The Gut Health Episode: Harvard Doctor Reveals What’s Normal (and What’s Not)

Hey, it's friend Mel, and welcome to the Mel Robbins podcast.

Let me start with the confession. I have wanted to do an episode on this topic for years,

because there are a few things that we all think about, we all deal with, and yet somehow,

we don't say them out loud, and you want to know what that topic is? Got issues.

At the top of that list, bloating, constipation, gas, IBS, and yes, you and I, we're going to talk

about poop. I can't even say that word when I was laughing, because if you have gut issues,

welcome to the club. That's the majority of people alive today. And for the longest time,

I was dealing with bloating that made no sense. I would wake up feeling totally fine,

and by midday, my jeans are tighter, my stomach is bulging out. I'm uncomfortable. In fact,

it's happening right now. It's probably because I have highways to jeans on, and I would be thinking,

what is going on? I have family members who are always backed up, especially when we travel.

Friends who will not poop at work, they hold it in all day long. So today, you and I are getting

curious, because we ignore our gut way more than you should. Mostly probably the same reason I

do your embarrassed or confused, or maybe you've told yourself, I just have good issues. This is

how it's always going to be. Today, we're changing that. This episode is the ultimate. No shame,

ask everything, gut health conversation with one of the top neuro gastroenterologists. I said

that right. I think neuro gastroenterologists in the world. Today, we're talking about what's

normal when it comes to poop and what's not. The hidden reason why you may be struggling with

bloating, constipation, and more importantly, exactly what you should do about it. The shocking

research that will make you never want to bring your phone in the bathroom again. We'll talk about

colon cancer risk and the signs you should never ignore. And the gut brain connection, and what's

really happening when you have butterflies in your stomach. Today, nothing's off limits.

Nothing is too awkward. And I promise you, if you've ever had that thought, is it just me or you've

turned around to flush the toilet and thought, what is that? This is the episode where you stop

guessing, you stop feeling weird about your body or uncomfortable in your own skin and finally

understand what your gut has been trying to tell you. Because once you understand your gut feeling,

you know how to work with your body instead of against it.

This April, get your rom-com on with you, me, and Tuscany, only in theaters April 10th.

From Will Packer, producer of Girls Trip, you, me, and Tuscany has all the ingredients of your

favorite rom-coms. Heart, huge laughs, and sizzling chemistry, starring Halle Bailey and Reggae Jean

Page, and set in the enchanting vineyards of Tuscany. This film is a movie escape that's perfect for

date night or girls night. Don't miss You, Me, and Tuscany, directed by Cat Coirole, only in theaters

April 10th. Are you ready to make a change in your life? If you're thinking about going back to

school, let me tell you about Southern New Hampshire University. They have more than 200 online

degree programs with affordable tuition and industry leading academic support. At SNHU, you're not

just another student. You're part of an entire community that cares about your success. So what are

you waiting for? Visit SNHU.edu slash Mel to learn more. The Mel Robbins podcast is presented by

Walmart Plus. Spring is the perfect time to reset. Not just your home, but your routines.

And one of the easiest ways to save time and money in your everyday life is with Walmart Plus.

Members get free same day delivery from Walmart stores, free shipping with no order minimum,

and even a streaming subscription choice of Paramount Plus or peacock included with membership.

Plus, you'll get 10 cents off per gallon at participating gas stations. Try Walmart Plus at Walmart

Plus dot com 35 dollar order minimum restrictions apply. Choose one ad supported service every 90 days

peacock premium or Paramount Plus essential additional registration required terms and conditions

apply available at participating stations may vary by location and subject to change.

Hey, it's friend Mel and welcome to the Mel Robbins podcast. I am so fired up for our conversation

today. I know we're going to laugh. We're going to learn it's such an honor to be together and

to spend this time with you. And if you're new here or somebody sent this episode to you,

maybe it showed up in your family group chat. I want to personally welcome you to the Mel Robbins

podcast family. Today's guest is one of the world's leading experts on the gut brain connection

and how your body influences your mental health stress and decision making. I'm talking about

Dr. Trisha Pasricha. Dr. Pasricha is a board certified neuro gastroenterologist,

a physician scientist and an assistant professor of medicine at Harvard Medical School.

She also holds a master of public health in biostatistics and epidemiology from Harvard.

She's the director of the Institute for Gut Brain Research at Beth Israel Deaconess Medical Center

where she leads NIH funded research on how the gut communicates with the brain and how that

connection shapes anxiety, mood, and disease. She completed her residency at Johns Hopkins. She's

also earned a master's in public health from Harvard. She's gone on to specialize in neuro gastro

entrolage and I still can't say the word. She's that impressive. She'll tell you how to say that word

at mass general hospital, the number one research hospital in the world. If she can help me with

bloating and pooping, we're going to be good. I don't care how you say her specialty. Dr. Pasricha

is also the long time, ask a doctor columnist for the Washington Post where she's known for telling

the truth. Busting medical myths and tackling topics. Most people are too embarrassed to talk about.

Including digestion, pooping, and gut symptoms that millions of people live with in silence.

She's also the author of the new best-selling book, You've Been Pooping All Wrong,

which tells you pretty much everything you need to know about how fun, direct,

informative this conversation is going to be. Oh yes, we're going there. This is one of those

conversations where I'm asking the questions that most of us are just too embarrassed to talk about.

So without further ado, please help me welcome Dr. Trisha Pasricha to the Mel Robbins podcast.

Thank you so much for having me, Mel. Oh my gosh. We are going to dig into this. I cannot wait.

