps break down and helps you absorb that food. And when suddenly that stops working so well, then you might see new floating poop for the first time. But that&#8217;s not the only sign. Often, sometimes people, their skin turns a little yellow, they have pain in their stomach. So if you&#8217;re otherwise living your best life, run it by your doctor. But it&#8217;s most likely just because you&#8217;re eating a ton of fiber, which is a great thing.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Yeah, I&#8217;m a fiber machine as the kids are saying these days.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah, yeah, me too.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Let&#8217;s talk about the schedule. What does a healthy bowel movement schedule look like? I think there&#8217;s this idea that you have to have a daily constitutional to be healthy. Is there anything to that idea?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>There definitely is something to that idea. And I think that this is because our bodies are naturally primed to have a bowel movement first thing in the morning. And the reason for that is one of the things that makes the colon a little bit different and special compared to other organs in our bodies is it really operates on a circadian rhythm and it&#8217;s a creature of habit. So when we go to sleep, the colon goes into this really quiet state. It doesn&#8217;t move around too much. That&#8217;s why for the most part, people sometimes talk about waking up in the middle of the night to go pee. It&#8217;s pretty rare for people to wake up in the middle of the night to have to poop, and that&#8217;s because your colon&#8217;s not really moving. But when it wakes up, when you wake up and it operates on the same circadian clock as you, then that first one to two hours upon waking is when you see some of the strongest contractions naturally occurring in your colon that you&#8217;re ever going to get the rest of the day for that 24 hour period.<\/p>\n<p>It&#8217;s during those first one to two hours that your colon is doing the work for you. And if you have a bowel movement when your colon is already contracting, it means you have to do way less work. You have to bear down less. You don&#8217;t have to strain as much. So it&#8217;s a nice window. And then people often in the morning start to stack on other habits that help the colon contract too. Like for example, a third of people who drink coffee, their colon is going to start to contract pretty quickly. People who go for walks in the morning, just a little exercise, can help stimulate those contractions. And we do a lot of those things early in the morning, so it&#8217;s a great time to have a bowel movement. All of that said, there&#8217;s a large portion of people whose mornings are totally hectic, totally crazy.<\/p>\n<p>They don&#8217;t have time for any of this, and they don&#8217;t go. That doesn&#8217;t mean that you have a problem or that you&#8217;re weird. It just means that you need to find a time to respond when your colon&#8217;s ready. And some other times during the day, the colon will start contracting if you eat a meal. So oftentimes there&#8217;s another wave of people who poop after dinner or poop after lunch. That&#8217;s totally normal. A lot of times people come to my clinic and they&#8217;re like, it&#8217;s so weird that I have to poop every time I eat. And I say, no, no, that&#8217;s a completely normal reflex. In fact, it&#8217;s like a reflux that we&#8217;re born with. Kids are pooping multiple times a day in response to eating, and then later on as adults, we try to suppress that and try not to respond to that reflex for no reason whatsoever.<\/p>\n<p>We should just respond. But it&#8217;s actually a perfectly normal part of our human physiology. So there&#8217;s a range of what I&#8217;d consider normal. And what I usually tell people is, no, it&#8217;s not once a day. If you go once a day, wonderful, but you don&#8217;t have to do that in order to be closer to God. What I do want you to do is have an effortless bowel movement whenever you go. It should be easy if you go once a day, but you&#8217;re straining your eyeballs out for 20 minutes. I wouldn&#8217;t consider that normal. So they&#8217;ve done a study in the US where they found that people who consider themselves to have normal bowel movements go anywhere from once every three days to up to three times a day. And anywhere in that big range could be considered normal, as long as it&#8217;s effortless and you&#8217;re comfortable and happy with that pattern.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>I imagine if you see a change in your schedule that lasts a long time, you&#8217;re like, well, maybe I should look at this. So if I usually do once a day and then I&#8217;m going three times a day, well, that&#8217;s interesting. I should probably check that out.