The Art of Manliness - You’ve Been Pooping Wrong： Here’s How to Do It Better

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00:01:01.280 one more time shopify.com slash manliness brett mckay here and welcome to another edition of the

00:01:09.180 aom podcast which since 2008 has featured conversations with the world's best authors

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00:01:34.740 Strenuous Life program at strenuouslife.com. Now on to the show.

00:01:46.720 Pooping. Everybody does it, but a lot of people are embarrassed to talk about it.

00:01:51.140 That's a shame, my guest says,

00:01:52.860 not only because your digestive health

00:01:54.220 is incredibly linked to your overall health,

00:01:56.140 but simply for the fact that there's much happiness

00:01:58.160 to be found in an easy, worry-free constitutional.

00:02:01.720 Harvard gastroenterologist, Dr. Trisha Pasrichas,

00:02:04.180 the author of You and Pooping All Wrong,

00:02:05.920 How to Make Your Valve Movements a Joy.

00:02:07.840 Today on the show, Trish and I have a fun

00:02:09.440 and frank conversation about the art and science

00:02:11.180 of valve movements, including the color of healthy stools,

00:02:14.100 how often you should be pooping,

00:02:15.600 if laxatives are safe to use,

00:02:17.300 the food to eat that's even better than prunes

00:02:18.760 for getting things going,

00:02:19.620 why you feel the urge to go poop at Barnes & Noble, the wonders of the bidet, the danger of

00:02:24.180 using your smartphone on the toilet, how to get more comfortable pooping in a public restroom,

00:02:28.040 and more. After the show's over, check out our show notes at awimp.is slash poop.

00:02:42.520 All right, Dr. Tricia Pasrisha, welcome to the show.

00:02:45.900 Thank you so much for having me, Brett. Glad to be here.

00:02:48.280 So you are a medical professor of gastroenterology. That's a hard word to say. I had to look it up

00:02:53.380 how to pronounce it. You specialize in gut health and a big part of your work involves

00:02:58.280 researching and talking a lot about poop. How'd you end up doing what you do?

00:03:04.700 Well, I kind of am a second generation gastroenterologist. I grew up as the

00:03:10.120 daughter of a gastroenterologist. And when you grow up like that, you think that talking about

00:03:14.680 poop every day is perfectly normal. And you think that that's what everyone else is doing.

00:03:19.160 And it was delightful. My father was and still is a gastroenterologist, but he was also a

00:03:24.820 researcher. And he was just so excited to tell me and my siblings about the cool stuff he was

00:03:33.000 discovering in his lab every day after he came home from work. And he was describing how colonoscopies

00:03:38.180 worked. And all of this I know now sounds really bizarre, but at the time it was just what we

00:03:43.120 talked about at the dinner table and how cool science was and specifically when it came to our

00:03:48.280 guts. So I loved it. And it was kind of what I grew up thinking was the coolest thing in the

00:03:53.220 world. So I knew I wanted to be a gastroenterologist since I was like a little girl. I had never

00:03:58.920 imagined wanting to be anything else. But then, you know, when I came to medical school and then

00:04:04.120 I started doing my own training, I really started to realize what a weird gap there was between what

00:04:10.300 other people seem to have learned about poop and their bowel movements and how their gut works

00:04:14.580 and what I learned. And people, for the most part, it seems like didn't really talk about

00:04:20.380 their guts and their poop after they turned like three or four. And it was like something everyone

00:04:25.420 just like stopped bringing up at the dinner table. And so I kind of went on this mission and it just

00:04:30.860 started with me talking to my patients about trying to normalize these conversations and

00:04:34.560 having them out loud. And ultimately that led to writing the book. But I really do think that

00:04:39.480 people need to have conversations more loudly because 40% of Americans are suffering from

00:04:46.200 bowel habits that disrupt their daily lives. But you wouldn't know that because we're so quiet

00:04:50.180 about them. Yeah. I mean, unlike you, we didn't talk about poop at the dinner table. I don't even

00:04:57.020 remember having conversations about my bowel movements with my family. And that carries over,

00:05:03.380 I think, for a lot of Americans to how they approach talking about it with their doctor.

00:05:07.640 As you said, a lot of Americans have bowel problems and it can cause a lot of discomfort,

00:05:13.600 a lot of inconvenience in their life.

00:05:15.380 And a lot of it is preventable.

00:05:17.660 Let's talk about this.

00:05:18.800 I think one of the reasons why people have a hard time talking about it is they don't

00:05:22.100 know how to talk about poop.

00:05:23.540 So when they go to the doctor saying, I got this problem with my bowel movements, I mean,

00:05:28.160 what should they call it?

00:05:29.000 Because you're always like, do I call it bowel movement?

00:05:31.080 Do I get scientific and call it stool, feces, human soil?

00:05:35.540 Like, what do you call it?

00:05:37.120 Yeah, liquidating your assets, like whatever you want. I have found that I use the word poop

00:05:43.860 usually unless somebody leads with another word that they find more comfortable. And the reason 0.95

00:05:48.920 I do that is when I was in medical training, the kind of formal word that all doctors use

00:05:54.300 is bowel movement. And so that's what I was trained to start saying. And I certainly started

00:05:58.800 saying that. And I had one professor who was a gastroenterologist and he was my research mentor

00:06:04.460 in medical school. And I shadowed him and he was the first guy I had ever seen, like this doctor,

00:06:11.220 middle-aged gentleman. And this young patient came in and he was like, so tell me what your poop

00:06:17.500 looks like. And I like looked at this guy and I was like, this is so weird. You're this doctor,

00:06:21.700 this white coat. That's the weirdest, you know, I've never seen a doctor say that like that in

00:06:25.260 a clinic before. But when he said it, this young patient in his twenties, like suddenly smiled for

00:06:30.520 the very first time. And like just the whole atmosphere in the room changed. And this guy

00:06:34.140 just totally shared exactly what was going on with him. And you could just tell it broke the

00:06:38.220 ice. It made it comfortable. And after that, I never looked back because I know oftentimes when

00:06:42.700 I tell people, Oh, tell me about your bowel movements. You know, everyone stiffens up a

00:06:47.620 little bit and they, they, and they too try to match my level of medicalization. And if you

00:06:52.840 could just tell me what's bothering you, I want to use whatever words make you comfortable. So

00:06:57.840 I think someone should lead with the words they want to use that allows you to talk about it

00:07:02.240 most really. And my hope is that your doctor is going to meet you right there.

00:07:05.920 Okay. That's great. It's funny. Bowel movement. So my, my name is Brett McKay. This is sort of

00:07:10.420 a tangent. Um, so when you get the initial things, it started when I was in like middle school,

00:07:14.300 cause I got really self-conscious about it. I initial BM and I had some kid to be like,

00:07:18.660 Oh, BM poop. And so now ever since then I do BHM that's my middle, middle initial.

00:07:24.540 Oh my gosh. No, you should embrace it. I've embraced TP as a gastroenterologist.

00:07:28.960 All right. So if you can do that, I can go back to BM. I'm going to embrace the BM.

00:07:34.680 So you described this idea of puphoria in your book. What is puphoria?

