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

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00:02:05.660 greens per box with news subscription only. Brett McKay here, and welcome to another edition of

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00:02:41.020 pooping everybody does it but a lot of people are embarrassed to talk about it that's a shame

00:02:54.160 my guest says not only because your digestive health is incredibly linked to your overall health

00:02:58.240 but simply for the fact that there's much happiness to be found in an easy

00:03:01.680 worry-free constitutional harvard gastroenterologist dr trisha push reaches the author of you and

00:03:07.260 pooping all wrong. How to make your valve movements a joy. Today on the show, Trish and I have a fun

00:03:11.860 and frank conversation about the art and science of valve movements, including the color of healthy

00:03:15.740 stools, how often you should be pooping, if laxatives are safe to use, the food to eat that's

00:03:20.420 even better than prunes for getting things going, why you feel the urge to go poop at Barnes and

00:03:24.160 Noble, the wonders of the bidet, the danger of using your smartphone on the toilet, how to get

00:03:28.520 more comfortable pooping in a public restroom, and more. After the show's over, check out our

00:03:32.460 show notes at awimp.is. All right, Dr. Tricia Pasrisha, welcome to the show.

00:03:48.440 Thank you so much for having me, Brett. Glad to be here.

00:03:50.680 So you are a medical professor of gastroenterology. That's a hard word to say. I had to look it up how

00:03:55.900 to pronounce it. You specialize in gut health and a big part of your work involves researching and

00:04:01.740 talking a lot about poop. Oh, yeah. How'd you end up doing what you do?

00:04:07.080 Well, I kind of am a second generation gastroenterologist. I grew up as the

00:04:12.540 daughter of a gastroenterologist. And when you grow up like that, you think that talking about

00:04:17.080 poop every day is perfectly normal. And you think that that's what everyone else is doing.

00:04:21.560 And it was delightful. My father was and still is a gastroenterologist, but he was also a

00:04:27.240 researcher. And he was just so excited to tell me and my siblings about the cool stuff he was

00:04:35.400 discovering in his lab every day after he came home from work. And he was describing how

00:04:39.720 colonoscopies worked. And all of this I know now sounds really bizarre, but at the time it was just

00:04:44.980 what we talked about at the dinner table and how cool science was and specifically when it came to

00:04:50.540 our gut. So I loved it. And it was kind of what I grew up thinking was the coolest thing in the

00:04:55.620 world. So I knew I wanted to be a gastroenterologist since I was like a little girl. I had never

00:05:01.340 imagined wanting to be anything else. But then, you know, when I came to medical school and then

00:05:06.540 I started doing my own training, I really started to realize what a weird gap there was between what

00:05:12.700 other people seem to have learned about poop and their bowel movements and how their gut works

00:05:16.980 and what I learned. And people, for the most part, it seems like didn't really talk about

00:05:22.800 their guts and their poop after they turned like three or four. And it was like something everyone 0.71

00:05:27.820 just like stopped bringing up at the dinner table. And so I kind of went on this mission and it just

00:05:33.260 started with me talking to my patients about trying to normalize these conversations and

00:05:36.960 having them out loud. And ultimately that led to writing the book. But I really do think that

00:05:41.900 people need to have conversations more loudly because 40% of Americans are suffering from

00:05:48.620 bowel habits that disrupt their daily lives, but you wouldn't know that because we're so quiet

00:05:52.580 about them. Yeah. I mean, unlike you, we didn't talk about poop at the dinner table. I don't even

00:05:59.420 remember having conversations about my bowel movements with my family. And that carries over,

00:06:05.800 I think for a lot of Americans, to how they approach talking about it with their doctor.

00:06:10.100 As you said, a lot of Americans have bowel problems and it can cause a lot of discomfort,

00:06:15.820 a lot of inconvenience in their life. And a lot of it is preventable. Yeah. Well, let's talk about

00:06:20.640 this. I think one of the reasons why people have a hard time talking about it is they don't know

00:06:24.600 how to talk about poop. So when they go to the doctor saying, I got this problem with my bowel

00:06:29.620 movements, I mean, what should they call it? Because you're always like, do I call it bowel 1.00

00:06:33.020 movement? Do I get scientific and call it stool, feces, human soil? Like what do we, what do you

00:06:39.100 call it? Yeah. Liquidating your assets, like whatever you want. I have found that I use the

00:06:45.720 word poop usually, unless somebody leads with another word that they find more comfortable.

00:06:50.780 And the reason I do that is when I was in medical training, the kind of formal word that all doctors

00:06:56.460 use is bowel movement. And so that's what I was trained to start saying. And I certainly started

00:07:01.220 saying that. And I had one professor who was a gastroenterologist and he was my research mentor

00:07:06.880 in medical school. And I shadowed him and he was the first guy I had ever seen, like this doctor,

00:07:13.620 middle-aged gentleman. And this young patient came in and he was like, so tell me what your poop 0.73

00:07:19.920 looks like. And I like looked at this guy and I was like, this is so weird. You're this doctor,

00:07:24.100 this white coat. That's the weirdest, you know, I've never seen a doctor say that like that in

00:07:27.660 a clinic before. But when he said it, this young patient in his twenties, like suddenly smiled for

00:07:32.920 the very first time. And like just the whole atmosphere in the room changed. And this guy

00:07:36.540 just totally shared exactly what was going on with him. And you could just tell it broke the

00:07:40.620 ice. It made it comfortable. And after that, I never looked back because I know oftentimes when

00:07:45.100 I tell people, Oh, tell me about your bowel movements. You know, everyone stiffens up a

00:07:50.040 little bit and they, they, and they too try to match my level of medicalization. And if you

00:07:55.260 could just tell me what's bothering you, I want to use whatever words make you comfortable. So

00:08:00.260 I think someone should lead with the words they want to use that allows you to talk about it most

00:08:04.840 freely. And my hope is that your doctor is going to meet you right there. Okay, that's great. It's

00:08:09.500 funny. Bowel movement. So my name is Brett McKay. This is sort of a tangent. So when you get the

00:08:14.580 initial things, it started when I was in middle school because I got really self-conscious about

00:08:17.880 it. Initial BM. And I had some kid be like, BM, poop. And so now ever since then, I do BHM. That's

00:08:25.780 my middle, middle initial. Oh my gosh. No, you should embrace it. I've embraced TP as a

00:08:30.400 gastroenterologist. All right. So if you can do that, I can, I can go back to BM. I'm going to

00:08:35.760 embrace the BM. So you described this idea of puphoria in your book. What is puphoria?