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yes, I tell people to get to know your own schedule and everyone&#8217;s going to be different and have some variation in their own life. You might be somebody who goes like clockwork every day, and that&#8217;s perfectly wonderful and healthy. But you may also see that you have some variations depending on whatever else you have during your week and how you travel and how you exercise. These things will change, but get to know what kinds of patterns are normal for you. And then most importantly, you should start looking every day before you flush, have a peek. The number of times I ask people, what did it look like? What color is your poop normally? And people just get all embarrassed and say, oh, I don&#8217;t know. I don&#8217;t really look well, I mean, first of all, how can you not look? I dunno how you resist that temptation, but you should look so that you then when something is different.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Yeah. Speaking of looking, have you kept up with these new AI devices you can attach to your toilet that takes a picture of your poop.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>I&#8217;ve seen some of that chatter, I&#8217;m excited about it. I mean, one, well, I think we&#8217;re all like, oh my gosh, a little horrified about the idea of a camera down there. But I&#8217;m sure they&#8217;ve sorted out the privacy issue. But I think, well, yeah, I am excited about what those could show us one day.&nbsp;<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Speaking of schedules, and let&#8217;s say someone they like, I don&#8217;t poop as often as I want. It makes me uncomfortable. I need to take a laxative. But they&#8217;re like, well, I don&#8217;t want to take a laxative because I don&#8217;t want to become dependent on it or something. Is there a problem with taking laxatives to have a bowel movement?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>So I have a few thoughts about this. One is that just to take a big step back, I don&#8217;t think there&#8217;s any problem with someone taking a laxative, especially because I know that for some people we can help and improve constipation with a lot of these different tweaks and lifestyle changes and a lot of the sort of things I lay out in my book, but there&#8217;s also a group of people who have conditions and diseases and changes in the neurons, the nerve cells of their colon, that some of these lifestyle changes are just not going to fix. Constipation can be a disease like any other disease, like high blood pressure, like diabetes, and there&#8217;s no shame in taking a medicine to treat that. And so I do feel that there&#8217;s often a lot of shame and a sense of self failure for when you take a laxative and if that&#8217;s what you need to be.<\/p>\n<p>Well, I don&#8217;t think that that&#8217;s the case. Now, that said, there are a lot of ways to treat it that don&#8217;t require laxatives, but know that laxatives are safe. You should use them as directed by your doctor. And a lot of the earlier studies that kind of got people worried that you could become dependent on laxatives, you were somehow damaging your colon. Ultimately, that data was not very consistent or proved to be robustly true. So I worry a little bit less about that. But I will say there are a lot of ways that you can improve your bowel habits and become less constipated just by changing things about what you&#8217;re eating and what you&#8217;re doing, and even the position of how you&#8217;re sitting on the toilet. I mean, it&#8217;s very common that people don&#8217;t want to take medicines, but you can take things as natural as like kiwis, right?<\/p>\n<p>In our grandparents&#8217; times, people were taking prunes and prunes are incredibly effective. But I have never successfully convinced a college student to take prunes. It&#8217;s one of those things that people just don&#8217;t reach for anymore these days. But kiwis have been shown in multiple randomized control trials, two kiwis a day that they are as effective as prunes, but they also don&#8217;t cause bloating. A lot of these fiber supplements and prunes can cause, kiwis don&#8217;t seem to do that. So it&#8217;s a pretty simple fix that&#8217;s relatively effective all things considered. And it&#8217;s not really a laxative, it&#8217;s actually just something that&#8217;s high fiber, got a lot of nutrients, and is good for you in other ways.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>I like prunes. I&#8217;m a prune booster.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>You&#8217;re pro prune.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>I&#8217;m pro prune. I mean, it&#8217;s a dried plum. What&#8217;s not to like.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>I think they&#8217;re fantastic. And I&#8217;m sure you&#8217;ve noticed they&#8217;re very good at their job.