I really can't wait to talk about poop. I know that we're going to get into that a little bit later,

but I'd like to start by asking you, how would my life be different? If I take everything that you're

about to teach us today to heart, I apply it to my life, I share it with my friends, what's

going to change about my life? Your life is going to change in two big ways. First, you're going to

stop thinking about your gut as a digestive organ. You're going to start thinking about your gut

as a brain because that's what it is. Your gut is a brain. It has more nerve cells than the

entirety of your spinal cord. It is creating all the same neurotransmitters like dopamine, like

serotonin, and it is constantly sending signals up to the brain in your head through this information

superhighway called the vagus nerve. And also so many of the diseases that we're most afraid of

from certain cancers to Parkinson's disease, these can all start in the gut. Once you realize that,

everything changes because then you can realize you can change your health, not 10 years from now,

but today, you can start to take control of your health through your gut and that gives you real

control. The second thing that's going to change for you is that you're going to realize this whole

time your symptoms were never all in your head. All of those GI symptoms, the bloating, the trouble,

the digestion, the going to the bathroom, none of that was ever just stress. And I think the reason

that so many people for so long haven't been believed is because some people aren't as familiar with

all of the data and all of the research that I'm going to share with you today. And once you have

that knowledge and that validation, it's going to give you power back an agency to get the help

that you need. Wow. So Dr. Pressreja, let's just start with the basic level. What is the gut

specifically? Yeah. Let me bring out this model here. Okay. Let's walk through it. Okay, so she's

pulling out. Okay, now we're all in medical school, everybody. You've pulled out a plastic model

of a human being. And basically what I'm looking at, if you're listening, we're going to narrate

this for you. We have a model that shows the insides of a human being. I can, I recognize the

lungs. I see like a bunch of squiggly stuff, which I guess are intestines, but Dr. Pressreja is

going to really narrate this for us. Yeah. And first thing I'm going to do is actually I'm going to

take the lungs out. I'm going to take the heart out just so we can see what the better'll do. I

promise you I'm not that heartless. No fun intended. Okay, so now I'm seeing, whoa, what am I seeing?

Yeah. So this, what I'm going to walk you through is the gut. The gut is our way of referring to

the gastrointestinal tract that is everything from the mouth all the way back to the anus. Okay,

hold on a second. You've already taught me something. When I hear the word gut, I think for my belly

button to my private parts. I think about the part that swells. I think about the part that hangs

out over my pants. Yeah. I think about just that section. So the first thing that you want us to

really reframe is that when you use the word gut, at least medically speaking, it's the mouth

and all the things that connect your mouth all the way through until it goes out the other side.

That is the entirety of the gastrointestinal tract. So everything that's part of that really,

really long complicated tubes, that's your gut. Huh. So let's walk through it. So suppose you take

a bite of food. It goes through your mouth here. Yep. And now follow along. It goes through this

tube at the back of your throat. Do you see this muscle? That long tube is called the esophagus.

Okay. And it goes from the esophagus down. You know what's interesting? Yeah. I don't know if you

feel this way as you're listening to this episode right now, but I've always thought the esophagus

actually goes down the front. Yeah. Like in front of. No, it's not so. It's hiding out in the back

there. So I had to actually remove the heart for you to be able to get a good look at it. Yeah,

it's in the back of your chest. For some reason, I thought it was in front of it. Is that because like

if it hurts, you like feel it in the front of the chest, it's weird. Yeah. When you get heartburn,

right? It's all kind of in that same area because the esophagus travels through your chest cavity

on its way down to the abdominal cavity. Okay. And then when you have heartburn, you're sort of

referring it to that general area and you're you don't know exactly where it's coming from. Is it

the back of the front? And you perceive it as just being from your chest, but actually your esophagus

is hiding all the way in the back. Wow. Mm hmm. I'm going to take this liver out here too,

just so you can see better where the esophagus is going. So goodbye. Okay. So it's behind the liver.

So it goes all the way back and then it connects here to your stomach. So this organ here is your

stomach. That's where the food gets broken down and acidified and broken into these really small

pieces. From the stomach, that piece of food is going to enter the small bowel first. That is

this long, windy tube that goes all the way around and is kind of bunched up in your abdominal

cavity. That's where all the nutrients get absorbed. Okay. So everything that your body wants,

everything that it needs. Why is it called the small bowel? Because it looks pretty big. Like long.

Yeah. It's long. You're right. It's long, but it is smaller in caliber. The large bowel,

sometimes called the colon, is this larger C-shaped organ here. So it is shorter than the small bowel,

the colon, but it's wider. Okay. I just want to describe this for you in case you're listening.

Because I'm standing here or sitting here rather kind of surprised because I thought the intestines,

you know, like if you think about your intestines, you think all this squiggly stuff, right?

So you know what's interesting is it looks kind of like a brain. The intestines really have the

same like macaroni shape. You're starting to get it. Yes. The brain. But here's where you got me

and I'm surprised. The colon isn't just the tail end of the macaroni. The colon is going up

and around all of the like small intestine. I thought it was just like the last foot or the last

like little section. I thought really? Yeah. It has a long way to go and that's because one of the

jobs of the colon is that it sucks water out of at this point, the waste that's there because

everything that you don't again, you absorb the nutrients you need in the small bowel. Now it's

the waste that reaches the colon. All the water is getting sucked out. So as it goes along this way,

it's getting drier and firmer and harder. Eventually, it makes its way to the back,

all the way to the back to your pelvis. So this is a female model. I'm going to hold this up.

This is a cross section of your pelvis, a female pelvis. Okay. So this is your bum right here is

the colon, the last part of the colon called the rectum. So this is where all that food you

eat and that has now become waste, that has now been fermented by your microbiome. It hangs out

here in the rectum until you're ready to release it back into the free world. A lot of times we're

ready. I know we're going to get into this a lot of times we are ready for it to be released,

but it is not releasing. And I know we're going to talk about all of this.

And thank goodness for those speakers. The speakers or the speakers that hold it tight. You have control

over your external sphincter. So if you say we are not ready, you can shut the door. Yes.

You can shut that door most of the time. Yeah, there are times where you can't.