00:07:40.680 Yeah, puphoria. It is a state that I want everyone to reach. And that is where having a bowel

00:07:47.660 movement is the absolute least of your daily concerns. It's this easy, effortless thing that

00:07:52.840 happens quickly without straining. And then you go about the rest of your day and live your best

00:07:57.600 life. You're not worried about feeling heavy for the rest of the morning or day because you didn't

00:08:03.120 have that window to go. Or you're worried, should I go out to brunch with my friends? Or should I

00:08:07.660 even meet people for dinner because I'm so worried about the bathroom situation? I don't want you to

00:08:11.740 live like that. And tragically, I think a lot of people are right now. So Puforia is a state of

00:08:17.060 mind and it's a lifestyle that I think we can all reach, some of us with just a little bit more

00:08:23.500 knowledge about our bowel habits that we just never got because we, the last time we talked

00:08:28.940 about our bowel habits with another soul was usually when we were potty training with our

00:08:32.340 mom and dad. And that was a long time ago. Most of us cannot remember that conversation.

00:08:36.920 So a healthy bowel movement, you're not even thinking about it because it's just not even on,

00:08:41.060 you don't have to worry about it at all. Yeah. You're not obsessed about, I mean,

00:08:44.520 there's another end of the spectrum where people, I mean, and this can be quite understandable,

00:08:48.180 but people fixate on their bowel movements all the time. Like they're worried about like,

00:08:51.900 did I go yet today? If I don't go, I feel off. And, you know, even if there's someone who you

00:08:57.040 might look from the outside and say, okay, they're going once a day, they're regular. But if you're

00:09:00.320 thinking about it all the time, you're becoming paranoid. If you haven't gone, that's not poop

00:09:04.000 for you either. Well, let's talk about what healthy poop looks like. And hopefully we can

00:09:08.020 answer some questions that people have always wondered about it. Let's start with the color

00:09:11.920 of poop. First off, why is poop usually brown? Yeah, the natural color is actually not brown.

00:09:19.040 The natural color of our poop is like this whitish clay colored, like kind of like a

00:09:24.380 grayish.

00:09:25.680 And what gives it its beautiful brown color is bile.

00:09:29.780 So our body produces this digestive juice.

00:09:32.160 It has bilirubin in it.

00:09:33.520 And that's just this chemical that gives it that brown color.

00:09:36.480 But if we were to take that away, it would actually look bizarrely whitish.

00:09:41.140 And that is why if you ever see like a pale whitish creamy stool, that's a problem.

00:09:47.160 That's an emergency.

00:09:47.740 it means that that bile is somehow being blocked somewhere. Maybe it's a gallstone. It could even

00:09:52.060 be a cancer. But if you ever see that, that's a big, big red flag. Go to the emergency room.

00:09:57.280 But then other than that, the normal color should be some shade of brown. And then, of course, 0.91

00:10:01.880 everybody poops the rainbow from time to time. I get these kinds of DMs like every week where

00:10:06.220 someone's like, I had a really weird purple poop or my poop was kind of greenish. Is that normal?

00:10:10.220 And it can be normal. A lot of times we eat things that we don't put together could impact

00:10:15.960 our poop. Like for example, a classic one is beets. If you've ever eaten beets, you are probably

00:10:22.280 going to have a maroon poop the next day or maybe the next day or two. And that's just the beets.

00:10:28.360 That's okay. But if you haven't eaten those beets and you see anything that looks like red,

00:10:31.940 that would be really worrisome for bleeding. So like bright red, maroon, or even like pitch black

00:10:37.400 and shiny, that could all be blood. Gotcha. So yeah, black poo, that could be okay. Sometimes

00:10:43.240 it suggests there's some sort of internal bleeding going on up your tract. But sometimes there's like,

00:10:48.220 I think iron supplementation can cause black poop. Yeah. You can have this real chicken and

00:10:54.140 egg situation because sometimes people are taking iron because they're having some bleeding and

00:10:59.100 they've lost blood. But then you see black poop and you're like, is this because you're taking

00:11:03.400 iron to treat bleeding or is it because you're bleeding? Yeah. And then I guess pepto-bismol

00:11:08.700 can also cause black poop. Yeah. I feel like we always forget to warn people about Pepto-Bismol 0.95

00:11:15.580 because it can turn your tongue black. It can make your poop black. And then people are really 0.91

00:11:18.780 horrified the next day. But if you've taken Pepto-Bismol black poop, you're allowed to 0.98

00:11:22.740 have a few black poops. And another interesting fact about Pepto-Bismol that you put in the book 0.98

00:11:27.280 is that if you don't want your farts to stink before a date or something, take Pepto-Bismol

00:11:32.760 before and that will make your farts less stinky. Okay. So poops naturally clay color until it meets

00:11:39.720 with bile. But this is one of those things that can freak me out because like, I mean, you hear

00:11:44.340 if you have like a clay colored stool, you know, that can mean you have pancreatic cancer or bile

00:11:48.840 duct blockage. And I can be looking at a light poop thinking like, well, is that a, is that clay

00:11:55.520 color? Like, I think there are different colors of clay. And I think, well, clay's maybe a light

00:11:59.800 tan. So maybe my poop is looking like clay, but we're talking about like white clay. Like it has

00:12:04.240 to be basically white. Yeah, I guess you're right. There's like nice different, there's earthy tones 0.67

00:12:08.660 of clay. This I'm talking about more like a whitish creamy color or kind of gray. And I would

00:12:14.560 say, you know, when in doubt, I mean, everyone's poop is going to look a little different. If you

00:12:18.980 have any doubts, I always tell my patients, picture it didn't happen. Take a picture of it

00:12:24.280 and then send it through your like electronic medical record and show your doctor and just

00:12:27.820 have them lay eyes on it. A doctor will be able to tell you really quickly, am I worried or excited

00:12:33.480 about this or not? Gotcha. And then red, if you haven't eaten beets, if you see red, that's another

00:12:38.340 thing you might want to go see your doctor about. Because it could be colon cancer, but it could be

00:12:43.000 something as benign as a hemorrhoid or an anal fissure or something like that. Totally. Yeah.

00:12:48.020 And most of the time, it is going to be something, not worrisome, it's going to be a hemorrhoid. But

00:12:52.800 what I never want someone to do, especially in this stage in 2026, where we are seeing this

00:12:57.920 really disturbing rise in early onset colorectal cancer is for someone to see bleeding and brush

00:13:03.720 it aside. I mean, this is the trend we're seeing in studies and with this, this rising cases that

00:13:08.340 young people, when they see blood, they're like, this is just my hemorrhoid, or I'm, I'm pretty

00:13:12.300 sure this is no big deal. It's always better to just quickly let your doctor know and let your

00:13:17.760 doctor reassure you and be like, oh yeah, we'll just do a quick exam. We'll make sure it's your

00:13:21.000 hemorrhoid, no problem. But make sure that someone's taking a look and giving you that

00:13:25.120 reassurance rather than just brush it off yourself. Let's talk about the shape and consistency. What

00:13:30.060 does a healthy poop consistency and shape look like? Yeah, I think most people think that a

00:13:36.640 perfect shape would be like this nice, like smooth sausage shaped. And then you go and like people

00:13:42.440 really aim to get this like wipeless wonder. And that is wonderful. That is like a nice consistency

00:13:47.360 that a lot of people have. But there's really such a range of what could be normal. And I would tell

00:13:53.700 people that, for the most part, if you start eating a lot more fiber, which a lot of us are

00:13:59.220 not doing, like 95% of Americans are not meeting our fiber goals. If you start to do that, it

00:14:03.920 actually becomes less and less likely that you're going to have that smooth little sausage that

00:14:08.420 everyone wants. You're going to start to have fluffier and fluffier stool. You might even start

00:14:11.620 to go more often. That's perfectly normal. It can be totally normal. And people sometimes when they

00:14:16.740 do that, they're like, I have diarrhea because I'm going three times a day and it's so soft.