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Oh yeah, for sure. Yeah. You mentioned something that I thought was interesting. I want to talk about, say if you&#8217;re having problems getting your poop out, you&#8217;re constipated or it&#8217;s a struggle, the position. So I think you might&#8217;ve seen these things on Instagram, the Squatty Potty. Is there anything to that, does that actually help?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah, so this is an interesting thing that we&#8217;ve done to ourselves as a mankind. We thousands and thousand of years ago, I mean they have found these upright chair like potties back in the Roman Empire, but well before that, we were just squatting. All of us squat in our most comfortable, natural way to poop. And we&#8217;ve trained ourselves out of that. But I have a 2-year-old and a 4-year-old, and if you ever go to a daycare and you see a bunch of kids in diapers, waddling around, they all pop the deepest squat when they are pooping, they don&#8217;t go sit in a chair and poop in their diaper. They squat. And that&#8217;s because that&#8217;s the easiest, most natural way to have a bowel movement. And here&#8217;s why we talked about the pelvic floor, and there&#8217;s so many muscles that make up the pelvic floor. One of the muscles there is called the puborectalis muscle.<\/p>\n<p>And if you think about your colon, like a long tube, this puborectalis muscle is like this sling that goes across the tube and chokes it closed. It&#8217;s almost like your body stepping on its own hose. And it&#8217;s like that when we&#8217;re just sitting around in our chairs at a desk at work, for example. And that&#8217;s kind of a good thing. It&#8217;s nice to have that little extra closure of that door so that there&#8217;s nothing leaking out. There&#8217;s no pressure, but you don&#8217;t want that door to be closed. You don&#8217;t want there to be a kink in that hose when you&#8217;re trying to poop. And that&#8217;s how we poop though when we sit at this 90 degree angle. Well, it turns out that if we try to recreate a little bit more of those dynamics of squatting, and we don&#8217;t have to actually squat, because I recognize obviously nobody wants to do that, but if you just raise your knees above the level of your waist, everybody will poop more easily. They&#8217;ve done these studies that show that, yeah, people who identify as having who&#8217;ve been diagnosed with pelvic floor dysfunction identify as constipated. They poop better when they do that. But even healthy people who think that they poop just fine. Studies have shown that when you raise your knees up, even if you think you&#8217;re already doing really well, you would be amazed at how much better you do.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>That&#8217;s awesome. So bring your feet up with the stool. I&#8217;m a fan of the Squatty Potty. Speaking of the scheduling, there&#8217;s this famous bit in <i>30 Rock<\/i>, the television show where Liz Lemon talks about every time she walks into a Barnes and Noble, she has to poop. And I&#8217;m like, that happens to me. I don&#8217;t know how many times, I mean, I&#8217;ve pooped in Barnes and Noble several times. As soon as I walked through those doors, I&#8217;m like, I got to poop.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yes.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>What&#8217;s going on there? Why do you have to poop when you go to Barnes and Noble?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah, you are not alone. That is such a thing. And it&#8217;s funny, it&#8217;s Barnes and Nobles. For some people it&#8217;s like the Target. I think the Target is a big one for a lot of people. And it&#8217;s been described, I think it was back in the 1980s, it was described in the Japanese literature. What is it about bookstores that make people poop? And there are a lot of theories about this, and I&#8217;ll give you mine. I mentioned earlier that your colon is this creature of habit. And the interesting thing about your colon is that it can be trained to respond and react to external cues, cues in your environment that will start contractions and start things to change. And if you go way back in time to remember Ivan Pavlov, the scientists we all learned about in middle school, who used to ring a bell and then the dogs would come and start salivating because when he rang the bell, he brought food in.<\/p>\n<p>But eventually he would start ringing the bell and not bring food in. There would be no, they wouldn&#8217;t see that there was food, but they&#8217;d start salivating anyway. And that idea tells us that just something about our environment that we&#8217;ve associated once with a good poop or a good moment in our digestive history can start to trigger those same cues and those same movements again when we start to build that into a pattern. So I think what happens is, one, in order to poop, you have to feel relaxed. That is a fundamental truth about pooping because your sphincter has to relax at that final part. And I think bookstores put people in that relaxed place, and a lot of people actually find that they have to read in order to have a bowel movement. We can talk a little bit more about that, but just a quick light read, it&#8217;s just distracting enough.