And then you can see, so this is the back of your colon in the part that's called the rectum.

For in women, we have our uterus here and then our bladder up front. So all the way at the back.

Wow. So how long should it take for the piece of food? So I had scrambled eggs this morning.

Yeah. So how long should it take for the eggs that I ate to go like if I if things are working

as they should, how long should it take from chewing it up and swallowing it for it to make

the exit? It should exit your stomach that first part within four hours. Four hours.

Yep. And if it's softer, easier to move through doesn't have to do a lot of hard breaking down

like fibers foods. If it's something soft like eggs, it'll move through the stomach even quicker.

But from the point from when it exits the stomach until you decide to release it into the world again,

that process can take days because for a lot of people, it moves through the small bowel over the

next day or two hangs out in the colon. But you know, we have control over that final step. And

there's some people for any number of reasons who are going to hold on to it a little bit longer

than others. So it can take a day two days sometimes even longer. Wow. But it's out of the stomach

within hours. With an hour. Yeah. And sometimes even again within 30 minutes if depending on what

you've eaten. Huh. That is absolutely fascinating. The thing about this though is that if you think

about the gut just this way, and this is the way that I think a lot of us have learned about the

gut in school, you will think about the gut just as a digestive organ. And it is so much more than

that. So the gut is also an immune organ. 70% of your body's immune system is here in the gut.

What does that even mean? It means that all 70% of the immune cells and the protective barrier

for you against everything the outside world is throwing at you is in the gut. So it's one of the

most important defenses you have against the outside world. And I think people don't appreciate that.

So the flu is going around. Yeah. Right. You're breathing in air or there's maybe some pollution.

You're breathing in air. You're in standing next to somebody who's smoking. You're breathing in

like it's going in through your mouth, right? Yeah. And so are you saying that from your mouth

all the way down the esophagus into the stomach, the small intestine, the colon, the right, that that

is protecting you from whatever was in the outside world. Yeah. That you then either breathed in

through your mouth or you ate in food that might have some sort of cat. Is that what you're saying?

That's exactly right. A lot of what we eat is obviously not sterile, right? We're putting

all kinds of different things into our body. We cook it. It's relatively clean, but it's obviously

got so many different things from the outside world. Chemicals, bacteria, whatever it is, someone

is stopping you from getting sick most of the time. And that's your gut. When it comes to respiratory

infections, a lot of the immune response does start in the lungs and it starts elsewhere. But

think about a lot of our respiratory illnesses like flu. So many people get diarrhea with the flu.

Because your gut does get activated. That's so true. That's right. Wow. Okay. So is the immune

piece of the gut? Is that simply protecting you from what's in the gut? Or does it also talk to

the rest of your body? It talks to the rest of the body. So it helps coordinate the entire response.

But you can think about it like we think of the skin as being that first barrier

against the outside world. But really the gut, if you look at the cross sectional area of your gut,

I mean, you pointed out the small bowel. It's huge. If you think if you were to spread it all out,

it's huge. It is in contact all the time with things that we've come from the outside world. And

so it's protecting you against the outside world. The gut is also doing more. It's also producing

hormones. And so it's responsible for the hormones that regulate your blood sugar, for example,

and also influence your mood. And then the other big thing, which I talk about all the time, is that

your gut is a brain. It is the home to the enteric nervous system. Enteric nervous system. You've

probably heard of the central nervous system. That's the brain in your head. But your gut has its

own nervous system. Millions of nerve cells that are in communication with each other. They're

in responding to signals from the outside world. And then they're communicating with the brain in

your head through this long. I want you to imagine a long winding nerve coming down from the brain,

making its way to every organ inside your chest cavity or abdominal cavity and all through

your gut. That's the vagus nerve. So, Dr. Pussricha, you're talking about it being the second

brain. And that the gut and the brain are in constant communication through all of these things

that are called the vagus nerve. But can you talk about the science and when researchers and

medical experts realize there is a two-way communication and how that connection gets formed

in a person? Yeah. We've known that the gut and the brain have been in communications for

over a century. If you go back to the 1890s, 1890s, you'll see in Dr. Journals, they were talking

about how it seemed like things like emotional stress seemed to cause this response of all places

inside the gut. And there was a famous set of experiments that was done in the 1950s at Cornell.

And the researchers had participants talk about really stressful emotional experiences. So,

they would talk about an argument they had with their spouse or the financial troubles they

were having. And while they were discussing these psychologically stressful events, the researchers

used a prototype of a colonoscopes, so they looked directly at the colon from the inside.

And as these people were talking, they would see the colon start to spasm and squeeze and move.

And these people would experience stomach cramps and gut cramps. And I think that tracks with what

that's not like what I experienced in real life. If I'm having an argument with my husband,

which doesn't happen that often. But if I'm having that, I sometimes feel cramps in my stomach

because it's a very unpleasant feeling. The problem is that for several decades, that was the way

we framed the gut brain connection entirely. We thought about that gut brain connection as the brain

talking down to the gut. It wasn't until the 1980s, 1990s that my field, which is neuro-gaster

entrology, the study of the gut brain connection really crystallized. And that's when people said,

wait a minute, this vagus nerve, this large nerve that's the conduit between the brain and the head

and the brain and the gut. Most of the signals, 80% of those signals, they're not going from the

brain and the head down to the gut. They're going from the gut to the brain.

So if most of the communication on the vagus nerve is happening from the gut to the brain,

it completely flipped the script. What does it mean to you that 80% of the messaging

begins in our guts telling our brain something? It makes me wonder, and this is what researchers then

started to ask, what if we had it backwards? What if it is gut dysfunction? That's responsible

for our anxiety. What if it's gut dysfunction that causes depression? What if it's gut dysfunction

that causes neurodegenerative disorders? And that completely changed our field and it's still

shaping medicine today? Wow. I mean, that's a both radical and a crazy amazing thing to believe.