00:14:20.220 That's fine. As long as it's not like interfering with your social life, you know, there's a range

00:14:24.160 of normal. And in fact, you should embrace that new you because it means you're doing something

00:14:26.840 healthy for yourself. And then, you know, on the flip side, sometimes when people are having these

00:14:30.880 like really, really tiny rabbit pellets, usually I say that that indicates that there's an issue

00:14:36.780 with constipation. But sometimes the fix can also be quite simple. It can be you need to hydrate

00:14:41.680 more or you need to not hold it in. We do that as adults. We have this urge to go. Sometimes it's

00:14:47.060 like when we're at work or we're on a date at a restaurant and we say, no, no, no, I'm not going

00:14:51.180 to go right now. I feel the urge. I'm not going to go. And when you do that, you're setting yourself

00:14:54.860 up for failure because that stool is just going to dry up and become more hard so that when you

00:14:59.400 decide you want to go later, it's not the same one that you started with 12 hours ago. It's a

00:15:03.380 totally different one. It's going to be more pebbly. So it's better to try to go when your

00:15:07.460 body tells you to, and you're going to get a little bit closer to that median.

00:15:10.740 Gotcha. So what happens to our stool whenever we get diarrhea? Why does the body decide

00:15:17.360 this stuff needs to be liquid and get out fast? What's happening there?

00:15:22.160 Yeah, there's lots of different causes. But in terms of your anatomy, your small bowel,

00:15:28.260 which is that first part of the tube after your stomach, the main point of your small bowel

00:15:32.360 is to absorb all the nutrients. And it's sucking out everything that it wants and breaking it down.

00:15:37.140 And then the stuff that it can't break down, which is usually like the fiber, which we

00:15:41.120 actually don't possess the enzymes to break down.

00:15:43.060 It makes its way to our microbiome in our colon.

00:15:45.520 Well, the colon has several jobs.

00:15:47.520 One of them is to suck water out of the stool as it passes through.

00:15:51.340 And stool passes a little bit more slowly through the colon.

00:15:53.740 So your colon has a lot of time to get that water out.

00:15:55.740 But if something happens that triggers that poop to move forward, and sometimes it's stress,

00:16:01.920 stress can cause our colon to suddenly start to contract.

00:16:04.980 that means we haven't had time to remove and absorb all the water out of it yet. So it's

00:16:09.940 going to gush out like diarrhea when we're stressed. Spicy food does that. Spicy food

00:16:14.500 sends this signal down to say, okay, evacuate everything we have. That too will make whatever

00:16:19.620 comes out to be a little bit fiery, a little uncomfortable, and it'll also be pretty liquidy.

00:16:23.700 And then there's other things like infections or just depending on how things are going with

00:16:28.160 other aspects of your life, travel and exercise, those things can also help speed things up. But

00:16:33.020 before you've really had a chance to absorb all the water.

00:16:35.880 Gotcha. And constipation is just the reverse. It's been in the colon too long. So all that

00:16:39.380 water has been sucked out. Yeah, exactly. And there's a ton of

00:16:42.800 different reasons why we think slow down and why we can get constipated. And you're right,

00:16:47.460 the longer we sit there, the longer that stool is just, your colon is going to keep doing its job

00:16:52.360 and it's going to keep making it harder and harder, which is why I sometimes think the most

00:16:56.120 important thing people can do who are constipated is just as soon as they hear that call, feel that

00:17:01.460 urge respond because it's not going to be the same poop later on. What causes constipation?

00:17:06.620 You said there's lots of potential sources. Yeah. Well, when someone comes into my clinic

00:17:11.420 and they have constipation, I try to explain the way the colon works in terms of trying to get

00:17:15.960 toothpaste out of a toothpaste tube. So sometimes the issue is that we're not squeezing that

00:17:20.820 toothpaste tube. And that means that maybe there's something that's stopping the colon

00:17:24.940 from contracting so much. We need to do that. We need to generate pressure in order to push

00:17:29.000 the stool outwards. And maybe the problem is actually not that we're not squeezing the tube,

00:17:33.480 but that the toothpaste itself is rock solid. And sometimes that happens because maybe we're not

00:17:38.900 getting enough fiber. Maybe we're not drinking enough. Maybe there's something else that's

00:17:41.760 making that stool really, really hard. But then the third, and I think most underappreciated part

00:17:46.780 of the problem is that, yeah, we're squeezing hard enough. The toothpaste is super soft,

00:17:50.320 but we forget to take the cap off the toothpaste tube. And then we're just pressing up against

00:17:54.760 this pelvic floor that is not cooperating. And that is very common. That happens to about one

00:18:00.620 in three people who have constipation and who've tried different laxatives and different things,

00:18:05.220 and they've failed. And basically what that means is that our pelvic floor, which is this set of

00:18:09.580 more than a dozen muscles sitting there at the bottom of our rectums, and they need to coordinate

00:18:15.620 in this really highly orchestrated dance. Some need to contract at the right time, some need to

00:18:20.240 relax. And for a lot of people, the sphincters that are supposed to be relaxing actually contract

00:18:25.920 when we bear down. If you think about it, we're like generating all this pressure to try to push

00:18:29.580 our poop out and people's sphincters contract. And that's very paradoxical. It's not supposed

00:18:33.900 to do that. So sometimes when you've tried everything, the most obvious answer is actually

00:18:38.820 something that doesn't involve anything related to your colon, but actually it's all the muscles

00:18:43.600 in your pelvis that's the problem. Yeah. You just went through what you call the three P's

00:18:47.340 of a good poop. So propulsion, that's that bearing down, that Vassalva maneuver, we kind of

00:18:53.800 get that thing going. Then the consistency, it's the pliability, the softness. If it's hard,

00:19:00.200 it's not going to come out. And that pelvic floor aspect, sort of the cap on the toothpaste.

00:19:05.680 Yeah. And I think for someone to reach pooforia and to have healthy, effortless balance every

00:19:10.860 day, you have to think about how you're optimizing all three of those things. All three of those

00:19:14.960 things need to be working at their best in order to have a balance. Because if even just one of

00:19:19.780 them is off, it's going to be hard to overcome it with just the other two. With the pelvic floor

00:19:24.260 piece, I think we think about that with just women because pelvic floor problems can result 1.00

00:19:29.200 after childbirth. But men can have pelvic floor problems too. And you recommend that if you have 0.98

00:19:34.820 a pelvic floor issue to go to a physical therapist who specializes in that. We'll talk about something

00:19:40.440 else you can do to help your pelvic floor when you're pooping later on in our conversation. 0.96

00:19:44.180 Going to the pliability part of the three Ps of a good poop,

00:19:47.920 this is the consistency of the poop.

00:19:49.740 Why does poop float sometimes?

00:19:52.300 Yeah, a couple of different reasons.

00:19:53.480 Sometimes if it's just soft enough because it has enough soluble material,

00:19:57.220 like enough fiber, it'll float.

00:19:58.520 Sometimes fat, like fat floats in poop.

00:20:01.860 So it depends on kind of what you've eaten and how well you've absorbed it.