00:08:43.080 Yeah. Pouphoria. It is a state that I want everyone to reach. And that is where having

00:08:49.680 a bowel movement is the absolute least of your daily concerns. It's this easy, effortless thing

00:08:55.060 that happens quickly without straining. And then you go about the rest of your day and live your

00:08:59.740 best life. You're not worried about feeling heavy for the rest of the morning or day because you

00:09:05.380 didn't have that window to go, or you're worried, should I go out to brunch with my friends? Or

00:09:09.780 should I even meet people for dinner because I'm so worried about the bathroom situation? That's

00:09:13.340 not, I don't want you to live like that. And tragically, I think a lot of people are right

00:09:17.200 now. So Puforia is a state of mind and it's a lifestyle that I think we can all reach. Some of

00:09:24.160 us with just a little bit more knowledge about our bowel habits that we just never got. Because

00:09:29.740 the last time we talked about our bowel habits with another soul was usually when we were potty

00:09:34.200 training with our mom and dad. And that was a long time ago. Most of us cannot remember that

00:09:37.900 conversation. So a healthy bowel movement, you're not even thinking about it because it's just not

00:09:42.900 even on, you don't have to worry about it at all. Yeah. You're not obsessed about, I mean,

00:09:46.940 there's another end of the spectrum where people, I mean, and this can be quite understandable,

00:09:50.580 people fixate on their bowel movements all the time. Like they're worried about like,

00:09:54.360 did I go yet today? If I don't go, I feel off. And even if there's someone who you might look

00:10:00.160 from the outside and say, okay, they're going once a day, they're regular. But if you're thinking

00:10:03.060 about it all the time, you're becoming paranoid. If you haven't gone, that's not pooforia either.

00:10:07.460 Well, let's talk about what healthy poop looks like. And hopefully we can answer some questions

00:10:11.360 that people have always wondered about it. Let's start with the color of poop. First off,

00:10:15.620 why is poop usually brown? Yeah, the natural color is actually not brown. The natural color

00:10:22.360 of our poop is like this whitish clay colored, like kind of like a grayish. And what gives it

00:10:29.160 its beautiful brown color is bile. So our body produces this digestive juice. It has bilirubin

00:10:35.500 in it. And that's just this chemical that gives it that brown color. But if we were to take that

00:10:39.960 away, it would actually look bizarrely whitish. And that is why if you ever see like a pale, 0.60

00:10:46.960 whitish, creamy stool, that's a problem. That's an emergency. It means that that bile is somehow

00:10:51.600 being blocked somewhere. Maybe it's a gallstone. It could even be a cancer. But if you ever see

00:10:56.140 that, that's a big, big red flag. Go to the emergency room. But then other than that,

00:11:00.940 the normal color should be some shade of brown. And then, of course, everybody poops the rainbow 0.75

00:11:05.380 from time to time. I get these kinds of DMs like every week where someone's like, I had a really

00:11:09.440 weird purple poop or my poop was kind of greenish. Is that normal? And it can be normal. A lot of 0.69

00:11:14.880 times we eat things that we don't put together could impact our poop. Like for example, a classic

00:11:20.720 one is beets. If you've ever eaten beets, you are probably going to have a maroon poop the next day

00:11:26.980 or maybe the next day or two. And that's just the beets. That's okay. But if you haven't eaten

00:11:32.080 those beets and you see anything that looks like red, that would be really worrisome for bleeding.

00:11:36.460 So like bright red, maroon, or even like pitch black and shiny, that could all be blood.

00:11:42.680 So yeah, black poo, that could be okay. 1.00

00:11:45.320 Sometimes it suggests there's some sort of internal bleeding going on up your tract.

00:11:49.320 But sometimes there's like, I think iron supplementation can cause black poop.

00:11:54.580 Yeah, you can have this real chicken and egg situation because sometimes people are taking

00:11:58.780 iron because they're having some bleeding and they've lost blood.

00:12:02.300 But then you see black poop and you're like, is this because you're taking iron to treat bleeding or is it because you're bleeding?

00:12:09.040 Yeah. And then I guess Pepto-Bismol can also cause black poop. 0.94

00:12:14.120 Yeah. I feel like we always forget to warn people about Pepto-Bismol because it can turn your tongue black, it can make your poop black, and then people are really horrified the next day.

00:12:22.220 But if you've taken Pepto-Bismol black poop, you're allowed to have a few black poops. 0.99

00:12:26.140 And another interesting fact about Pepto-Bismol that you put in the book is that if you don't want your farts to stink before, you know, like a date or something, take Pepto-Bismol before and that will make your farts less stinky.

00:12:38.900 Okay, so poops naturally clay color until it meets with bile. 0.97

00:12:42.880 But this is one of those things that can freak me out because like, I mean, you hear if you have like a clay colored stool, you know, that can mean you have pancreatic cancer or bile duct blockage.

00:12:52.060 and I can be looking at a light poop thinking like what is that a is that clay color like I

00:12:58.720 think there are different colors of clay and I think well clay's maybe a light tan so maybe my

00:13:03.200 poop is looking like clay but we're talking about like white clay like it has to be basically white

00:13:07.640 yeah I guess you're right there's like nice different there's earthy tones of clay this

00:13:12.140 I'm talking about more like a whitish creamy color or kind of gray and I would say you know

00:13:17.520 when in doubt, I mean, everyone's poop is going to look a little different. If you have any doubts,

00:13:22.300 I always tell my patients, picture it didn't happen. Take a picture of it and then send it

00:13:27.480 through your like electronic medical record and show your doctor and just like have them lay eyes

00:13:31.240 on it. A doctor will be able to tell you really quickly, am I worried or excited about this or

00:13:36.520 not? Gotcha. And then red, if you haven't eaten beets, if you see red, that's another thing you

00:13:40.980 might want to go see your doctor about because it could be colon cancer, but it could be something

00:13:45.660 as benign as a hemorrhoid or an anal fissure or something like that. Totally. Yeah. And most of

00:13:50.940 the time, you know, it is going to be something not worrisome. It's going to be a hemorrhoid.

00:13:55.140 But what I never want someone to do, especially in this stage in 2026, where we are seeing this

00:14:00.320 really disturbing rise in early onset colorectal cancer is for someone to see bleeding and brush

00:14:06.120 it aside. I mean, this is the trend we're seeing in studies. And with this, this rising cases that

00:14:10.740 young people, when they see blood, they're like, this is just my hemorrhoid, or I'm pretty sure 0.98

00:14:14.880 this is no big deal. It's always better to just quickly let your doctor know and let your doctor

00:14:20.440 reassure you and be like, oh yeah, we'll just do a quick exam. We'll make sure it's your hemorrhoid.

00:14:23.840 No problem. But make sure that someone's taking a look and giving you that reassurance rather than

00:14:28.480 just brush it off yourself. Let's talk about the shape and consistency. What does a healthy

00:14:33.220 poop consistency and shape look like? Yeah, I think most people think that a perfect shape

00:14:39.780 would be like this nice, like smooth sausage shaped. And then you go and like people really

00:14:45.160 aim to get this like wipeless wonder. And that is wonderful. That is like a nice consistency

00:14:49.780 that a lot of people have. But there's really such a range of what could be normal. And I would tell

00:14:56.120 people that for the most part, if you start eating a lot more fiber, which a lot of us are not doing,

00:15:02.120 like 95% of Americans are not meeting our fiber goals. If you start to do that, it actually

00:15:06.520 becomes less and less likely that you're going to have that smooth little sausage that everyone

00:15:11.080 wants. You're going to start to have fluffier and fluffier stool. You might even start to go more

00:15:14.540 often. That's perfectly normal. It can be totally normal. And people sometimes when they do that,

00:15:19.380 they're like, I have diarrhea because I'm going three times a day and it's so soft. That's fine.

00:15:23.560 As long as it's not like interfering with your social life, you know, there's a range of normal.