I mean, I think it's true. I really do. It's more than a belief. I mean, thank God.

At this point, we have decades now of data that's showing that this is true.

Well, I think it's like something that's super amazing to consider because that means there are other

ways that you can treat those symptoms or really go after those conditions and feel better in your

life. Yeah, that's exactly right. I mean, if your whole life you've been told that your gut

symptoms are due to stress, they're due to your anxiety, they're due to your depression,

then you're left only with this set of tools and medications and treatments that are going to

address the brain in your head. That's all you have. So you're going to be taking things like

antidepressants and anxiety medicines. Maybe you'll do cognitive behavioral therapy. All of these

tools are important and they have a really important place in treatment of these disorders.

However, once you realize that the gut can be the source of the problem, it opens this door

to this whole other toolkit of treatments that will primarily target the gut to interrupt that

vicious cycle. So it gives you options back. And even if it's not the actual source,

it certainly is contributing to the extent to which the symptoms feel even worse.

Absolutely. I mean, we don't think of the gut brain connection as just the brain talking to the

gut, or just the gut talking to the brain. We have seen so many times, it's a vicious cycle,

right? Like if you have horrible gut symptoms as many people are living with every day,

that can give you anxiety and then the anxiety can fuel the gut symptoms and vice versa. And it's

not sometimes just intervening at the level of the brain in the head that can stop them. Sometimes

you need to stop the upstream source and shut off the faucet and that's looking at the gut.

Well, what I love about this is that if you're somebody that really struggles with anxiety or

your aruminator and you're constantly up in your head or you're feeling extremely depressed right

now, going up in your head and wrestling your thoughts feels like an overwhelming thing to do.

Knowing that you're going to talk to us about ways we can take better care of our gut that are

clinically and research-backed in terms of helping alleviate those symptoms, that's amazing.

So from a medical standpoint, when I say I have a gut feeling or I've got butterflies in my stomach,

what does that mean? Like what's the science behind that?

Yeah, those are, that's real physiology. Those aren't just metaphors. So stress, fear, excitement,

these can all trigger our amygdala. That's a certain part of the brain that's an important

emotional processing hub. It causes the amygdala to signal to another part of the brain to release a

hormone called corticotrophin releasing hormone or CRH. CRH is two things. It acts on the stomach to

slow it down and then it moves down to the colon and it speeds it up. So that's why when we are on

a first date, we might feel butterflies in our stomach or when we have to give a presentation

like right before we suddenly have to go to the bathroom like right now. That's why does that

happen? Why do I always have to pee or go number two right before I'm about to give a speech or

I'm about to walk in here and do an interview with you which like why do I have to go to the bathroom

night now? Yeah, well early in my career, I discovered one of the mechanisms by which this happened.

So what I did was I used a machine called an electro-gastrogram. It's very similar to an EKG,

which people used to measure the heart rate. So the heart beats at this regular rhythm of

60 beats per minute. So well, it turns out your stomach actually has its own rhythm and it's

contracting at a regular rate of about three beats per minute. But what I found is that when you're

telling a lie, that regular rhythm of three beats per minute, it goes into total chaos. It doesn't

contract anymore at three beats per minute. It enters this chaotic rhythm called A-rhythmia where

there's no discernible pattern. And it turns out that that discovery where you could actually

potentially use your stomach as a lie detector. It got an asteroid named after me. But more importantly,

it taught me something really profound about the gut and the brain, which is this. The gut can respond

to external information often so much quicker than your conscious brain can process. And

some people call that a gut feeling. But here's what we get wrong about gut feelings.

We often assign gut feelings. We label them as being good or bad inherently.

And a gut feeling is neither good or bad. It's a scientific phenomena. It's a physiological

signal. And it's simply a message. And that message is this, the stakes of the situation are

higher than you realize. That's the message. It's not good. It's not bad. And we are the ones who

give it this label and assign it some prophetic value that it's telling me something. But actually,

I think if we're looking at this just on a scientific level, one of the most powerful tools we can

make, we can use in something that we should learn is that instead of just impulsively acting on

what we're calling a gut feeling, we should learn to pause, listen to that gut feeling. And instead

of asking, is this good or bad? Ask yourself, what am I missing about this situation? What is my

gut perceiving that my brain in my head has not yet understood? Let me give you two examples.

Great. So suppose you're a leader in your group and someone's presenting a new proposal.

And that proposal sounds great on paper and everyone in the room, they're nodding along, they like it.

You suddenly get this tightening in your gut. Popular culture would say, oh, that's a gut feeling.

It's a bad gut feeling. There's something off about this proposal. Yes. You should reject it.

Yes. And maybe the proposal is horrible. I'm not sure. But I think it would be premature to say that.

What you should wonder and consider is what if you're getting a gut feeling that's responding not to

some inherent risk but to novelty? What if this proposal is challenging your way of thinking in a way

you've never done before? Maybe that's a wonderful thing. I love this idea that whenever you get a gut

feeling, don't immediately go, oh, there's a gut feeling. Good or bad. What I'm hearing you say is

when you get a gut feeling, it's like ding, ding, ding, pay attention. That's right. There's

something that I need to pay attention to. What's the second example? Well, suppose we're on a date.

Yes. And you've met this new man. I love what you're wearing, by the way, on this date.

I appreciate you. I'm sure this wearing date is already going so well. Cool suit. She looks amazing.

Okay. Thank you. So date is obviously going well. They're complementing you. Yes.

And the conversation's going fine. And then maybe suppose that moment in the date comes where like

your hand reaches out, their hand reaches out fingers, touch fingers. Tingly. Yeah, except

nothing happens. Suppose you touch each other and that's it. You don't get butterflies. Yeah. Now,

of course, here we go. Pop science. Jump. Send and says, oh, there's no spark. There's no chemistry.