<\/p>\n<p>It gets things moving and it helps them feel good about it. And I think for some people, I&#8217;ve heard this, it&#8217;s the smell of the pages. Something about it triggers disassociation. And maybe you go poop once in a Barnes and Noble. Now the second time you walk in, now you smell the same pages, you feel relaxed and happy. It was a pleasant experience last time. So you go again, and now you&#8217;ve ingrained this pattern and it keeps happening. And now you&#8217;ve got this whole sensory experience every time you walk into a bookstore that it&#8217;s like a safe space and it&#8217;s pleasant, and you go. And I think that&#8217;s how we build habits. And I also think that&#8217;s what happens in the target. You go in there, you pick up your coffee, you&#8217;re by yourself, you&#8217;re having a nice walk around, and it feels safe, and it feels lovely. And then you have a nice bowel movement. That&#8217;s my theory.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Okay. Yeah. Yeah. I think there might be something to that. And if you&#8217;re going to read in Barnes and Noble, leave the books on the shelf.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah, don&#8217;t bring the merchandise in.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Yeah, no merchandise. They have a sign that says, don&#8217;t do that.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>They know.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Right. Well, let&#8217;s talk about reading on the toilet. A lot of people do this. When I was growing up, you didn&#8217;t have smartphones. And so I would read the back of my deodorant. I read about tampons, my sister&#8217;s tampons were there and be like, what&#8217;s going on? Because it&#8217;s the only thing there.&nbsp;<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>You learned so much.&nbsp;<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>I learned so much while I was on the toilet. But a lot of people these days, they take their smartphones in there and they&#8217;re on there for a long time. Why is that a problem?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah, yeah. I was like, I would learn all 30 weird ingredients on the back of the air freshener. I would read the far side comics. People used to have these little discreet bathroom readers that were just the kind of reading material that could not actually suck you in toilet books. It would be toilet books, and it would be a quick read just to distract your mind for a few minutes. It would be like last week, sports section of the newspaper, whatever it was, you do it, you&#8217;d relax, you get the jet and you&#8217;d move on. Today, you never see those little bathroom bookshelves anymore. Nobody has that because we&#8217;re all bringing our smartphones in. And the problem is that just like we&#8217;ve learned in other spheres, like when we&#8217;re trying to go to sleep or when we&#8217;re trying to have some social connection at the dinner table, the smartphones distract us and really hijack our brains to keep us fully engaged with whatever app we&#8217;re on.<\/p>\n<p>The same thing happens in the bathroom. And so we did this study in my laboratory two years ago where we asked people who were coming in for their screening colonoscopy, all about their bowel habits and whether they used their smartphone on the toilet. And then we looked to see when we did their colonoscopies, whether they had hemorrhoids or not. And it turns out that one, yes, all of us are bringing our smartphones in two thirds of the people who we interviewed were bringing their smartphones into the bathroom. But the ones who did, they were 46% more likely to have hemorrhoids, so yikes. And then two, they were five times as likely to be spending more than five minutes at a time in the bathroom just bringing your smartphone in. And that was after controlling and taking to account how constipated they were or how much they strained those things were actually, there were no differences between the smartphone users and not.<\/p>\n<p>So really what we think is the problem is the time, the amount of time you spend there sitting on this open bowl with no pelvic floor support, hemorrhoids are just these cushions of veins. And those veins eventually start to passively fill with blood. And when they become engorged, they pop out. That&#8217;s when we call them hemorrhoids, and that&#8217;s when we say they&#8217;re uncomfortable and painful. But if you sit there like that, it&#8217;s not going to happen after just doing it for one time. But if that&#8217;s your pattern, you do that every day for weeks to years, eventually we think that connective tissue around them weakens and you get a problem. So that&#8217;s why we tell people, one, bring back the old fashioned bathroom reader. Throw in that weird old comic book that you actually can only read one page of before you have to move on, or just set a two TikTok limit. But sometimes I go into these public bathrooms at work and I&#8217;ll hear somebody watching an episode of the Pitt, that happened to me last week, and I was like, first of all, I know what episode you&#8217;re on, and this is not the place. Just pull your pants up and go watch it at your desk. You don&#8217;t have to do this in the current compromised position that you&#8217;re in.