00:15:26.900 And in fact, you should embrace that new you because it means you're doing something healthy

00:15:29.540 for yourself. And then, you know, on the flip side, sometimes when people are having these like

00:15:33.500 really, really tiny rabbit pellets, usually I say that that indicates that there's an issue

00:15:39.180 with constipation. But sometimes the fix can also be quite simple. It can be you need to hydrate

00:15:44.100 more or you need to not hold it in. We do that as adults. We have this urge to go. Sometimes it's

00:15:49.460 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

00:15:53.580 to go right now. I feel the urge. I'm not going to go. And when you do that, you're setting yourself

00:15:57.260 up for failure because that stool is just going to dry up and become more hard so that when you

00:16:01.800 decide you want to go later, it's not the same one that you started with 12 hours ago. It's a

00:16:05.780 totally different one. It's going to be more pebbly. So it's better to try to go when your

00:16:09.860 body tells you to, and you're going to get a little bit closer to that median. Gotcha. So

00:16:13.940 what happens to our stool whenever we get diarrhea? Why does the body decide this stuff 0.65

00:16:20.780 needs to be liquid and get out fast? Like what's happening there? Yeah, there's lots of different

00:16:26.300 causes. But, you know, in terms of your anatomy, your small bowel, which is that first part of the

00:16:31.800 tube after your stomach, the main point of your small bowel is to absorb all the nutrients. And

00:16:37.180 it's sucking out everything that it wants and breaking it down. And then the stuff that it

00:16:40.400 can't break down, which is usually like the fiber, which we actually don't possess the enzymes to

00:16:45.060 break down. It makes its way to our microbiome in our colon. Well, the colon has several jobs.

00:16:49.940 One of them is to suck water out of the stool as it passes through. And stool passes a little bit

00:16:55.140 more slowly through the colon. So your colon has a lot of time to get that water out. But if

00:16:58.380 something happens that triggers that poop to move forward, and sometimes it's stress,

00:17:04.320 stress can cause our colon to suddenly start to contract. That means we haven't had time

00:17:09.220 to remove and absorb all the water out of it yet. So it's going to gush out like diarrhea when we're

00:17:14.140 stressed. Spicy food does that. Spicy food sends this signal down to say, okay, evacuate everything

00:17:19.480 we have. That too will make whatever comes out to be a little bit fiery, a little uncomfortable,

00:17:24.300 and it'll also be pretty liquidy. And then there's other things like infections or just

00:17:28.660 depending on how things are going with other aspects of your life, travel and exercise,

00:17:33.220 those things can also help speed things up. But before you've really had a chance to absorb all

00:17:37.420 the water. Gotcha. And constipation is just the reverse. It's been in the colon too long. So all

00:17:41.660 that water has been sucked out. Yeah, exactly. And there's a ton of different reasons why things

00:17:46.600 slow down and why we can get constipated. And you're right. The longer we sit there,

00:17:51.020 the longer that stool is just, your colon is going to keep doing its job and it's going to

00:17:55.240 keep making it harder and harder, which is why I sometimes think the most important thing people

00:17:59.220 can do who are constipated is just as soon as they hear that call, feel that urge, respond,

00:18:05.300 because it's not going to be the same poop later on. What causes constipation? You said there's

00:18:09.320 lots of potential sources. Yeah. Well, when someone comes into my clinic and they have

00:18:14.180 constipation, I try to explain the way the colon works in terms of trying to get toothpaste out

00:18:18.980 of a toothpaste tube. So sometimes the issue is that we're not squeezing that toothpaste tube.

00:18:24.060 And that means that maybe there's something that's stopping the colon from contracting so much. We

00:18:28.900 need to do that. We need to generate pressure in order to push the stool outwards. And maybe 1.00

00:18:33.300 the problem is actually not that we're not squeezing the tube, but that the toothpaste

00:18:37.260 itself is rock solid. And sometimes that happens because maybe we're not getting enough fiber.

00:18:42.220 Maybe we're not drinking enough. Maybe there's something else that's making that stool really,

00:18:45.000 really hard. But then the third, and I think most underappreciated part of the problem is that,

00:18:50.060 yeah, we're squeezing hard enough. The toothpaste is super soft, but we forget to take the cap off

00:18:54.400 the toothpaste tube. And then we're just pressing up against this pelvic floor that is not

00:18:58.980 cooperating. And that is very common. That happens to about one in three people who have constipation

00:19:05.360 and who've tried different laxatives and different things and they've failed. And basically what that

00:19:09.460 means is that our pelvic floor, which is the set of more than a dozen muscles sitting there at the

00:19:14.060 bottom of our rectums. And they need to coordinate in this really highly orchestrated dance. Some 1.00

00:19:20.360 need to contract at the right time. Some need to relax. And for a lot of people, the sphincters

00:19:25.900 that are supposed to be relaxing actually contract when we bear down. If you think about it, we're

00:19:29.900 generating all this pressure to try to push our poop out. And people's sphincters contract. And 0.69

00:19:34.740 that's very paradoxical. It's not supposed to do that. So sometimes when you've tried everything,

00:19:39.180 The most obvious answer is actually something that doesn't involve anything related to your

00:19:44.200 colon, but actually it's all the muscles in your pelvis that's the problem.

00:19:47.560 Yeah.

00:19:47.680 You just went through what you call the three Ps of a good poop.

00:19:51.600 So propulsion, that's that bearing down, that Vassalva maneuver, we kind of get that thing

00:19:58.440 going.

00:19:58.680 Then the consistency, it's the pliability, the softness.

00:20:02.000 If it's hard, it's not going to come out.

00:20:03.720 And that pelvic floor aspect, sort of the cap on the toothpaste.

00:20:08.000 Yeah.

00:20:08.400 Yeah. And I think for someone to reach puphoria and to have healthy, effortless bowel wounds every

00:20:13.280 day, you have to think about how you're optimizing all three of those things. All three of those

00:20:17.360 things need to be working at their best in order to have a bowel wound because if even just one of

00:20:22.180 them is off, it's going to be hard to overcome it with just the other two. With the pelvic floor

00:20:26.660 piece, I think we think about that with just women because pelvic floor problems can result 1.00

00:20:31.600 after childbirth, but men can have pelvic floor problems too. And you recommend that if you have

00:20:37.200 a pelvic floor issue to go to a physical therapist who specializes in that. We'll talk about something

00:20:42.860 else you can do to help your pelvic floor when you're pooping later on our conversation.

00:20:46.820 Going to the pliability part of the three Ps of a good poop, this is the consistency of the poop.