He's not the guy. She's not the girl. And you might assign a lot of value to that absence

of a gut feeling and say, you know what, the spark, it just wasn't there. It's not worth it.

I think a lot of people do. Totally. And what I'd like to remind you is that the physiology, again,

your gut is not telling the future. It is not a good or bad thing when you have that feeling or

when you don't have that feeling. Because what if what is happening in that moment is simply that

you feel safe, that you feel completely regulated. Is that not a wonderful thing?

And maybe, right, like maybe this guy is not the right guy for you. I can't tell you that your

gut is not telling you that. It's asking you to maybe go on one more day, maybe gather more

information and see if he's a right guy and he may still not be there's actually a lot of research

around what they call the slow burn relationship where there's not a ton of sparks in the beginning

but the more time you spend with somebody, the more you realize it's the calmness and the state

of just being okay, that is really the beautiful thing. And a lot of us race towards that like

excitement thing and read it as a good thing. And maybe a lot of the excitement, ah thing,

sometimes is actually your body going, oh, this is just like the other six people that goes to

you, please don't lean into this. Yeah. And you don't know, this person could be different.

Because just remember your gut, it's not trying to write the story for you. It's simply asking you

to read your own story more closely. I love that. So no more, I got a gut feeling, I'm doing it.

It's, I got a gut feeling, oh, I got to pay attention. Yeah. And based on what's happening,

do I do it? Do I not? Boom. Gather more information. Don't act impulsively. Just take a beat.

Now that we've talked about the gut, how many people have issues with the gut? Like how widespread

is it? And can you list off some of the common things that people can struggle with when it comes

to the gut? Yeah. Well, here's a number that made me realize that we have a gut health crisis,

hiding in plain sight, 40%. 40% 40% of Americans say that their bowels disrupt their daily lives, 40%.

So that means all of us know somebody, love somebody. Maybe we are somebody who's dealing with

this every single day. And that's just a tip of the iceberg. 15% of Americans have irritable

bowel syndrome. Three out of four Americans can't poop in a public restroom. One out of three,

struggle to go to the bathroom on vacation. One out of 10 live with chronic unexplained pain

every time they eat one out of 10. And the kids are also not all right in my own lab. We found

that college students about a quarter of college students spend more than 10 minutes at a time

trying to have a bowel movement every time they go. And the crazy thing here is that most of these

people would not identify as being sick. They wouldn't think necessarily that they have a problem.

They kind of would have normalized all these symptoms. And that is the entire problem.

The problem is that we are not having a loud enough conversation about our gut health and

acknowledging what all of us are going through. And I think part of that is due to the fact that

most of what we learn about having a bowel movement comes from what our parents taught us when

we were toddlers potty training. And what they taught us is pretty similar to what your grandparents

taught them. And at some point we have to ask ourselves can it really be true that grandma's

method was a hundred percent flawless? Like there's nothing else the science can teach us about

how to have a better bowel movement. And when I started my GI clinic soon after I was done training

one of the most common questions that fully grown adults would ask me was just this.

Are my bowel movements normal? And if that's the question that we're all asking is adults

it taught me that we've just been winging it for way too long. And we all think everybody else has

it under control. But clearly the data shows us otherwise. Okay I want to just dig in there just a

little bit. Please. Because how do you want us Dr. Pesreja? When it comes to gut health and the

whole system from your mouth all the way to the exit. And all of the important functions that

happen there from hydration to nutrients to immunity to hormone creation which impacts your mood to

all this unbelievable stuff that is happening in the gut. How do you want us like medically speaking

to actually think about our bowel movements? What what is it like because I think because I'll just

be this might be too too much information. But you know every one of us has a bowel movement

and you have to turn around to flush the toilet. And I know I'm not the only person that looks

down to see what's happening down there. But I don't know what I'm looking for and I don't know

how to even think about the information that could be there to tell me something. Because now all

the big tests that everybody's doing to figure out your full longevity and all this stuff you

got to poop in addition scoop it out. And so we're testing it. But I'm glad we're talking about

this because I think those numbers are jaw dropping 40% of people yeah are dealing with this 15

percent of people have IBS three out of four people cannot go number two in a public bathroom.

Yeah. In fact I was having a conversation this morning with a couple colleagues both of whom admitted

they don't go number two at work. Yeah and we're at work what eight 12 hours a day. We think about

how now is I and I think most of us think it's psychological. But I don't maybe it's not.

And I think it's insane that one out of three people can't go the bathroom when they're

on vacation or traveling when you're supposed to be relaxed. I know lots of people like that who

will literally be traveling and it's it's been seven days since I've gone number two hundred percent.

Yeah. Okay so let's talk about the like what is is it data like how how why is this important when

it comes to gut health. Yeah I think you're spot on I don't think you need a lot of these third

party tests that will claim to look at all these different things in your stool when you just need

to turn around and take a look because every time you go to the bathroom it's kind of like getting

a little report card on your health. And so you can take a look and learn so much information

just by what you're seeing and what you know about that bowel movement. All right so I'm glad

that you look Mel. Okay. I find it so odd when I ask my patients well what did your poop look like

and they say I don't I don't look I think they're lying. I even to you as the doctor like what do we

hear for then you know and so like you have to look when you look here's what I want you to be on

the lookout for the shape the consistency of the stool gives you a lot of information about how

quickly that stool has been able to move through your colon. Okay. The color we're going to get

into that gives you a lot of information how you felt make note of that how did you feel when

you had a bowel movement were you in pain were you uncomfortable when you had a bowel movement

did you feel better after you had one did you feel bloated in between you can gather lots of

different information from what it looks like how you felt and then you can use that information

to make some changes. What do you want to say to somebody who has chronic constipation and

they're a clencher about the reality of that this might because none of us have been trained to poop

and if you really think about it one of the things I was thinking about is I've all the sudden felt