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Alright, so you limit your time on the toilet unless you want hemorrhoids and hemorrhoids aren&#8217;t fine.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Exactly. No, indeed.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Speaking of going to the bathroom in public, a lot of people have problems with that. And some people we talked about earlier, they feel relaxed enough to poop at Target, but some people don&#8217;t feel comfortable pooping in a public bathroom. But as you said earlier, if you fill in that urge, you should probably go if you don&#8217;t want to get constipated. So how do you get over that? I don&#8217;t know, reluctance to go to the bathroom in public?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah, it&#8217;s a lot of strategizing, but I do feel really strongly about this that you should go when your body tells you it&#8217;s time to go, because you&#8217;re going to make it harder on yourself and you&#8217;re going to strain harder later if you don&#8217;t respond. And so one, I think, and this is something that medical doctors are just surprisingly very good at, you should identify well in advance, do a reconnaissance mission. What are the safest bathrooms in your building? What is the safest bathroom? If it&#8217;s not in your building, in the cafe next door or at the Barnes and Nobles nearby, if you&#8217;re out in public, find what the safe quiet bathroom is well in advance. And then don&#8217;t share that secret with anyone. Keep it to yourself. But if you&#8217;re in a situation where you are just caught with whatever bathroom is on hand, and there&#8217;s lots of people there, I actually sometimes tell people, put some headphones in and just tune out.<\/p>\n<p>Do a noise canceling thing, or play some nice music so that you&#8217;re not distracted and worried and thinking about what everyone else is doing. And you&#8217;re so worried that everyone&#8217;s thinking about you and they&#8217;re listening for any sound you might be making. And once you just tune them out and put the headphones in, it can really help you just focus on the moment at hand because your goal is to just get in and out too. And this actually goes two ways. If you&#8217;re somebody who&#8217;s sitting in a stall and since somebody else comes in next to you and has to go and you&#8217;re just sitting there on TikTok, you have to be a good citizen and pull your pants up and get out of there. Don&#8217;t keep scrolling because you have to do unto others as you&#8217;d like to be treated yourself. And I guess the other thing I tell people to do is you can make a little bit of white noise if you need to, if you really feel like you have to. You can shake the toilet paper holder, you can play some alarm ringtone on your cell phone and something to distract yourself and distract everybody else. If you really feel like you want to.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Actually, I don&#8217;t mind going to the bathroom in public. And when other people are taking care of business, I&#8217;m like, okay, you&#8217;re taking care of business. That&#8217;s what you&#8217;re supposed to do here.&nbsp;<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah, good for you.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>You&#8217;re in the right spot. Besides pooping in public, one thing that can throw off your bowel movement schedule is traveling. I&#8217;ve got an issue with this. Whenever I travel, my intestines are just like, we&#8217;ve closed up shop.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yes.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>What&#8217;s going on there?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah. This is very, very common when we travel, a lot of different factors conspire against our colon at the same time. So first off, your colon operates on a circadian rhythm. And let&#8217;s suppose you&#8217;re going to Europe for spring break, and suddenly your colon is waking up at 2:00 AM and it&#8217;s not actually time to go and it&#8217;s all thrown off. Or you start to sleep in late. You don&#8217;t wake up on time, you sleep in. Maybe you would usually drink coffee in the morning and take the dog for a walk. Now you&#8217;re not doing that. Now you&#8217;re lounging in bed and just transferring your body from bed to beach, and you&#8217;re not doing all those things that usually prime your body successfully for a bowel movement. And then second, I mean a lot of us, this is myself included, the best part of travel is the food.