00:20:52.140 Why does poop float sometimes? Yeah, a couple of different reasons. Sometimes if it's just

00:20:56.840 soft enough because it has enough soluble material, like enough fiber it'll float. Sometimes

00:21:01.280 fat, like fat floats in poop. So it depends on kind of what you've eaten and how well you've

00:21:06.620 absorbed it. There are certain conditions where people do not absorb nutrients and the food that

00:21:13.020 they eat as well as we'd like them to. And traditionally we think about those as resulting

00:21:17.360 in like really serious floaters. So there's like a range that could be normal, but if this is your

00:21:23.380 consistent pattern and you have any other symptoms, like you get pain, bloating when you eat,

00:21:28.600 if you have a lot of floaters in your stool, you should actually just run that by somebody and make

00:21:33.260 sure that you don't have an issue with absorption. Gotcha. I mean, so this is always a concern for

00:21:37.840 me because I read these articles like, oh, pancreatic cancer, colon cancer. And it's like,

00:21:40.680 oh, floating poop. And I'm like, my, okay, I'm, I'm, I'm going to be TMI here, but like minor

00:21:46.240 regular, regular floaters, but they look normal. They feel normal. I think it's because I just

00:21:49.280 eat a lot of fiber. I eat like 60 grams of fiber. Good for you. So I think that's what it is. Am I

00:21:55.360 right? Should I go see my doctor? Well, you can always, you should always run anything by your

00:21:59.640 doctor you're concerned about, but, but what you've described sounds very, very typical for

00:22:02.920 somebody who's just eating a lot of fiber. Once we start eating a lot of fiber and 60 grams is

00:22:06.500 like an A plus amount of fiber, then, you know, people's poop does change and people are really

00:22:11.900 caught off guard by it. The reason people say that floating poop is a sign of pancreatic cancer

00:22:16.700 is because the pancreas helps break down and helps you absorb that food. And when suddenly that stops

00:22:21.440 working so well, then you might see new floating poop for the first time. But that's not the only

00:22:26.900 sign often. Like sometimes people, you know, their skin turns a little yellow, they have pain in their

00:22:31.900 stomach. So if you're otherwise living your best life, run it by your doctor, but it's most likely

00:22:37.560 just because you're eating a ton of fiber, which is a great thing. Yeah, I'm a fiber maxer, as the

00:22:42.760 kids are saying these days. Yeah, yeah, me too. Let's talk about the schedule. What does a healthy

00:22:49.200 bowel movement schedule look like? Because I think there's this idea that you have to have a daily

00:22:53.040 constitutional to be healthy. Is there anything to that idea? There definitely is something to that

00:22:58.860 idea. And I think that this is because our bodies are naturally primed to have a bowel movement

00:23:05.320 first thing in the morning. And the reason for that is one of the things that makes the colon

00:23:09.760 a little bit different and special compared to other organs in our bodies is it really

00:23:13.840 operates on a circadian rhythm and it's a creature of habit. So when we go to sleep,

00:23:19.600 the colon goes into this really quiet state. It doesn't move around too much. That's why for the

00:23:24.600 most part, you know, people sometimes talk about waking up in the middle of the night to go pee.

00:23:28.320 it's pretty rare for people to wake up in the middle of the night to have to poop and that's

00:23:32.100 because your colon's not really moving but when it wakes up when you wake up and it operates on

00:23:36.920 the same circadian clock as you then that first one to two hours upon waking is when you see some

00:23:44.060 of the strongest contractions naturally occurring in your colon that you're ever going to get the

00:23:48.620 rest of the day for that 24-hour period it's during those first one to two hours that your

00:23:52.320 colon is doing the work for you and if you have a bowel movement when your colon is already

00:23:56.880 contracting, it means you have to do way less work. You have to bear down less. You don't have

00:24:01.220 to strain as much. So it's a nice window. And then people often in the morning start to stack

00:24:06.180 on other habits that help the colon contract too. Like for example, a third of people who drink

00:24:10.720 coffee, their colon is going to start to contract pretty quickly. People who go for walks in the

00:24:15.600 morning, just a little exercise can help stimulate those contractions. And we do a lot of those

00:24:19.200 things early in the morning. So it's a great time to have a bowel movement. All of that said,

00:24:24.000 there's just like a large portion of people whose mornings are totally hectic totally crazy

00:24:29.080 they don't have time for any of this and they don't go that doesn't mean that you have a problem

00:24:34.200 or that you're weird it just means that you need to find a time to respond when your colon's ready

00:24:39.220 and some other times during the day the colon will start contracting if you eat a meal so

00:24:44.280 oftentimes there's another wave of people who poop after dinner or poop after lunch that's totally

00:24:49.300 normal a lot of times people come to my clinic and they're like it's so weird that I have to poop

00:24:53.020 every time I eat. And I say, no, no, that's a completely normal reflex. In fact, it's like

00:24:58.180 a reflex that we're born with. Kids are pooping multiple times a day in response to eating. And

00:25:02.980 then later on as adults, we try to suppress that and try not to respond to that reflex for no reason

00:25:07.580 whatsoever. We should just respond. But it's actually a perfectly normal part of our human

00:25:11.640 physiology. So there's a range of what I'd consider normal. And what I usually tell people

00:25:16.440 is, no, it's not once a day. If you go once a day, wonderful. But you don't have to do that

00:25:22.460 in order to be closer to God, what I do want you to do is have an effortless bowel movement

00:25:27.460 whenever you go. It should be easy. If you go once a day, but you're straining your eyeballs

00:25:31.580 out for 20 minutes, I wouldn't consider that normal. So they've done a study in the US where

00:25:37.240 they found that people who consider themselves to have normal bowel movements go anywhere from

00:25:41.700 once every three days to up to three times a day. And anywhere in that big range could be

00:25:46.940 considered normal as long as, you know, it's effortless and you're comfortable and happy

00:25:51.320 with that pattern. And I imagine if you see a change in your schedule that lasts a long time,

00:25:56.720 you're like, well, maybe I should look at this. So if I usually do once a day and then I'm going

00:26:00.620 three times a day, well, that's interesting. I should probably check that out.

00:26:06.100 Yes. I tell people to get to know your own pattern and everyone's going to be different

00:26:11.020 and have some variation in their own life. Like you might be somebody who goes like clockwork

00:26:15.740 every day and that's perfectly wonderful and healthy, but you may also see that you have

00:26:20.640 some variations depending on whatever else you have during your week and how you travel and how

00:26:25.240 you exercise. These things will change, but get to know what kinds of patterns are normal for you.

00:26:29.200 And then most importantly, you should start looking every day. Like before you flush,

00:26:33.600 have a peek. The number of times I ask people, well, what did it look like? What color is your

00:26:37.600 poop normally? And people just get all embarrassed and say, oh, I don't know. I don't really look.

00:26:41.840 Well, I mean, first of all, how can you not look? I don't know how you resist that temptation,

00:26:45.480 but you should look so that then you know when something is different.

00:26:49.860 Yeah, speaking of looking,

00:26:51.540 have you kept up with these new AI devices

00:26:53.680 you can attach to your toilet

00:26:54.780 that takes a picture of your poop and give you a- 0.81

00:26:57.080 I've seen some of that chatter.

00:26:59.460 I'm excited about, I mean, one, I'm,

00:27:01.740 well, I think we're all like, oh my gosh,

00:27:03.180 a little horrified about the idea of a camera down there,

00:27:05.020 but I'm sure they've sorted out the privacy issues.

00:27:07.960 But I think, well, yeah, I mean,

00:27:09.680 I'm excited about what those could show us one day.

00:27:12.580 Yeah, because I mean, yeah,

00:27:13.300 I think looking at your poop tells you a lot

00:27:14.700 about your overall health.

00:27:16.640 We're going to take a quick break

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00:29:40.520 and applicable terms. And now back to the show. Speaking of schedules, and let's say someone,

00:29:48.120 they're like, I don't poop as often as I want. It makes me uncomfortable. I need to take a laxative.