bad as a mom because I'm thinking about those diapers that you change yeah where you're sweet

little babies there and you're like oh what is this this is like oh my gosh mustard poop

is felt terrible and so our reaction to it yes also creates this like embarrassment and shame

around something that's so normal I'm so glad you said that I from day one we treat our bodies

our bowel movements as this nefarious entity like it's so embarrassing it's so yucky it's so

yucky you shouldn't make poop jokes it's so horrible and and we internalize that from when we're

kids and so suddenly after we're done potty training nobody's checking in on you again to make

sure you're doing it right right like we go to the dentist a couple times a year and they're like

hey did you do two minutes each side make sure you get your gums are you getting the back of your

tongue who's asking you what you do when you shut the door to have a bowel movement after you're

done potty training nobody's checking in and it's so common right that I have patients who come to my

clinic and it's actually the case that they've been dragged in by their partner and their

partner will be like every time I say you know we need to go somewhere they'll be like oh just five

minutes and they know it's gonna be 60 minutes later that they come out and what I want to say to

you is that if you're somebody who has been struggling you've tried what you feel like is everything

you've tried the fiber you've tried like the mirror lacks you exercise you think you know you've

done what you can maybe even try to prescription medicine and it's not working consider that you

could be in that one in three which is so common that's 33% that there are four of us in the studio

right now well I should be four of us with constipation four of us with constipation then yes well

I'm sure I'll just speak for all this we're all constipated today at least one of us has a

mechanics issue absolutely right that's incredible and the beauty of it is unlike a lot of medical

conditions where the solution is gonna be I'm afraid you need this medication you're gonna have to

take it every day you might need to take it at the same time every day it becomes part of your

lifestyle the solution to this is a certain kind of physical therapy called biofeedback that's

the kind of therapy that's been proven we're talking about eight to 12 weeks is what the studies have

shown that 80 to 90% of people get better but if you want to know a quick fix yes if you're not ready

for the PT yes what one really important study found is that one out of six people who seem to have

pelvic floor dysfunction like this one out of six the entire problem could be solved just by

raising their knees above their waist when they had about movement using something like a stool

a stack of books a pair of nice stilettos raise their knees above their waist I'm gonna put my

heels on and go go number two Chris it'll help yes well you know it's funny you say that because our

every time our adult kids are home mm-hmm I walk into my own bathroom the garbage can is right

in front of my toilet yeah because they have moved it from the side to put it in front to put

their feet up of course I don't put it back but that's because they're on to it actual yeah that

actual the mechanics of the knees being up so I want you to picture so again this is the cross

section of the female anatomy so what I'm pointing out to you is this is the rectum yep and this

is the end of the colon it's kind of curved as it comes down now imagine that there's a rubber band

around this last part of the tube that is choking it shut we have a muscle the puborectalis muscle

that chokes that muscle close that's a good thing this muscle saves our butt that's

what that's how we don't put our pants right okay exactly however we can't have a good

bowel movement and relax that muscle so it opens up that tube sitting in this 90 degree chair-like

position that we have in our modern toilets the best way to open up that tube is to squat right

and squatting is something that we used to do thousands of years ago but we've changed those

mechanics and obviously squatting is a difficult thing for a lot of people to do and I'm not asking

actually I don't squat but I do raise my knees above the waist and you can just do that with

something as simple as a stool oh my god I love you and I'm loving this conversation there's

so many more questions that I have I know there's so many questions that you want me to ask her but

let's take a pause to give our sponsors a second to shine and I want to give you a chance to

drop the link to this conversation in your family group chat because I can't wait to see what your

friend group says everybody is gonna love this don't go anywhere I haven't even gotten started with

the embarrassing questions and you don't want to miss it stay with us you know that feeling

when your brain is fried you have like 12 irritating tasks you don't care about but you have to do

them anyway that's where I've been lately the administrative stuff was eating up half my day so

I've been using Microsoft co-pilot as my extra set of hands it's like having your own personal

assistant that's why Microsoft co-pilot is my favorite AI tool last week I had to send this long

overly complicated email about scheduling and travel the kind of thing that takes up

way too much energy for what it is I open co-pilot talk to it out loud while I was walking around

my kitchen and co-pilot turned it into a clean professional draft it was amazing and because my

brain wasn't fried I had the energy to sit down and eat dinner with Chris without feeling mentally

wiped that's the whole point for me Microsoft co-pilot clears the clutter so I can be more present

for the moments that matter that's why I'm using it if you want to try it for yourself visit

Microsoft.com backslash Mel Robbins to download the co-pilot app get started with co-pilot today

for free and see how handing off the small stuff gives you more energy for the moments that matter

that's Microsoft.com backslash Mel Robbins did you know that your skin is your body's largest organ

it protects you regulates your temperature and is your first line of defense if you're serious about

taking care of yourself taking care of your skin is not optional and look I get it there's so

many products and 12 step skincare routines out there it's overwhelming expensive have you heard

about the shark facial proglow it's a first of its kind five step facial system that gives you

professional level results at home and just 10 minutes it combines exfoliation to remove dead

skin cells with pro level pore extraction to clear buildup and intense hydration infusion so your

skin can actually absorb what you put on it plus it has a de puffy attachment with warming

technology to help increase circulation and cooling technology to help your skin de puff and the

best part it's palm size so you can go and glow anywhere no appointments no complicated routine

just professional level results at home for skin that looks as good as it feels visit shark beauty

com and use code mel for 10% off that shark beauty dot com and code mel

so when I was out in Los Angeles for the golden gloves I saw this very famous actress wearing

this beautiful cashmere puffer vest it was beautiful and so I took a photo so I could remember

what it looked like and then you know what I did I went to quince and guess what was on the quince

website the Mongolian cashmere puffer vest it looked exactly like the one this famous actress

was wearing it's the perfect layer lightweight warm and comfortable I loved it so much I

immediately ordered it in a second color and here's what makes quince different they cut out the

middle person and worked directly with ethical factories which means you're not paying for a markup

just high quality clothes that last at a reasonable price and these days I'm all about quality

not quantity right now go to quince dot com slash mel for free shipping and 365 day returns

that's a full year to wear it and love it and you will now available in Canada too

don't keep settling for clothes that don't last go to q-u-i-n-c-e dot com slash mel for free shipping

and 365 day returns quince dot com slash mel

welcome back it's your friend Mel Robbins today you and I are here with professor at the Harvard