<\/p>\n<p>Half the time we go, we want to try local cuisine, but when you go to Europe, and this is what I see with a lot of college students who are my patients, you should go eat the local food for sure. But you can&#8217;t eat six bowls of pasta in a row without any form of impunity. And I really think that people need to aggressively seek out fiber when they&#8217;re on vacation, more so than they would at home. If you eat a ton of fiber at home and then suddenly you eat half of that or less than half of that, your colon&#8217;s going to respond and react and it&#8217;s not going to be happy. And then lastly, I think people do get dehydrated on vacation. People are drinking more often like alcoholic beverages. They&#8217;re out walking around being tourists. They&#8217;re just not drinking as much water and all of these things together. And let&#8217;s not even forget about the fact that we&#8217;re stressed because we&#8217;re traveling with our families half the time, or maybe we have to share a bathroom with our cousins. All of these things come together at once, and it makes it really hard to stay regular.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Okay. So I think we&#8217;ve covered a lot here about poop. Let&#8217;s say we&#8217;ve taken care of business. There&#8217;s the wiping part, but you make the case for the bidet.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Oh yeah.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Why do you think everyone should get a bidet?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>I love a bidet. And you&#8217;ll never meet somebody who has a bidet who feels like just medium about it.<\/p>\n<p>Yeah. We got a bidet a couple years ago, and I&#8217;m like, everyone should have this. What have we been doing in the United States that we haven&#8217;t had this?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Exactly. You feel like you&#8217;re born again. It&#8217;s like you want to make sure everybody knows about this. You make people feel bad if they haven&#8217;t seen the light. That&#8217;s what a bidet does to you. It&#8217;s obnoxious. But bidets are so wonderful. And the weird thing is, and I talk about this all the time, and normally the pushback I get from Americans who haven&#8217;t tried them before is, this is one, this is really weird. Why would I want anything touching me back there? And first of all, obviously bidet are for external use only, but it&#8217;s not any weirder. If you take a step back, wiping is the weirdest thing we can do. Right. I mentioned I had a 2-year-old, if I&#8217;m changing his diaper when he was a baby and I got a little poop on my hand, this happens. The last thing I would do is just wipe that poop off my hand with a paper towel and then just go about my day as normal.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Yeah. The analogy I&#8217;ve heard is if you&#8217;ve out in the garden working, you got mud on your arm, you wouldn&#8217;t get a paper towel and just rub the mud because it wouldn&#8217;t come off. You would put it underneath the sink.&nbsp;<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah. You got to get some water on that. And yet, for some reason, this absolute most delicate part of our body, I think this part is underappreciated. That area is that skin is actually quite delicate. I think. We think it must be so sturdy standing up against yucky poop, but actually it&#8217;s really soft and delicate and it can tear quite easily. A bidet is gentle, clean, hygienic. And I found a lot of people who don&#8217;t even realize they&#8217;re the kind that would benefit from it. I tell people who I treat, a lot of patients who have Parkinson&#8217;s disease or trouble moving, they love bidets because they don&#8217;t have to worry about balancing and reaching back there. Bidet just takes care of that. But actually everyone would benefit from it. Think about women who are on their periods. A bidet is so delightful because you have a lot going on at once. Half the time when you&#8217;re postpartum, a bidet is lovely because you want to be very gentle. People who have hemorrhoids, people who have fissures, people who just have really hairy bums. People feel like just wiping and it doesn&#8217;t really get everything out. When you have a lot of hair back there, a bidet solves all of this for you.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Yeah no more dingle berries.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>And then you can get the kind with the heated seats and stuff.&nbsp;<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Oh yeah, that&#8217;s what we have. And then it&#8217;s got a fan. So after you&#8217;re done, it dries your butt.