00:29:53.700 But they're like, well, I don't want to take a laxative because I don't want to become dependent

00:29:56.960 on it or something. Is there a problem with taking laxatives to have a bowel movement?

00:30:02.180 Yeah, no. So I have a few thoughts about this. One is that just to take a big step back,

00:30:08.160 I don't think there's any problem with someone taking a laxative, especially because I know that

00:30:13.480 for some people, we can help and improve constipation with a lot of these different

00:30:19.200 tweaks and lifestyle changes and a lot of the sort of things I lay out in my book. But there's

00:30:23.240 also a group of people who have conditions and diseases and changes in the neurons, the nerve

00:30:29.040 cells of their colon, that some of these lifestyle changes are just not going to fix.

00:30:33.400 Constipation can be a disease like any other disease, like high blood pressure, like diabetes.

00:30:37.620 And there's no shame in taking a medicine to treat that. And so I do feel that there's often

00:30:42.840 a lot of shame and a sense of like self-failure for when you take a laxative. And if that's what

00:30:48.780 you need to be well, I don't think that that's the case. Now, that said, there are a lot of ways

00:30:54.900 to treat it that don't require laxatives, but know that laxatives are safe. You should use them

00:30:59.480 as directed by your doctor. And a lot of the earlier studies that kind of got people worried

00:31:05.200 that you could become dependent on laxatives, you were somehow damaging your colon, ultimately that

00:31:09.860 data was not very consistent or proved to be robustly true. So I worry a little bit less

00:31:14.420 about that, but I will say there are a lot of ways that you can improve your bowel habits,

00:31:18.960 become less constipated just by changing things about what you're eating and what you're doing,

00:31:22.900 and even the position of how you're sitting on the toilet.

00:31:26.080 I mean, it's very common that people don't want to take a medicines,

00:31:28.420 but you can take things as natural as like kiwis, right?

00:31:32.000 Like in our grandparents' times, people were taking prunes,

00:31:35.280 and prunes are incredibly effective.

00:31:36.780 But I have never successfully convinced a college student to take prunes.

00:31:41.440 It's like one of those things that people just don't reach for anymore these days.

00:31:44.080 But kiwis have been shown in multiple randomized control trials, 0.99

00:31:48.120 two kiwis a day, that they are as effective as prunes,

00:31:51.760 but they also don't cause bloating.

00:31:53.840 Like a lot of these like fiber supplements

00:31:55.360 and prunes can cause,

00:31:56.340 kiwis don't seem to do that. 1.00

00:31:57.360 So it's a pretty simple fix

00:31:59.040 that's relatively effective,

00:32:01.360 all things considered.

00:32:02.580 And it's not really a laxative.

00:32:04.340 It's actually just something that's high fiber,

00:32:05.640 got a lot of nutrients

00:32:06.360 and is good for you in other ways.

00:32:08.080 I like prunes.

00:32:09.140 I'm a prune booster.

00:32:10.900 You're pro prune.

00:32:11.680 I'm pro prune.

00:32:12.200 I mean, it's a dried plum.

00:32:13.360 What's not to like?

00:32:14.600 I think they're fantastic.

00:32:15.520 And I'm sure you've noticed

00:32:16.560 they're very good at their job.

00:32:19.100 Oh yeah, for sure.

00:32:19.980 Yeah.

00:32:20.440 You mentioned something

00:32:21.220 that I thought was interesting. I want to talk about, say, if you're having problems getting

00:32:24.480 your poop out, you're constipated, or it's a struggle, the position. So I think people might

00:32:29.920 have seen these things on Instagram, the squatty potty. Is there anything to that? Does that

00:32:34.980 actually help? Yeah. So this is an interesting thing that we've done to ourselves as a mankind.

00:32:42.980 You know, we, thousands and thousands of years ago, they, I mean, they have found like these

00:32:46.560 upright chair-like potties back in the Roman Empire. But well before that, we were just

00:32:53.020 squatting. All of us squat in our most comfortable, natural way to poop. And we've trained ourselves

00:32:58.160 out of that. But I have a two-year-old and a four-year-old. And if you ever go to a daycare

00:33:03.080 and you see a bunch of kids in diapers waddling around, they all pop the deepest squat when they 0.96

00:33:08.580 are pooping. They don't go sit in a chair and poop in their diaper. They squat. And that's

00:33:12.820 because that's the easiest, most natural way to have a bowel movement. And here's why. We talked

00:33:17.580 about the pelvic floor, and there's so many muscles that make up the pelvic floor. One of

00:33:21.320 the muscles there is called the puborectalis muscle. And if you think about your colon like

00:33:26.500 a long tube, this puborectalis muscle is like this sling that goes across the tube and chokes it

00:33:32.600 closed. It's almost like your body stepping on its own hose. And it's like that when we're just

00:33:37.840 sitting around in our chairs at like at a desk at work, for example. And that's kind of a good

00:33:43.140 thing. Like it's nice to have like that little like extra closure of that door so that there's

00:33:47.720 nothing leaking out. There's no pressure, but you don't want that door to be closed. You don't want

00:33:51.860 there to be a kink in that hose when you're trying to poop. And that's how we poop though,

00:33:56.640 when we sit at this 90 degree angle. Well, it turns out that if we try to recreate a little

00:34:01.520 bit more of those dynamics of squatting and we don't have to actually squat because I recognize

00:34:05.780 obviously nobody wants to, nobody wants to do that. But if you just raise your knees above the

00:34:11.480 level of your waist, everybody will poop more easily. They've done these studies that show that

00:34:16.340 yeah, people who identify as having, who've been diagnosed with pelvic floor dysfunction,

00:34:20.540 identifies conservation, they poop better when they do that. But even healthy people who think

00:34:25.540 that they poop just fine, studies have shown that when you raise your knees up, even if you think

00:34:31.040 you're already doing really well, you would be amazed at how much better you do. That's awesome.

00:34:35.520 So bring your feet up with a stool.

00:34:36.860 I'm a fan of the squatty potty.

00:34:38.440 Speaking of the scheduling, there's this famous bit in 30 Rock, the television show,

00:34:43.560 where Liz Lemon talks about every time she walks into a Barnes & Noble, she has to poop.

00:34:48.620 And I'm like, that happens to me.

00:34:51.140 I don't know how many times.

00:34:51.780 I mean, I've pooped in Barnes & Noble several times.

00:34:53.360 As soon as I walk through those doors, I'm like, I got to poop.

00:34:56.100 Yes.

00:34:56.540 What's going on there?

00:34:57.380 Why do you have to poop when you go to Barnes & Noble?

00:34:59.680 Yeah.

00:35:00.160 You are not alone.

00:35:01.100 That is such a thing.

00:35:02.320 And it's funny.

00:35:03.320 It's Barnes & Nobles for some people.

00:35:04.980 For some people, it's like the target. I think the target is like a big one for a lot of people.