Medical School and renowned researcher and neuro gastroenterologist dr. Trisha puss reacha

we're talking about everything you need to know about gut health all right dr. puss reacha

so what are the symptoms or the things that people complain about just because when we say

gut issues especially now that you're talking about mouth to the rear end I would love to hear

what are people coming in and actually complaining about that you can normalize and then we can talk

about the symptoms that you should never ignore and then we can talk about the symptoms that are

simply what you're always going to experience until you understand what your body's trying to tell you

yeah one of the most common things that people come to my clinic complaining about is that they

struggle to have a bowel movement and that can mean a lot of different things some people can say

I go to the bathroom every single day great but it takes me 20 minutes I'm straining it's hard

how long should it take less than five ideally less than one minute okay it should be an in-and-out

job wow yeah but if you're having a bowel movement every day you might be told you might believe

that that makes me normal but it's uncomfortable for you and you're spending 20 30 minutes at a time

that's not normal people complain about having discomfort bloating pain cramps until they're

able to have a bowel movement and then for some people the bowel movement helps those symptoms get

better sometimes that's only momentarily and then they come right back and then they're there and

they're there and they're building until the next bowel movement sometimes people complain about

a lot of urgency like they're just interrupted by they're at work they're out with friends and suddenly

out of nowhere they have to go to the bat and have to do it now there are a lot of people one out of

seven people okay I want to just internalize this number one out of seven people poop their pants

regularly in America that's what the studies have shown so people feel so isolated sometimes

and embarrassed and ashamed when they have bowel accidents it's actually more common than you think

and a lot of people are struggling and dealing with it even if nobody like brings it up at your

boat club a lot of people in that room will experience which are experienced because sometimes people

talk about that bloating just plain old bloating which is so uncomfortable it's this feeling of

distinction that you're too like you eat just a little bit but you feel so full and you feel

gassy that's a big complaint and then there's another group of people who it's not so much having

a bowel movement that's a problem but eating is the problem it feels like everything they eat causes

discomfort or even pain maybe a little nausea and they're not sure they've tried everything they've

tried to eliminate all different kinds of foods they've gone on all the different kinds of diets and

they can't seem to pinpoint why what is it about food that's giving the trouble these are the

kinds of people who come into my clinic and of course as I said a lot of them have anxiety and

depression certainly a lot of them stress fuels these problems and makes them worse but oftentimes

it's not the stress that's the primary problem or the anxiety or the depression exactly it's that

your god is going haywire and you're not quite sure how to address it and there are things that

you're about to show us based on the research and based on your clinical practice that will help

us address it what got symptoms should you never ignore because they signal that something bigger

could be happening yeah let me tell you about two okay and this is this is one that I want people

to pay attention because I think this could really save a life so the things that I worry about first

for colorectal cancer and something that I'm worried about a lot I think every scientist in the

country right now and in the world thinks is one of the most important scientific problems of our

day is why are more and more younger people getting colorectal cancer and so they did a study where

they looked at what are the four most common symptoms of early onset meaning before the age of 50

colorectal cancer but these also apply to colorectal cancer at any age okay and so these four

symptoms are one abdominal pain two rectal bleeding three iron deficiency anemia this is a blood

test that tells us that your red blood cells have become smaller and that's due to iron loss

this is really important in women because when women have iron deficiency anemia and it can feel like

fatigue or tired you get the blood test oftentimes people will say this has to be due to your

period because we lose a lot of iron we lose blood with our periods if you have these other

symptoms or you're like wait a minute but my periods are kind of light I really want you to pause

and not brush this aside and then the fourth symptom is the most important and also the most vague so

it's what makes it really complicated is any change in your bowel habits meaning new diarrhea

new constipation some change to the pattern maybe suddenly your bowel your poop went from being

really thick to really really thin anything that's new for you that seems to stick around get

attention because this study found that people who have three or four of the four symptoms I just

mentioned they had a sixfold higher likelihood of having colorectal cancer than people who had fewer

sixfold sixfold so you've got stomach cramps stomach abdominal pain abdominal pain you have bleeding

from your rear end yep you have iron deficiency yep and you have a change in kind of what is kind of

historically your rhythm and how long would you see that change stick around like a week yeah I

would go get help for any of these symptoms no more than one or two weeks if it's persisted and

there have been some really high profile cases of celebrities who have said the only sign I had was

that fourth one just that's something changed in the pattern and I thought it was like my coffee or

something else but then I changed the coffee and it didn't go away if you're worried if something's

off don't wait don't brush it aside as normal do not be embarrassed by it just run it by your doctor

Dr. Pressreacher why do you think there is this very troubling trend of so many young people not

only getting but dying of colon cancer yeah it's it's an important question it's a big question

we used to think about cancer in general as being a function of our genetics and smoking right but

we've stopped smoking so much as a society and obviously our genetics aren't changing but what

can change with generations is something called epigenetics or changes to our genes that occur

on top of the actual gene itself that can be due to influences from our environment so as these

cases have been rising we're arriving more and more at the conclusion that there has to be something

in our environment that is changing and that environment could be the air we're breathing it

could be chemicals we're introduced to it could also be the foods we're eating don't you think it's

ultra-process foods and all the chemicals then crap that's in food that's packaged and the people

especially in the United States I really do and there have been some major studies that have linked

colorectal cancers specifically at a younger age to ultra-process food consumption is the rise in

colon cancer in younger patients is that higher in a country like the United States where we have

like horrible regulations when it comes to ultra-process foods it's a global trend and that's what's

really worries and of course the rise of ultra-process foods has not just been isolated to the United