00:20:05.360 There are certain conditions where people do not absorb nutrients

00:20:09.720 and the food that they eat as well as we'd like them to.

00:20:12.240 And traditionally, we think about those as resulting in like really serious floaters.

00:20:17.520 If you're so there's like a range that could be normal.

00:20:20.120 But if this is your consistent pattern and you have any other symptoms, like you get

00:20:24.440 pain, bloating when you eat, if you have a lot of floaters in your stool, you should

00:20:28.700 actually just run that by somebody and make sure that you don't have an issue with absorption.

00:20:33.460 Gotcha.

00:20:33.900 I mean, so this is always a concern for me because I read these articles like, oh, pancreatic

00:20:37.100 cancer, colon cancer.

00:20:38.060 And it's like, oh, floating poop.

00:20:38.940 And I'm like, okay, I'm going to be TMI here, but like mine are regular floaters.

00:20:45.160 They look normal.

00:20:45.900 They feel normal.

00:20:46.340 I think it's because I just eat a lot of fiber.

00:20:47.720 I eat like 60 grams of fiber.

00:20:49.720 Good for you.

00:20:50.940 So I think that's what it is.

00:20:52.720 Am I right?

00:20:53.180 Yeah.

00:20:53.620 Or should I go see my doctor?

00:20:55.280 Well, you should always run anything by your doctor you're concerned about.

00:20:58.200 But what you've described sounds very, very typical for somebody who's just eating a lot of fiber.

00:21:02.000 Once we start eating a lot of fiber and 60 grams is like an A plus amount of fiber,

00:21:06.240 then you know people's poop does change and people are really caught off guard by it the reason people

00:21:11.580 say that that floating poop is a sign of pancreatic cancer is because the pancreas helps break down

00:21:16.380 and helps you absorb that food and when suddenly that stops working so well then you might see new

00:21:21.780 floating poop for the first time but that's not the only sign often like sometimes people you know

00:21:26.680 their skin turns a little yellow they have pain in their stomach so if you're otherwise living your

00:21:31.640 best life you know run it by your doctor but you know it's most likely just because you're eating

00:21:35.840 a ton of fiber, which is a great thing. Yeah. I'm a big, I'm a fiber maxer as the kids are

00:21:40.700 saying these days. Yeah. Yeah. Me too. Let's talk about the schedule. What does a healthy

00:21:46.800 bowel movement schedule look like? So I think there's this idea that you have to have a daily

00:21:50.640 constitutional to be healthy. Is there anything to that idea? There definitely is something to

00:21:56.260 that idea. And I think that this is because our bodies are naturally primed to have a bowel

00:22:02.540 movement first thing in the morning. And the reason for that is one of the things that makes

00:22:06.960 the colon a little bit different and special compared to other organs in our bodies is it

00:22:10.720 really operates on a circadian rhythm and it's a creature of habit. So when we go to sleep,

00:22:17.200 the colon goes into this really quiet state. It doesn't move around too much. That's why for the

00:22:22.180 most part, you know, people sometimes talk about waking up in the middle of the night to go pee.

00:22:26.500 It's pretty rare for people to wake up in the middle of the night to have to poop. And that's

00:22:29.700 because your colon's not really moving, but when it wakes up, when you wake up and it operates on

00:22:34.520 the same circadian clock as you, then that first one to two hours upon waking is when you see some

00:22:41.660 of the strongest contractions naturally occurring in your colon that you're ever going to get the

00:22:46.220 rest of the day. For that 24 hour period, it's during those first one to two hours that your

00:22:49.920 colon is doing the work for you. And if you have a bowel movement when your colon is already

00:22:54.480 contracting, it means you have to do way less work. You have to bear down less. You don't have

00:22:58.800 to strain as much. So it's a nice window. And then people often in the morning start to stack

00:23:03.780 on other habits that help the colon contract too. Like for example, a third of people who drink

00:23:08.320 coffee, their colon is going to start to contract pretty quickly. People who go for walks in the

00:23:13.200 morning, just a little exercise can help stimulate those contractions. And we do a lot of those

00:23:16.780 things early in the morning. So it's a great time to have a bowel movement. All of that said,

00:23:22.400 there's just like a large portion of people whose mornings are totally hectic, totally crazy.

00:23:26.680 they don't have time for any of this and they don't go that doesn't mean that you have a problem or

00:23:32.060 that you're weird it just means that you need to find a time to respond when your colon's ready

00:23:36.800 and and some other times during the day the colon will start contracting if you eat a meal so

00:23:41.860 oftentimes there's another wave of people who poop after dinner or poop after lunch that's totally

00:23:46.880 normal a lot of times people come to my clinic and they're like it's so weird that I have to poop

00:23:50.620 every time I eat and I say no no that's a completely normal reflex in fact you know it's

00:23:55.640 like a reflex that we're born with. Kids are pooping multiple times a day in response to

00:24:00.160 eating. And then later on as adults, we try to suppress that and try not to respond to that

00:24:04.020 reflex for no reason whatsoever. We should just respond. But it's actually a perfectly normal

00:24:08.360 part of our human physiology. So there's a range of what I'd consider normal. And what I usually

00:24:13.600 tell people is, no, it's not once a day. If you go once a day, wonderful. But you don't have to

00:24:19.360 do that in order to be closer to God. What I do want you to do is have an effortless bowel movement

00:24:25.040 whenever you go, it should be easy. If you go once a day, but you're straining your eyeballs

00:24:29.180 out for 20 minutes, I wouldn't consider that normal. So they've done a study in the US where

00:24:34.820 they found that people who consider themselves to have normal bowel movements go anywhere from

00:24:39.280 once every three days to up to three times a day. And anywhere in that big range could be

00:24:44.520 considered normal as long as, you know, it's effortless and you're comfortable and happy

00:24:48.920 with that pattern. And I imagine if you see a change in your schedule that lasts a long time,

00:24:54.240 you're like, well, maybe I should look at this. So if I usually do once a day and then I'm going

00:24:58.220 three times a day, well, that's interesting. I should probably check that out.

00:25:03.700 Yes. I tell people to get to know your own pad and, and, and everyone's going to be different

00:25:08.620 and have some variation in their own life. Like you might be somebody who goes like clockwork

00:25:13.340 every day and that's perfectly wonderful and, and healthy, but you may also see that you have

00:25:18.240 some variations depending on whatever else you have during your week and how you travel and how

00:25:22.820 you exercise these things will change but get to know what kinds of patterns are normal for you

00:25:26.700 and then most importantly you should start looking every day like before you flush have a peek the

00:25:32.080 number of times i ask people what did it look like what color is your poop normally and people

00:25:36.640 just get all embarrassed and say oh i don't know i don't really look well i mean first of all like

00:25:40.780 how can you not look i don't know how you resist that temptation but but you should look so that

00:25:44.700 you then you know when something is different yeah speaking of looking have you kept up with

00:25:50.020 these new AI devices you can attach to your toilet that takes a picture of your poop and give you?

00:25:54.700 I've seen some of that chatter. I'm excited about, I mean, one, I'm, well, I think we're all like,

00:26:00.400 oh my gosh, a little horrified about the idea of a camera down there, but I'm sure they've sorted

00:26:03.420 out the privacy issues. But I think, well, yeah, I mean, I'm excited about what those could show

00:26:09.440 us one day. Yeah. I mean, yeah, I think looking at your poop tells you a lot about your overall

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00:31:01.780 And now back to the show. Speaking of schedules, and let's say someone, they're like, I don't poop

00:31:08.320 as often as I want. It makes me uncomfortable. I need to take a laxative. But they're like, well,

00:31:13.780 I don't want to take a laxative because I don't want to become dependent on it or something.