00:35:09.120 And it's been described like I think it was back in the 1980s. It was described in the Japanese

00:35:15.480 literature. Like, what is it about bookstores that make people poop? And there are a lot of

00:35:19.920 theories about this. And I'll give you mine. I mentioned earlier that your colon is this creature

00:35:25.180 of habit. And the interesting thing about your colon is that it can be trained to respond and

00:35:31.140 react to external cues, cues in your environment that will start contractions and start things to

00:35:36.380 change. And if you go like way back in time to remember Ivan Pavlov, the scientist we all learned

00:35:42.120 about in like middle school who used to ring a bell and then the dogs would come and start

00:35:46.400 salivating because when he rang the bell, he brought food in. But eventually he would start

00:35:50.800 ringing the bell and not bring food in. There would be no, they wouldn't see that there was

00:35:54.280 food, but they'd start salivating anyway. And that idea tells us that just something about our

00:36:00.140 environment that we've associated once with a good poop or a good moment in our digestive history

00:36:05.100 can start to trigger those same cues and those same movements again when we start to build that

00:36:10.300 into a pattern. So I think what happens is, one, in order to poop, you have to feel relaxed.

00:36:14.800 That is like a fundamental truth about pooping because your sthincters have to relax at that

00:36:19.400 final part. And I think bookstores put people in that relaxed place. And a lot of people actually

00:36:25.040 find that they have to read in order to have a bowel movement. We can talk a little bit more

00:36:28.840 about that, but like just a quick light read, it's just distracting enough. It gets things moving and

00:36:33.800 helps them feel good about it. And I think for some people I've heard this, like it's the smell

00:36:38.820 of the pages, something about it triggers disassociation and you have one, you go, maybe

00:36:44.440 you go poop once in a Barnes and Noble. Now, the second time you walk in, now you smell the same

00:36:49.800 pages. You feel relaxed and happy. You know, it was a pleasant experience last time. So you go

00:36:54.920 again. And now you've ingrained this pattern and it keeps happening. And now you've got this like

00:36:59.820 whole sensory experience every time you walk into a bookstore, that's like a safe space and it's

00:37:04.260 pleasant and you go. And I think that's how we build habits. And I also think that's what happens

00:37:08.080 in the target. Like you go in there, you pick up your coffee, you're by yourself, you're having a

00:37:13.160 nice walk around and it feels safe and it feels lovely. And then you have a nice bowel movement.

00:37:17.780 That's my theory. Okay. Yeah. Yeah. I think there might be something to that. And if you're going

00:37:20.880 to read in Barnes and Noble, leave the books on the shelf. Yeah. Don't bring the merchandise in.

00:37:25.200 Yeah. No merchandise. Guys, you have a sign that says, don't do that.

00:37:28.760 They know. They can understand. Right. Well, let's talk about reading on the toilet. A lot

00:37:32.440 of people do this. When I was growing up, we didn't have smartphones. And so I would read

00:37:37.780 like the back of my deodorant. I read about tampons, like my sister's tampons were there

00:37:43.700 and be like, what's going on? I mean, it's the only thing there. You've learned so much. I learned so

00:37:47.400 much while I was on the toilet. But a lot of people these days, they take their smartphones

00:37:50.540 in there and they're on there for a long time. Why is that a problem? Yeah. Yeah. I was, I was

00:37:57.540 like you, I would learn all 30 weird ingredients on the back of the air freshener. I would read

00:38:02.980 like the far side comics. Like people used to have these like little discreet bathroom readers

00:38:08.880 that were just like the kind of reading material that could not actually suck you in, you know,

00:38:13.880 It would be like toilet books. Yeah. And it would be like a quick read just to distract your mind

00:38:19.040 for a few minutes. It would be like last week sports section of the newspaper, like whatever

00:38:22.000 it was, you do it, you'd relax, you get the judgment and you'd move on. Today, you never

00:38:26.720 see those little bathroom bookshelves anymore. Nobody has that because we're all bringing our

00:38:30.360 smartphones in. And the problem is that just like we've learned in other spheres, like when we're

00:38:36.100 trying to go to sleep or when we're trying to have some social connection at the dinner table,

00:38:39.700 the smartphones distract us and really hijack our brains to keep us fully engaged with whatever app

00:38:47.480 we're on. The same thing happens in the bathroom. And so we did this study in my laboratory two

00:38:52.800 years ago where we asked people who were coming in for their screening colonoscopy all about their

00:38:58.400 bowel habits and whether they use their smartphone on the toilet. And then we looked to see when we

00:39:03.640 did their colonoscopies, whether they had hemorrhoids or not. And it turns out that one,

00:39:08.560 Yes, all of us are bringing our smartphones in, like 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 into account how constipated they were or how much they strained. Those things were actually, there were no differences between the smartphone users and not.

00:39:36.560 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's when we call them hemorrhoids. And that's when we say they're uncomfortable and painful. But if you sit there like that, you know, it's not going to happen after just doing it for one time.

00:40:00.040 But if that'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's why we tell people, one, bring back the old fashioned bathroom reader, like throw in that like weird old comic book that you actually can only read one page of free to move on or just set like a two tick tock limit.

00:40:19.280 But sometimes I go into these public bathrooms like at work and like I'll hear somebody watching an episode of the pit that happened to me last week.

00:40:26.500 And I was like, first of all, I know what episode you're on.

00:40:28.960 And like this is not the place.

00:40:30.460 Like just pull your pants up and go watch it at your desk.

00:40:33.040 You don't have to do this in the current compromised position that you're in.

00:40:36.640 All right.

00:40:36.840 So you limit your time on the toilet unless you want hemorrhoids and hemorrhoids are fine.

00:40:40.360 Yeah, exactly.

00:40:41.040 No, indeed.

00:40:41.800 Speaking of going to the bathroom in public, a lot of people have problems with that.

00:40:45.520 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?

00:41:05.220 Yeah, it's a lot of strategizing, but I do feel really strongly about this, that

00:41:09.980 you should go when your body tells you it's time to go because you're going to make it harder on

00:41:15.140 yourself and you're going to strain harder later if you don't respond. And so one, I think, and

00:41:20.740 this is something that like medical doctors are just surprisingly very good at. You should identify

00:41:27.420 like well in advance, do a reconnaissance mission. Like what are the safest bathrooms

00:41:32.700 in your building? What is the safest bathroom if it's not in your building in the cafe next door

00:41:37.360 or at the Barnes and Nobles nearby? If you're out in public, find what the safe, quiet bathroom is

00:41:42.200 well in advance. And then don't share that secret with anyone. Keep it to yourself. But if you're

00:41:47.180 in a situation where you are like just caught with whatever bathroom is on hand and there's

00:41:50.840 lots of people there, I actually sometimes tell people put some headphones in and just tune out,

00:41:56.460 like do a noise canceling thing or play some nice music so that you're not distracted and worried

00:42:01.800 and thinking about what everyone else is doing

00:42:04.060 and you're so worried that everyone's thinking about you

00:42:06.840 and they're listening for any sound you might be making

00:42:09.280 and once you just tune them out

00:42:11.620 and put the headphones in

00:42:12.720 it can really help you just focus on the moment at hand

00:42:15.700 because your goal is to just get in and out too

00:42:17.520 and this actually goes two ways

00:42:19.220 if you're somebody who's sitting in a stall

00:42:21.440 and since somebody else comes in next to you

00:42:23.660 and has to go

00:42:24.460 and you're just sitting there on TikTok

00:42:26.860 you have to be a good citizen

00:42:29.120 and pull your pants up and get out of there 1.00

00:42:31.320 Like don't keep scrolling because you have to do unto others as you'd like to be treated yourself.