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Just drive full service.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>And they&#8217;re affordable. They&#8217;re not that expensive, and they&#8217;re easy to install. You don&#8217;t have to get a separate bidet that you put next to your toilet. It&#8217;s an attachment right on your toilet.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>And let&#8217;s just emphasize it&#8217;s an attachment that runs through your clean water supply. This is a common concern. Are you just splashing dirty water back at you? Absolutely not. This is splashing clean water. It goes to your clean water supply. There&#8217;s no risk of weird back splash.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>And then some people, if they don&#8217;t go bidet, they&#8217;ll all just use the wipes like adult diaper wipes essentially. Those are nice, but the problem is you&#8217;re not supposed to flush &#8217;em down the toilet.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Exactly. Even the ones that say flushable, which a lot of them do, you actually can damage your pipes, and they&#8217;re not actually as degradable as we&#8217;d like. So if you&#8217;re starting to throw those in, the little can next to your commode. Eventually when those build up, you&#8217;re like, why didn&#8217;t I just get a bidet? That&#8217;s not pleasant either.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>It&#8217;s interesting the cultural differences about wiping. So I lived in Mexico for two years when I was in my twenties, and I remember when I first got there and I was living with some Mexicans, a lot of them don&#8217;t flush the toilet paper. They&#8217;d have a waste basket and they just wipe and put it in the trash. I&#8217;m like, that&#8217;s interesting. So I had to start doing that. It was kind of weird for two years to wipe and then throw it away. It was weird.&nbsp;<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>I saw that a lot in Europe too, where there was no bidets in Morocco when I was traveling. And I think it&#8217;s a plumbing issue. The pipes were really old, and you have to be really careful. But good God, what if ever there was a sign to get a bidet.&nbsp;<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>But if you do have to wipe, you suggest not to wipe, but to blot.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Yeah, I&#8217;m a blotter or a dabber. I like to dab. And again, that&#8217;s because I see people in my line of work. People are often prepping for colonoscopies or they have some condition where they have diarrhea and they&#8217;re constantly wiping \u2014 that area just gets inflamed and red and unhappy very, very quickly. If you&#8217;re doing a lot of wiping just dab, you don&#8217;t need to go overly aggressive. Just add, because that skin is so, so delicate.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>So speaking to this pliability of the three of pooping, making our poops easy to get out, what can we eat for optimal poop health?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Well, there&#8217;s three layers of what I tell people to do. So the first one is eat more fiber. And actually, if I could do nothing else, that&#8217;s one, two, and three, because we are all struggling, I&#8217;m actually delighted that you hit 60 grams for men under 50. It&#8217;s like 38 grams. For women, it&#8217;s 25, and a lot of us just aren&#8217;t meeting that. So if you can do that by any means necessary, even if that&#8217;s a fiber supplement, I would chalk that as a win. But the second sort of thing that has been shown, if you&#8217;re doing that and you&#8217;re ready for the 102 level course, the second thing that&#8217;s really been shown to help with your gut microbiome, so those are the trillions of microbes living in your colon and their genetic material is to have a diversity of plant-based sources in your diet every week.<\/p>\n<p>And that contributes to the diversity of those microbes. And you want that. That&#8217;s a marker of good health and of a healthy microbiome is the different numbers of species in there. And those microbes just remember, they&#8217;re not just sitting there. They&#8217;re not passive actors in your colon. They&#8217;re taking what you&#8217;re feeding them and fermenting it and creating these new compounds, which sometimes are called postbiotics, but they&#8217;re like things like short chain fatty acids that get absorbed into the bloodstream and go to other parts of your body. So it is really important what you feed them and how you think about them. So eating a diversity of plants is the second thing that I tell people to try to aim to do. So meaning don&#8217;t eat the same routine thing every single day for lunch every single day for dinner. Start to diversify that. But then three, and this is I think the hardest one, the 103 level course is to start incorporating fermented foods into your diet.