00:31:17.660 Is there a problem with taking laxatives to have a bowel movement?

00:31:22.400 Yeah, no. So I have a few thoughts about this. One is that just to take a big step back,

00:31:27.360 I don't think there'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.

00:31:42.000 But there'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.

00:31:52.480 constipation can be a disease like any other disease, like high blood pressure, like diabetes.

00:31:56.920 And there's no shame in taking a medicine to treat that. And so I do feel that there's often

00:32:02.120 a lot of shame and a sense of like self-failure for when you take a laxative. And if that's what

00:32:08.060 you need to be well, I don't think that that's the case. Now that said, there are a lot of ways

00:32:14.180 to treat it that don't require laxatives, but know that laxatives are safe. You should use them as

00:32:18.900 directed by your doctor. And a lot of the earlier studies that kind of got people worried that you

00:32:25.080 could become dependent on laxatives, you were somehow damaging your colon. Ultimately, that

00:32:29.160 data was not very consistent or proved to be robustly true. So I worry a little bit less

00:32:33.700 about that. But I will say there are a lot of ways that you can improve your bowel habits,

00:32:38.240 become less constipated just by changing things about what you're eating and what you're doing,

00:32:42.180 and even the position of how you're sitting on the toilet. I mean, it's very common that people

00:32:46.420 don't want to take a medicines, but you can take things as natural as like kiwis, right? Like in

00:32:51.640 our grandparents' times, people were taking prunes and prunes are incredibly effective, but

00:32:56.240 I have never successfully convinced a college student to take prunes. It's like one of those

00:33:01.340 things that people just don't reach for anymore these days, but kiwis have been shown in multiple

00:33:05.520 randomized control trials, two kiwis a day, that they are as effective as prunes, but they also

00:33:11.780 don't cause bloating. Like a lot of these like fiber supplements and prunes can cause, kiwis

00:33:15.820 don't seem to do that. So it's a pretty simple fix that's relatively effective, all things 1.00

00:33:21.000 considered. And it's not really a laxative. It's actually just something that's high fiber,

00:33:24.940 got a lot of nutrients and is good for you in other ways. I like prunes. I'm a prune booster.

00:33:30.180 You're pro prune. I'm pro prune. I mean, it's a dried plum. What's not to like?

00:33:33.880 I think they're fantastic. And I'm sure you've noticed they're very good at their job.

00:33:38.380 Oh yeah, for sure. Yeah. You mentioned something that I thought was interesting. I want to talk

00:33:41.580 about, say, if you're having problems getting your poop out, you're constipated, or it's a

00:33:46.340 struggle, the position. So I think people might have seen these things on Instagram, the squatty

00:33:51.820 potty. Is there anything to that? Does that actually help? Yeah. So this is an interesting

00:33:58.380 thing that we've done to ourselves as a mankind. You know, we, thousands and thousands of years

00:34:04.040 ago, they, I mean, they have found like these upright chair-like potties like back in the

00:34:09.180 Roman Empire. But like well before that, we were just squatting. All of us squat in our most

00:34:14.900 comfortable, natural way to poop. And we've trained ourselves out of that. But I have a two-year-old

00:34:20.000 and a four-year-old. And if you ever go to a daycare and you see a bunch of kids in diapers,

00:34:24.080 like waddling around, they all pop the deepest squat when they are pooping. You know, they don't

00:34:29.320 like go sit in a chair and poop in their diaper. They squat. And that's because that's the easiest,

00:34:33.360 most natural way to have a bowel movement. And here's why. You know, we talked about the pelvic

00:34:37.440 floor and there's so many muscles that make up the pelvic floor. One of the muscles there

00:34:41.340 is called the puborectalis muscle. And if you think about your colon like a long tube,

00:34:47.280 this puborectalis muscle is like this sling that goes across the tube and chokes it closed. It's

00:34:52.480 almost like your body stepping on its own hose. And it's like that when we're just sitting around

00:34:57.780 in our chairs at like at a desk at work, for example. And that's kind of a good thing. Like

00:35:02.860 it's nice to have like that little like extra closure of that door so that there's nothing

00:35:07.220 leaking out. There's no pressure, but you don't want that door to be closed. You don't want there

00:35:11.260 to be a kink in that hose when you're trying to poop. And that's how we poop though, when we sit 1.00

00:35:16.500 at this 90 degree angle. Well, it turns out that if we try to recreate a little bit more of those

00:35:21.340 dynamics of squatting, and we don't have to actually squat because I recognize obviously

00:35:25.920 nobody wants to, nobody wants to do that. But if you just raise your knees above the level of your

00:35:31.300 waist, everybody will poop more easily. They've done these studies that show that, yeah, people

00:35:36.120 who identify as having, who've been diagnosed with pelvic floor dysfunction, identifies

00:35:40.180 conservation, they poop better when they do that. But even healthy people who think that they poop

00:35:45.380 just fine, studies have shown that when you raise your knees up, even if you think you're already

00:35:50.780 doing really well, you would be amazed at how much better you do. That's awesome. So bring your feet

00:35:55.520 up with the stool. I'm a fan of the squatty potty. Speaking of the scheduling, there's this famous

00:36:00.120 bit in 30 Rock, the television show where Liz Lemon talks about every time she walks into a

00:36:05.760 Barnes and Noble, she has to poop. And I'm like, that happens to me. I don't know how many times,

00:36:11.080 I mean, I've pooped in Barnes and Noble several times. As soon as I walked into those doors,

00:36:13.700 I'm like, I got to poop. Yes. What's going on there? Why do you have to poop when you go to

00:36:17.740 Barnes and Noble? Yeah. You are not alone. That is such a thing. And it's funny. It's Barnes and

00:36:23.220 Nobles for some people. For some people, it's like the target. I think the target is like a

00:36:27.080 big one for a lot of people. And it's been described, like I think it was back in the 1980s,

00:36:32.940 it was described in the Japanese literature, like what is it about bookstores that make people poop?

00:36:38.060 And there are a lot of theories about this, and I'll give you mine. I mentioned earlier that your

00:36:43.220 colon is this creature of habit. And the interesting thing about your colon is that

00:36:47.700 it can be trained to respond and react to external cues, cues in your environment that

00:36:53.760 will start contractions and start things to change. And if you go like way back in time to

00:36:58.780 remember Ivan Pavlov, the scientist we all learned about in like middle school who used to ring a

00:37:03.360 bell and then the dogs would come and start salivating because when he rang the bell, he

00:37:07.640 brought food in. But eventually he would start ringing the bell and not bring food in. There

00:37:12.280 would be no, they wouldn't see that there was food, but they'd start salivating anyway.

00:37:16.080 And that idea tells us that just something about our environment that we've associated

00:37:20.860 once with a good poop or a good moment in our digestive history can start to trigger those

00:37:26.880 same cues and those same movements again when we start to build that into a pattern. So I think

00:37:30.580 what happens is, one, in order to poop, you have to feel relaxed. That is like a fundamental truth

00:37:36.220 about pooping because your sthincters have to relax at that final part. And I think bookstores

00:37:40.720 put people in that relaxed place. And a lot of people actually find that they have to read in

00:37:46.320 order to have a bowel movement. We can talk a little bit more about that, but like just a quick

00:37:49.640 light read. It's just distracting enough. It gets things moving and it helps them feel good about

00:37:54.220 it. And I think for some people I've heard this, like it's the smell of the pages, something about

00:38:00.500 it triggers this association. And you have one, you go, maybe you go poop once in a Barnes and

00:38:05.180 Noble. Now, the second time you walk in, now you smell the same pages. You feel relaxed and happy.