00:42:36.380 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.

00:42:41.260 If you like really feel like you have to, you can shake the toilet paper holder.

00:42:44.620 You can like play some alarm ringtone on your cell phone and something to distract yourself and distract everybody else.

00:42:51.140 If you really feel like you want to.

00:42:53.020 I actually I don't mind going to the bathroom in public.

00:42:55.400 And like when I hear when other people are taking care of business, I'm like, OK, you're taking care of business.

00:42:59.600 That's what you're supposed to do here.

00:43:01.480 Yeah, good for you.

00:43:02.220 You're in the right spot.

00:43:02.980 You're in the right spot, you know?

00:43:04.920 Besides pooping in public,

00:43:06.800 one thing that can throw off your bowel movement schedule

00:43:08.800 is traveling.

00:43:10.260 I've got an issue with this.

00:43:11.200 Whenever I travel, my intestines are just like,

00:43:14.280 we've closed up shop.

00:43:15.820 Yes.

00:43:16.280 What's going on there?

00:43:18.140 Yeah, this is very, very common.

00:43:20.100 When we travel, a lot of different factors

00:43:23.400 conspire against our colon at the same time.

00:43:25.960 So first of all, your colon operates on a circadian rhythm.

00:43:30.320 And like, let's suppose you're going to Europe for spring break. And suddenly your colon is waking up like at 2 a.m. and it's not actually time to go. And it's all thrown off. Or you start to sleep in late. You don'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're not doing that.

00:43:52.040 now you're lounging in bed and just transferring your body from bed to beach. And you're not doing

00:43:57.660 all those things that usually prime your body success successfully for bowel movement. And then

00:44:02.420 second, I mean, a lot of us, this is myself included, the best part of travel is the food

00:44:07.520 half the time. Like we go, we want to try local cuisine, but you know, when you go to Europe,

00:44:11.800 and this is what I see with a lot of college students who are my patients, you should go

00:44:15.960 eat the local food for sure, but you can't eat six bowls of pasta in a row without any form of

00:44:23.020 impunity. And I really think that people need to aggressively seek out fiber when they're on

00:44:28.620 vacation more so than they would at home. Like if you eat a ton of fiber at home and then suddenly

00:44:33.820 you eat half of that or less than half of that, your colon is going to respond and react and it's

00:44:39.100 not going to be happy. And then lastly, I think people do get dehydrated on vacation. People are

00:44:44.440 drinking more often like alcoholic beverages they're out walking around being tourists they're

00:44:49.420 just not drinking as much water and all of these things together and let's like not even forget

00:44:53.780 about the fact that we're stressed because we're traveling with our families half the time or maybe

00:44:57.600 we have to share a bathroom with our cousins like all of these things come together at once and it

00:45:01.880 makes it really hard to stay regular okay so i think we've covered a lot here about poop let's

00:45:07.540 say we've taken care of business there's the wiping part but you make the case for the bidet

00:45:13.080 Oh, yeah.

00:45:13.480 Why do you think everyone should get a bidet?

00:45:15.380 I love a bidet.

00:45:16.840 And you'll never meet somebody who has a bidet who feels like just medium about it.

00:45:21.800 Once you try.

00:45:22.680 Yeah, we got a bidet a couple years ago.

00:45:24.280 And I'm like, everyone should have this.

00:45:26.160 What have we been doing in the United States that we haven't had this?

00:45:29.540 Exactly.

00:45:30.060 You feel like you're born again.

00:45:31.840 It's like you want to make sure everybody knows about this.

00:45:34.380 You make people feel bad if they haven't seen the light.

00:45:37.020 Like that's what bidets do to you.

00:45:38.420 It's obnoxious.

00:45:39.760 But bidets are so wonderful.

00:45:41.160 And the weird thing is like, well, you know, and I talk about this all the time and normally the pushback I get from Americans who haven't tried them before is like, you know, this is one, this is really weird.

00:45:49.620 Like, why would I want like anything touching me back there?

00:45:52.460 And first of all, like obviously bidets are for external use only, but it's not any weirder.

00:45:58.540 If you take a step back, wiping is the weirdest thing we can do, right?

00:46:02.520 Like if I saw, you know, I mentioned I had a two year old.

00:46:05.060 If I'm changing his diaper when he was a baby and I got a little poop on my hand, this happens.

00:46:10.520 the last thing I would do is just wipe that poop off my hand with a paper towel and then just go

00:46:15.560 about my day yeah as normal yeah the analogy I've heard is like if you've got if you're out in the

00:46:18.980 garden working you got mud on your arm like you wouldn't get a paper towel and just rub the mud

00:46:24.760 because like it wouldn't come off you wouldn't put it underneath the sink yeah totally you got

00:46:28.840 to get some water on that and yet for some reason this like absolute most delicate part of our body

00:46:33.640 I think this part is underappreciated that that area is that skin is actually quite delicate I

00:46:40.200 think we think it must be so sturdy because it's standing up against yucky poop, but actually it's

00:46:44.380 really soft and delicate and it can tear quite easily. A bidet is gentle, clean, hygienic.

00:46:51.340 And I found a lot of people who don't even realize they're the kind that would benefit from it. Like,

00:46:56.480 you know, I tell people who I treat a lot of patients who have Parkinson's disease or trouble

00:47:01.460 moving. They love bidets because they don't have to worry about balancing and reaching back there.

00:47:06.440 A bidet just takes care of that. But actually like everyone would benefit from it. Think about

00:47:10.120 women who are on their periods. A bidet is so delightful because you have a lot going on at 1.00

00:47:15.360 once half the time. When you're postpartum, a bidet is lovely because you want to be very gentle.

00:47:19.640 People who have hemorrhoids, people who have fissures, people who just have really hairy

00:47:24.000 bums, people feel like just wiping and it doesn't really like get everything out when you have a lot

00:47:28.800 of hair back there. A bidet solves all of this for you. Yeah. No more dingleberries. Yeah. And

00:47:34.640 then you can get like the kind with the like heated seats and stuff. Oh yeah. That's what we

00:47:37.760 have and then it's got a fan so after you're done yeah just dry full service yeah and they're

00:47:44.920 affordable they're not that expensive and they're easy to install like you don't have to get like a

00:47:48.440 separate bidet that you put next to your toilet it's just it's an attachment right on your toilet

00:47:53.140 yeah and let's just like emphasize it's an attachment that runs through your clean water

00:47:58.060 supply this is a common like concern like are you just splashing dirty water back at you like

00:48:02.300 absolutely not this is splashing clean water it goes to your clean water so there's no risk of

00:48:07.360 weird backsplash. And then some people, if they don't go bidet, they'll all just use like the

00:48:11.300 wipes, like adult diaper wipes, essentially. Those are nice, but the problem is you're not

00:48:15.960 supposed to flush them down the toilet. Exactly. Even the ones that say flushable,

00:48:20.340 which a lot of them do, you actually can damage your pipes and they're not actually as degradable