<\/p>\n<p>This is the thing that every gastroenterologist loves to preach about. But there have been some really powerful studies showing how even two groups of people both eating a high fiber diet, when one of them adds fermented foods, their microbes produce even more anti-inflammatory compounds. And you can measure those in the blood. And so fermented foods are kind of hard sometimes. They&#8217;re not necessarily the obvious things that we think of in a typical American diet, but you can get them through just Greek yogurt, which is the most common thing that I usually eat and incorporate into my diet every day because it&#8217;s very filling. It makes a great breakfast. I eat it that way. But it&#8217;s also stuff like kombucha, sauerkraut, kimchi, they&#8217;re even present to some extent in sourdough bread or soy sauce. They&#8217;re there. So the more you can incorporate and start getting in the habit of throwing in fermented foods into your diet, that&#8217;ll give you even that extra boost.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>So yeah, my morning, my diet in the morning is like my colon morning, so the morning I have eggs with these fiber wraps. That&#8217;s where I get a lot of the fibers, these fiber wraps. And then I have a mid-morning meal where I&#8217;ll have oatmeal, or it could be like a high fiber cereal, and then I&#8217;ll put some Greek yogurt in there and then some blueberries. And then I also eat some either sauerkraut or kimchi with my eggs first thing in the morning.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Oh, wow. I love that. That&#8217;s like a perfect breakfast. You&#8217;ve got all of the components in there.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Yeah. Well, Trisha, this has been an amazing conversation. I&#8217;ve been doing this for 17 years. I never thought I&#8217;d have a podcast about poop, but I did. Where can people go to learn more about the book and your work?<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Well, they can get the book, <i>You&#8217;ve Been Pooping All Wrong<\/i>. Anywhere that they get books and they can follow me on Instagram.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>Fantastic. Well, Dr. Trisha Pasricha, thanks for your time. It&#8217;s been a pleasure.<\/p>\n<p><strong>Dr. Trisha Pasricha:<\/strong><\/p>\n<p>Thanks, Brett. This was so much fun.<\/p>\n<p><strong>Brett McKay:<\/strong><\/p>\n<p>My guest today is Dr. Trisha Pasricha, the author of <i>You&#8217;ve Been Pooping All Wrong<\/i>. It&#8217;s available on amazon.com and bookstores everywhere. You can find more information about our work at our website, www.trishapasricha.com. Also, check out our show notes at aom.is\/poop, where you can find links to resources where you can delve deeper into this topic. Until next time, this is Brett McKay reminding you to not only listen to the podcast, but to put what you&#8217;ve heard into action.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; Pooping. Everybody does it, but a lot of people are embarrassed to talk about it. That&#8217;s a shame, my guest says, not only because your digestive health is incredibly linked to your overall health, but simply for the fact that there is much happiness to be found in an easy, worry-free constitutional. Harvard gastroenterologist [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":193186,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"activitypub_content_warning":"","activitypub_content_visibility":"","activitypub_max_image_attachments":3,"activitypub_interaction_policy_quote":"anyone","activitypub_status":"federated","footnotes":""},"categories":[42265,7,156],"tags":[],"class_list":["post-193185","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health","category-health-fitness","category-podcast"],"featured_image_urls":{"aom":"https:\/\/content.artofmanliness.com\/uploads\/2026\/03\/toilet-372x230.jpg","reactor-320":"https:\/\/content.artofmanliness.com\/uploads\/2026\/03\/toilet-320x167.jpg"},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.5 (Yoast SEO v27.5) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Podcast #1,112: You\u2019ve Been Pooping Wrong \u2014 Here\u2019s How to Do It Better | The Art of Manliness<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.artofmanliness.com\/health-fitness\/health\/podcast-1112-youve-been-pooping-wrong-heres-how-to-do-it-better\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Podcast #1,112: You\u2019ve Been Pooping Wrong \u2014 Here\u2019s How to Do It Better | The Art of Manliness\" \/>\n<meta property=\"og:description\" content=\"&nbsp; Pooping. Everybody does it, but a lot of people are embarrassed to talk about it. That&#8217;s a shame, my guest says, not only because your digestive health is incredibly linked to your overall health, but simply for the fact that there is much happiness to be found in an easy, worry-free constitutional. 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