00:38:11.460 You know, it was a pleasant experience last time. So you go again and now you've ingrained this

00:38:16.300 pattern and it keeps happening. And now you've got this like whole sensory experience. Every time

00:38:20.620 you walk into a bookstore, that's like a safe space and it's pleasant and you go. And I think

00:38:24.900 that's how we build habits. And I also think that's what happens in the target. Like you go

00:38:28.820 in there, you pick up your coffee, you're by yourself, you're having a nice walk around and

00:38:33.900 it feels safe and it feels lovely. And then you have a nice bowel movement. That's my theory.

00:38:37.940 Okay. Yeah. Yeah. I think there might be something to that. And if you're going to

00:38:40.240 read in Barnes and Noble, leave the books on the shelf. Yeah. Don't bring the merchandise in.

00:38:44.480 Yeah, no merchandise.

00:38:45.380 Guys, you have a sign that says don't do that.

00:38:48.020 They know.

00:38:48.580 They can understand.

00:38:49.620 Well, let's talk about reading on the toilet.

00:38:51.380 A lot of people do this.

00:38:53.260 When I was growing up, we didn't have smartphones.

00:38:56.200 And so I would read like the back of my deodorant.

00:38:59.280 I read about tampons, like my sister's tampons were there.

00:39:03.040 I'd be like, what's going on?

00:39:04.060 I mean, it's the only thing there.

00:39:05.060 You learned so much.

00:39:06.040 I learned so much while I was on the toilet.

00:39:08.100 But a lot of people these days, they take their smartphones in there

00:39:10.320 and they're on there for a long time.

00:39:13.660 Why is that a problem?

00:39:14.480 Yeah. Yeah. I was, I was like you, I would learn all 30 weird ingredients on the back of the air freshener. I would read like the far side comics. Like people used to have these like little discreet bathroom readers that were just like the kind of reading material that could not actually suck you in, you know, like it would be like toilet books. Yeah. And it would be like 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'd relax, you get the job and you'd move on.

00:39:44.480 Today, you never see those little bathroom bookshelves anymore. Nobody has that because

00:39:48.940 we're all bringing our smartphones in. And the problem is that just like we've learned in other

00:39:53.400 spheres, like when we're trying to go to sleep or when we're trying to have some social connection

00:39:58.200 at the dinner table, the smartphones distract us and really hijack our brains to keep us fully

00:40:04.940 engaged with whatever app we're on. The same thing happens in the bathroom. And so we did this

00:40:10.340 study in my laboratory two years ago, where we asked people who were coming in for their

00:40:15.900 screening colonoscopy all about their bowel habits and whether they use their smartphone

00:40:19.460 on the toilet. And then we looked to see when we did their colonoscopies, whether they had

00:40:24.500 hemorrhoids or not. And it turns out that one, yes, all of us are bringing our smartphones in

00:40:29.720 like two thirds of the people who we interviewed were bringing their smartphones into the bathroom,

00:40:33.600 but the ones who did, they were 46% more likely to have hemorrhoids. So yikes. And then

00:40:40.240 And two, they were five times as likely to be spending more than five minutes at a time

00:40:45.080 in the bathroom, just bringing your smartphone in.

00:40:47.040 And that was after controlling and taking into account how constipated they were or

00:40:51.700 how much they strained.

00:40:52.560 Those things were actually, there were no differences between the smartphone users and

00:40:55.660 not.

00:40:55.920 So really what we think is the problem is the time.

00:40:59.200 The amount of time you spend there sitting on this open bowl with no pelvic floor support,

00:41:04.000 hemorrhoids are just these cushions of veins.

00:41:06.020 And those veins eventually start to passively fill with blood.

00:41:09.740 and when they become engorged, they pop out, that's when we call them hemorrhoids. And that's

00:41:13.380 when we say they're uncomfortable and painful. But if you sit there like that, you know, it's

00:41:17.600 not going to happen after just doing it for one time. But if that's your pattern, you do that

00:41:20.640 every day for weeks to years, eventually we think that connective tissue around them

00:41:25.420 weakens and you get a problem. So that's why we tell people, one, bring back the old fashioned

00:41:30.360 bathroom reader, like throw in that like weird old comic book that you actually can only read

00:41:35.280 one page of free to move on or just set like a two TikTok limit. But sometimes I go into these

00:41:40.180 public bathrooms like at work and like I'll hear somebody watching an episode of The Pit. That

00:41:44.480 happened to me last week. And I was like, first of all, I know what episodes you're on. And like,

00:41:48.680 this is not the place. Like just pull your pants up and go watch it at your desk. You don't have

00:41:52.620 to do this in the current compromised position that you're in. All right. So you limit your

00:41:56.720 time on the toilet unless you want hemorrhoids and hemorrhoids are fun. Yeah, exactly. No,

00:42:00.660 indeed. Speaking of going to the bathroom in public, a lot of people have problems with that.

00:42:04.800 And some people, you know, we talked about earlier, you know, they feel relaxed enough to poop at Target, but some people don't feel comfortable pooping in a public bathroom. But as you said earlier, if you feel in that urge, you should probably go if you don't want to get constipated. So how do you get over that, I don't know, reluctance to go to the bathroom in public?

00:42:24.500 Yeah, it's a lot of strategizing, but I do feel really strongly about this, that

00:42:29.280 you should go when your body tells you it's time to go because you're going to make it harder on

00:42:34.420 yourself and you're going to strain harder later if you don't respond. And so one, I think, and

00:42:40.020 this is something that like medical doctors are just surprisingly very good at. You should identify

00:42:46.700 like well in advance, do a reconnaissance mission. Like what are the safest bathrooms

00:42:51.980 in your building? What is the safest bathroom if it's not in your building in the cafe next door

00:42:56.660 or at the Barnes and Nobles nearby? If you're out in public, find what the safe, quiet bathroom is

00:43:01.480 well in advance. And then don't share that secret with anyone. Keep it to yourself. But if you're

00:43:06.460 in a situation where you are like just caught with whatever bathroom is on hand and there's

00:43:10.120 lots of people there, I actually sometimes tell people put some headphones in and just tune out,

00:43:15.740 like do a noise canceling thing or play some nice music so that you're not distracted and worried

00:43:21.080 and thinking about what everyone else is doing

00:43:23.360 and you're so worried that everyone's thinking about you

00:43:26.120 and they're listening for any sound you might be making

00:43:28.560 and once you just tune them out

00:43:30.900 and put the headphones in,

00:43:32.380 it can really help you just focus on the moment at hand

00:43:34.980 because your goal is to just get in and out too.

00:43:37.300 And this actually goes two ways.

00:43:38.600 If you're somebody who's sitting in a stall

00:43:40.720 and since somebody else comes in next to you

00:43:42.940 and has to go and you're just sitting there on TikTok,

00:43:46.640 you have to be a good citizen

00:43:48.400 and pull your pants up and get out of there.

00:43:50.600 Like don't keep scrolling because you have to do unto others as you'd like to be treated yourself.