00:48:26.220 as we'd like. So if you're starting to throw those in the little can next to your commode,

00:48:31.720 eventually when those build up, you're like, why didn't I just get a bidet? Like that's not

00:48:35.320 pleasant either it's interesting the cultural differences about wiping so i lived in mexico

00:48:39.520 for two years when i was in my 20s and i remember when i first got there and i was living with some

00:48:45.000 mexicans a lot of them don't flush the toilet paper they'd have like a waste basket and they 1.00

00:48:49.440 just wipe and put it in the trash i'm like that's interesting so i had to start doing that it was

00:48:54.560 kind of weird for two years to wipe and then throw it away i saw that a lot in europe too where there

00:49:01.700 was no bidets and like in Morocco when I was traveling. And I think it's like a plumbing

00:49:06.160 issue. Like the pipes were really old and like, you have to be really careful, but like, good

00:49:09.900 God, what if ever there was a sign to get a bidet at that point. But if you do have to wipe, you

00:49:14.600 suggest not to wipe, but to blot. Yeah. I'm a blotter or a dabber. I like a dab. And again,

00:49:20.500 that's because I see people in, you know, like in my line of work, people are often prepping for

00:49:24.700 colonoscopies or they have some condition where they have diarrhea and they're constantly wiping

00:49:28.600 that area just gets inflamed and red and unhappy very, very quickly. If you're doing a lot of

00:49:34.180 wiping, just dab, like you don't need to go like overly aggressive, just dab because that skin is

00:49:39.520 so, so delicate. So speaking to this pliability of the three P's of pooping, making our poops

00:49:45.700 easy to get out, what can we eat for optimal poop health? Well, there's three layers of what I tell

00:49:53.260 people to do. So like the first one is eat more fiber. And actually like if I could do nothing

00:49:57.100 else that's like one, two, and three, because we're all struggling. I'm actually like delighted

00:50:00.480 that you hit 60 grams. For men under 50, it's like 38 grams. For women, it's 25. And a lot of

00:50:05.240 us just aren't meeting that. So if you can do that by any means necessary, even if that's a

00:50:09.620 fiber supplement, I would chalk that as a win. But the second sort of thing that has been shown,

00:50:15.120 like if you're doing that and you're ready for the 102 level course, the second thing that's

00:50:19.200 really been shown to help with your gut microbiome. So those are the trillions of

00:50:23.040 microbes living in your colon and their genetic material is to have a diversity of plant-based

00:50:29.640 sources in your diet every week. And that contributes to the diversity of those microbes.

00:50:34.700 And you want that. That's a marker of good health and of a healthy microbiome is the different,

00:50:39.440 different numbers of species in there. And those microbes, you know, just remember,

00:50:44.040 they're not just sitting there. They're not passive actors in your colon. They're taking

00:50:48.220 what you're feeding them and fermenting it and creating these new compounds, which sometimes

00:50:52.840 are called postbiotics, but they're like things like short chain fatty acids that get absorbed

00:50:56.720 into the bloodstream and go to other parts of your body. So it is really important what you

00:51:00.700 feed them and how you think about them. So eating a diversity of plants is the second thing that I

00:51:05.040 tell people to try to aim to do. So meaning like don't eat the same routine thing every single day

00:51:11.000 for lunch, every single day for dinner, like start to diversify that. But then three, and this is I

00:51:15.700 think the hardest one, the 103 level course, is to start incorporating fermented foods into your

00:51:21.460 diet. This is like the thing that every gastroenterologist like loves to preach about,

00:51:25.680 but there have been some really powerful studies showing how even two groups of people both eating

00:51:30.480 a high fiber diet, when one of them adds fermented foods, their microbes produce even more

00:51:36.060 anti-inflammatory compounds and you can measure those in the blood. And so fermented foods are

00:51:41.040 like kind of hard. Sometimes they're not like necessarily the obvious things that we think of

00:51:44.940 in a typical American diet, but you can get them through just like Greek yogurt, which is the most

00:51:49.500 common thing that I usually eat and incorporate into my diet every day because it's very filling.

00:51:54.000 It's like makes a great breakfast. I eat it that way. But it's also stuff like kombucha,

00:51:58.060 sauerkraut, kimchi. They're even present to some extent in like sourdough bread or soy sauce. Like

00:52:04.040 they're there. So the more you can incorporate and start getting in the habit of throwing in

00:52:08.140 fermented foods into your diet, like that'll give you even that extra boost. So yeah, my morning,

00:52:13.660 my diet in the morning is like my colon morning. So in the morning I have eggs with these like

00:52:17.700 fiber wraps. That's where I get a lot of the fibers, these fiber wraps. And then I have like

00:52:21.700 a mid-morning meal where I'll have oatmeal or it could be like a high fiber cereal. And then I'll

00:52:27.260 put some Greek yogurt in there and then some blueberries. And then I also eat some either

00:52:33.060 sauerkraut or kimchi with my eggs first thing in the morning. Oh, wow. I love that. That's like a

00:52:37.080 perfect breakfast. You've got all of the components in there. Yeah. Well, Tricia, this has been an

00:52:41.600 amazing conversation. I've been doing this for 17 years. I never thought I'd have a podcast about

00:52:46.420 poop, but I did. So it was a great one. Where can people go to learn more about the book in your

00:52:51.640 work? Well, they can get the book You've Been Pooping All Wrong anywhere that they get books,

00:52:55.900 and they can follow me on Instagram at Trisha Pasricha, MD.

00:52:59.520 Fantastic. Well, Dr. Trisha Pasricha, thanks for time. It's been a pleasure.

00:53:02.660 Thanks, Brett. This was so much fun.

00:53:05.300 My guest here is Dr. Trisha Pasricha, the author of You've Been Pooping All Wrong.

00:53:08.760 It's available on Amazon.com and bookstores everywhere. You can find more information

00:53:11.920 about our work at our website, trishapasricha.com. Also check out our show notes at aom.if.

00:53:16.420 slash poop where you can find links to resources

00:53:18.260 where you can delve deeper into this topic,

00:53:19.760 including an article on our top 10 toilet books

00:53:22.420 so you can start building your bathroom library.

00:53:32.160 Well, that wraps up another edition of the A1 Podcast.

00:53:34.840 If you haven't done so already,

00:53:35.760 I'd appreciate it if you take one minute

00:53:37.140 to give us a review on the podcast player you use.

00:53:39.740 And if you've done that already, thank you.

00:53:41.380 Please consider sharing the show

00:53:42.540 with a friend or family member

00:53:43.580 who would think we're something out of it.

00:53:44.760 As always, thank you for the continued support.

00:53:46.960 Until next time, it's Brett McKay.

00:53:48.420 Reminds you on listening to the podcast,

00:53:49.940 but put what you've heard into action.

00:54:11.520 Before you go, here's another episode worth adding to the queue.

00:54:14.440 In episode number 821, we explore why routines, especially over rigid ones, can actually make life harder, not easier.

00:54:21.340 We talk discipline without obsession, structure without rigidity, and where real growth comes from.

00:54:26.040 You can find it at aom.is slash routines.

00:54:28.880 That's aom.is slash routines.

00:54:30.920 Go check it out, episode number 821.

The Art of Manliness - April 07, 2026

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

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