00:43:55.660 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.

00:44:00.540 If you like really feel like you have to, you can shake the toilet paper holder.

00:44:03.900 You can like play some alarm ringtone on your cell phone and something to distract yourself and distract everybody else.

00:44:10.420 If you really feel like you want to.

00:44:12.300 I actually I don't mind going to the bathroom in public.

00:44:14.680 And like when I hear when other people are taking care of business, I'm like, OK, you're taking care of business.

00:44:18.880 That's what you're supposed to do here.

00:44:20.740 Yeah, good for you.

00:44:21.480 You're in the right spot.

00:44:22.260 You're in the right spot, you know?

00:44:24.200 Besides pooping in public,

00:44:26.080 one thing that can throw off your bowel movement schedule

00:44:28.080 is traveling.

00:44:29.540 I've got an issue with this.

00:44:30.500 Whenever I travel, my intestines are just like,

00:44:33.560 we've closed up shop.

00:44:35.100 Yes.

00:44:35.560 What's going on there?

00:44:37.420 Yeah, this is very, very common.

00:44:39.380 When we travel, a lot of different factors

00:44:42.680 conspire against our colon at the same time.

00:44:45.240 So first of all, like your colon operates

00:44:48.660 on a circadian rhythm.

00:44:49.560 And like, let's suppose you're going to Europe for spring break and suddenly your colon is

00:44:56.100 waking up like at 2 a.m. and it's not actually time to go and it's all thrown off or you

00:45:02.320 start to sleep in late.

00:45:03.860 You don't wake up on time.

00:45:04.820 You sleep in.

00:45:06.260 Maybe you would usually drink coffee in the morning and take the dog for a walk.

00:45:10.420 Now you're not doing that.

00:45:11.400 Now you're lounging in bed and just transferring your body from bed to beach and you're not

00:45:16.700 doing all those things that usually prime your body successfully for bowel movement. And then

00:45:21.700 second, I mean, a lot of us, this is myself included, the best part of travel is the food

00:45:26.780 half the time. We go, we want to try local cuisine, but when you go to Europe, and this is

00:45:31.460 what I see with a lot of college students who are my patients, you should go eat the local food for

00:45:36.440 sure, but you can't eat six bowls of pasta in a row without any form of impunity. And I really

00:45:44.240 think that people need to aggressively seek out fiber when they're on vacation more so than they

00:45:49.360 would at home. Like if you eat a ton of fiber at home and then suddenly you eat half of that or

00:45:54.380 less than half of that, your colon is going to respond and react and it's not going to be happy.

00:46:00.160 And then lastly, I think people do get dehydrated on vacation. People are drinking more often like

00:46:04.840 alcoholic beverages. They're out walking around being tourists. They're just not drinking as much

00:46:09.700 water and all of these things together. And let's like not even forget about the fact that we're

00:46:13.980 stressed because we're traveling with our families half the time, or maybe we have to share a bathroom

00:46:17.800 with our cousins. Like all of these things come together at once and it makes it really hard to

00:46:22.120 stay regular. Okay. So I think we've covered a lot here about poop. Let's say we've taken care

00:46:27.620 of business. There's the wiping part, but you make the case for the bidet. Oh yeah. Why do

00:46:32.920 you think everyone should get a bidet? I love a bidet and you'll never meet somebody who has a

00:46:38.460 bidet who feels like just medium about it. Once you try. Yeah. We got a bidet a couple of years

00:46:43.240 ago. And I'm like, everyone should have this. What have we been doing in the United States

00:46:46.840 that we haven't had this? Exactly. You feel like you're born again. It's like, you want to make

00:46:51.900 sure everybody knows about this. You make people feel bad if they haven't seen the light. Like

00:46:56.400 that's what bidets do to you. It's obnoxious, but bidets are so wonderful. And the weird thing is

00:47:01.300 like, well, I, you know, and I talk about this all the time and normally the pushback I get

00:47:04.420 from Americans who haven't tried them before is like, you know, this is one, this is really weird.

00:47:08.900 Like, why would I want like anything touching me back there? And first of all, like obviously

00:47:12.800 bidets are for external use only, but it's not any weirder. If you take a step back,

00:47:19.220 wiping is the weirdest thing we can do, right? Like if I saw, you know, I mentioned I had a

00:47:23.860 two-year-old, if I'm changing his diaper when he was a baby and I got a little poop on my hand,

00:47:29.240 this happens. The last thing I would do is just wipe that poop off my hand with a paper towel

00:47:34.020 and then just go about my day as normal. Yeah. The analogy I've heard is like,

00:47:37.280 if you've got, if you're out in the garden working and you got mud on your arm, like you

00:47:41.440 wouldn't get a paper towel and just rub the mud because like it wouldn't come off. You would put

00:47:45.600 it underneath the sink. And that's mud. Totally. You got to get some water on that. And yet for

00:47:49.780 some reason, this like absolute most delicate part of our body, I think this part is underappreciated

00:47:54.580 that that area is that skin is actually quite delicate. I think we think it must be so sturdy

00:48:00.980 because it's standing up against yucky poop, but actually it's really soft and delicate and it can

00:48:05.460 hair quite easily. A bidet is gentle, clean, hygienic. And I found a lot of people who don't

00:48:13.700 even realize they're the kind that would benefit from it. Like, you know, I tell people who I treat

00:48:18.220 a lot of patients who have Parkinson's disease or trouble moving. They love bidets because they

00:48:22.980 don't have to worry about balancing and reaching back there. A bidet just takes care of that. 0.99

00:48:27.000 But actually like everyone would benefit from it. Think about women who are on their periods. A bidet 1.00

00:48:31.980 is so delightful because you have a lot going on at once half the time when you're postpartum a

00:48:37.220 bidet is lovely because you want to be very gentle people have hemorrhoids people have fissures

00:48:41.160 people who just have really hairy bums people feel like just wiping and it doesn't really like

00:48:46.780 get everything out when you have a lot of hair back there a bidet solves all of this for you

00:48:51.420 yeah no more dingleberries yeah and then you can get like the kind with the like

00:48:55.460 heated oh yeah that's what we have and then it's got a fan so after you're done

00:49:00.660 yeah just dry full service yeah and they're affordable they're not that expensive and

00:49:05.960 they're easy to install like you don't have to get like a separate bidet that you put next to

00:49:09.720 your toilet it's just it's an attachment right on your toilet yeah and let's just like emphasize

00:49:14.600 it's an attachment that runs through your clean water supply this is a common like concern like

00:49:19.480 are you just splashing dirty water back at you like absolutely not this is splashing clean water

00:49:24.480 it goes to your clean water so there's no risk of weird backsplash and then some people if they

00:49:29.000 don't go bidet, I'll just use like the wipes, like adult diaper wipes, essentially. Those are

00:49:33.880 nice, but the problem is you're not supposed to flush them down the toilet. Exactly. Even the

00:49:38.240 ones that say flushable, which a lot of them do, you actually can damage your pipes and they're

00:49:43.420 not actually as degradable as we'd like. So if you're starting to throw those in the little can

00:49:49.360 next to your commode, eventually when those build up, you're like, why didn't I just get a bidet?

00:49:54.000 Like that's not pleasant either. It's interesting the cultural differences about wiping. So I lived 0.75

00:49:58.280 in mexico for two years when i was in my 20s and i remember when i first got there and i was living 1.00

00:50:03.840 with some mexicans a lot of them don't flush the toilet paper they'd have like a waste basket 1.00

00:50:08.120 and they just wipe and put it in the trash i'm like that's interesting so i had to start doing 1.00

00:50:13.500 that it was kind of weird for two years to wipe oh it's the worst i i saw that a lot in europe

00:50:20.220 too where there was no bidets and like in morocco when i was traveling and i think it's like a

00:50:25.160 plumbing issue. The pipes were really old and you have to be really careful. But good God,

00:50:29.560 if ever there was a sign to get a bidet at that point. But if you do have to wipe,

00:50:33.780 you suggest not to wipe, but to blot. Yeah, I'm a blotter or a dabber. I like a dab. And again,

00:50:39.800 that's because I see people... In my line of work, people are often prepping for colonoscopies or

00:50:45.020 they have some condition where they have diarrhea and they're constantly wiping. That area just

00:50:49.280 gets inflamed and red and unhappy very, very quickly if you're doing a lot of wiping. Just

00:50:54.440 dab like you don't need to go like overly aggressive just dab because that skin is so so 1.00

00:50:59.260 delicate so speaking to this pliability of the three piece of pooping making our poops easy to

00:51:05.520 get out what can we eat to for optimal poop health well there's three layers of what i tell people to

00:51:12.920 just like the first one is eat more fiber and actually like if i could do nothing else that's

00:51:16.800 like one two and three because we're all struggling i'm actually like delighted that you hit 60 grams

00:51:21.160 For men under 50, it's like 38 grams.

00:51:23.300 For women, it's 25.

00:51:24.160 And a lot of us just aren't meeting that.

00:51:25.500 So if you can do that by any means necessary, even if that's a fiber supplement, I would

00:51:30.060 chalk that as a win.

00:51:31.860 But the second sort of thing that has been shown, like if you're doing that and you're

00:51:35.900 ready for the 102 level course, the second thing that's really been shown to help with

00:51:39.840 your gut microbiome.

00:51:40.860 So those are the trillions of microbes living in your colon and their genetic material is

00:51:46.280 to have a diversity of plant-based sources in your diet every week.

00:51:50.920 And that contributes to the diversity of those microbes.

00:51:53.980 And you want that.

00:51:54.820 That's a marker of good health and of a healthy microbiome is the different, different numbers

00:51:59.420 of species in there.

00:52:00.800 And those microbes, you know, just remember, they're not just sitting there.

00:52:04.820 They're not passive actors in your colon.

00:52:06.780 They're taking what you're feeding them and fermenting it and creating these new compounds,

00:52:11.680 which sometimes are called postbiotics.

00:52:13.240 But they're like things like short chain fatty acids that get absorbed into the bloodstream

00:52:16.760 and go to other parts of your body.

00:52:18.220 So it is really important what you feed them and how you think about them.

00:52:21.560 So eating a diversity of plants is the second thing that I tell people to try to aim to

00:52:25.560 do.

00:52:26.000 So meaning like don't eat the same routine thing every single day for lunch, every single

00:52:31.360 day for dinner, like start to diversify that.

00:52:33.400 But then three, and this is, I think, the hardest one, the 103 level course, is to start

00:52:38.480 incorporating fermented foods into your diet.

00:52:41.360 This is like the thing that every gastroenterologist like loves to preach about.

00:52:44.800 But there have been some really powerful studies showing how even two groups of people both

00:52:49.520 eating a high fiber diet, when one of them adds fermented foods, their microbes produce

00:52:54.720 even more anti-inflammatory compounds and you can measure those in the blood.

00:52:58.640 And so fermented foods are like kind of hard.

00:53:01.440 Sometimes they're not like necessarily the obvious things that we think of in a typical

00:53:04.740 American diet, but you can get them through just like Greek yogurt, which is the most

00:53:08.780 common thing that I usually eat and incorporate into my diet every day because it's very

00:53:12.720 filling.

00:53:13.060 It's like makes a great breakfast.

00:53:14.800 I eat it that way.

00:53:15.340 But it's also stuff like kombucha, sauerkraut, kimchi.

00:53:19.120 They're even present to some extent in like sourdough bread or soy sauce.

00:53:23.240 Like they're there.

00:53:24.020 So the more you can incorporate and start getting in the habit of throwing in fermented

00:53:27.720 foods into your diet, like that'll give you even that extra boost.

00:53:31.160 So yeah, my morning, my diet in the morning is like my colon morning.

00:53:35.460 And so in the morning, I have eggs with these like fiber wraps.

00:53:37.640 That's where I get a lot of the fibers, these fiber wraps.

00:53:39.980 And then I have like a mid-morning meal where I'll have oatmeal or it could be like a high

00:53:44.780 fiber cereal and then I'll put some Greek yogurt in there and then some blueberries. And then I

00:53:51.120 also eat some either sauerkraut or kimchi with my eggs first thing in the morning.

00:53:54.920 Oh, wow. I love that. That's like a perfect breakfast. You've got all of the components

00:53:58.460 in there. Yeah. Well, Tricia, this has been an amazing conversation. I've been doing this for,

00:54:03.040 you know, 17 years. I never thought I'd have a podcast about poop, but I did.

00:54:07.000 This is a great one. Where can people go to learn more about the book and your work?

00:54:11.180 Well, they can get the book

00:54:13.080 You've Been Pooping All Wrong

00:54:14.040 anywhere that they get books

00:54:15.180 and they can follow me on Instagram

00:54:16.680 at Trisha Pasricha MD

00:54:18.260 Fantastic

00:54:19.160 Well, Dr. Trisha Pasricha

00:54:20.420 thanks for your time

00:54:20.820 it's been a pleasure

00:54:21.280 Thanks, Brett

00:54:22.480 this was so much fun

00:54:23.240 My guest today was Dr. Trisha Pasricha

00:54:26.340 the author of

00:54:26.940 You've Been Pooping All Wrong

00:54:27.820 it's available on Amazon.com

00:54:29.300 and bookstores everywhere

00:54:30.080 you can find more information

00:54:31.220 about her work

00:54:31.660 at our website

00:54:32.260 TrishaPasricha.com

00:54:33.600 also check out our show notes

00:54:34.860 at AOM.IS slash poop

00:54:36.320 where you can find links

00:54:36.980 to resources

00:54:37.540 where you can delve deeper

00:54:38.200 into this topic

00:54:38.740 including an article

00:54:40.320 on our top 10 toilet books

00:54:41.700 so you can start building

00:54:42.680 your bathroom library.

00:54:51.440 Well, that wraps up

00:54:52.440 another edition of the A1 Podcast.

00:54:54.120 If you haven't done so already,

00:54:55.040 I'd appreciate it

00:54:55.700 if you take one minute

00:54:56.440 to give us a review

00:54:57.280 on the podcast player you use.

00:54:59.040 And if you've done that already,

00:54:59.960 thank you.

00:55:00.660 Please consider sharing the show

00:55:01.820 with a friend or family member

00:55:02.860 who would think

00:55:03.300 you could get something out of it.

00:55:04.380 As always,

00:55:05.240 thank you for the continued support.

00:55:06.220 Until next time,

00:55:06.680 it's Brett McKay.

00:55:07.700 Remind you to listen to A1 Podcast,

00:55:08.820 but put what you've heard into action.

The Art of Manliness - April 07, 2026

You’ve Been Pooping Wrong： Here’s How to Do It Better

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