States it's been happening all over what we've also found and they've done some really big studies

here at Harvard and the nurses health study they found that people who drink more for example

sugar-sweetened beverages as children as teenagers they're more likely to develop early

on sick colorectal cancer once they become younger adults and we've been drinking more and more

of these sugar-sweetened beverages as a society we've seen that trend happen over time since

in the United States alongside with ultra-process foods and so it's probably a combination of a

lot of different things I also you know I tell all of my patients especially when I'm making this

diagnosis that first of all cancer is not your fault it is never someone else's fault

cancer is the result of so many things some of which we have control over or some control over

many of which we do not right and sometimes you say to yourself they can't be ultra-process food I

hear this a lot it can't be alcohol it can't be ultra-process food because how can I not honestly

like people will say like well my aunt you know drank you know seven drinks you know like a day

or whatever and she lived to be the age of 90 and what I try to explain to people is that

think about cancer as building a tower of building blocks is how explain it some people start out

life with five blocks stacked against them and it only takes 10 to get cancer you your aunt may have

started out with just one or two blocks and then suppose you eat a lot of processed meats every day

there's one more block you grow up in a town where air pollution is really severe there's another

two blocks and then suddenly you've hit 10 blocks and somebody who's had other patterns of behavior

they're more sedentary than you whatever it is they never hit that 10 block threshold and it feels

unfair it feels hard to imagine why but it's simply because we're starting at different places

and a lot of the risk factors for colorectal cancer and these cases that we've been seeing

rising they start in our childhoods they started a time when we may or may not have had that kind

of control over our lives yeah wow I have so many people I need to send this to so I want to take

a quick break because of that last topic we were just talking about three people popped into my mind

and I bet the same thing happened to you so take a moment share this episode and share Dr.

Puss Riccia with you do you know how amazing it is that we get access and get to spend time

together with her and to learn all this holy cow thank you for being generous with the link thank

you for being here and thank you for not going anywhere because we have so many more things to

dig into when we return stay with us oh my gosh don't you agree there's nothing more overwhelming

than the vitamin and supplement aisle at the pharmacy I mean you're walking in looking for one

supplement someone recommended what was that thing they said and suddenly you're staring at 47

versions of it different labels different promises different prices and now you're doing this

mental gymnastics mathematic equation okay wait is this a ruin is this dose even right for me

here's the thing with supplements you don't want to guess you want quality you can trust and you

wanted to be simple that's where Nordic naturals come in Nordic naturals helps take the guesswork

out of supplements with high quality vitamins and supplements that make it easier to find exactly

what you're looking for and if omega-3s are on your list because they support your heart your brain

your overall health Nordic naturals offers exceptionally fresh purified fish oils with a clean

lemon taste if you want to simplify your supplement routine and feel confident about what you're

taking check out Nordic naturals use promo code mel for 15% off your next order at nordic.com and

discover the power of omega-3 with Nordic naturals the number one selling omega-3 brand in the United

States these statements have not been evaluated by the food and drug administration this product is

not intended to diagnose treat cure or prevent any disease eight it's your friend bell sometimes

the hardest part of starting something new is well starting especially with new exercise routines

that's why ultra running shoes are designed to make that first step more comfortable the secret

is in the ultra fit which has more room for your toes when your toes aren't squished they're free

to do what they do best and you get comfort balance and strength all in one so you can move more

naturally from nailing that run you've been putting off to simply just getting outside hello

breath of fresh air these shoes move with you every step of the way shop now at ultra running

dot com that's a l t r a running dot com and stay out there

this is a paid ad by better health you know my mom has had a huge impact on me she's the reason

I dream bigger work harder and I try to spread more joy women deserve to be celebrated and we

deserve to be cared for because so many women are running on empty trying to hold everything

together work stress family stuff relationships deal with everybody else's needs if that's you

whether you're navigating career pressure parenting caregiving or just feeling stretch to thin therapy

with better help can help you check in with yourself unpack what's feeling heavy and build healthier

pathways forward and get the support you need better help is the world's largest online therapy

platform and they may getting started so easy you just take a short questionnaire about your

needs and preferences and thanks to better helps industry leading matry they usually get it right

the first time and if you don't like the therapist they match you with you can switch your emotional

well being matters find support and feel later in therapy sign up and get 10% off at better help

dot com slash mel robins that's better hlp dot com slash mel robins

welcome back it's friend mel robins today we are here with world renowned neuro gastro

enturologist her name is dr trisha puss reach i i know you're loving this as much as i am so let's

just jump right back in so you're best selling book you've been pooping all wrong how to make your

bowel movements a joy congratulations it focuses on how much you can learn by just focusing on your

bowel movements so can you explain to the person listening all the things that you can learn about

your health just by turning around and taking a look at the information that is in the toilet bowl

yeah like i said that information that you get just by looking is like a report card on your health

your poop just having a look and just thinking about that experience of when you had the bowel

movement will tell you about the food you've eaten the quality of the food that you've eaten

it's going to tell you about inflammation and possibly infections or the kinds of inflammation

that come from our environment and our food it's going to tell you about how the brain in your gut

is working you're going to get information by asking yourselves how often did i go in one day

how did i feel when i went was it hard did i strain is the consistency rock solid or is it

soft and floating all of these pieces of information tell you about how your gut is functioning

as a brain as an immune organ as a hormone producing organ and that has an influence on your entire

health i am so excited to talk about our bowel movements me too let's start with what is normal

doctor press reach and what is not normal when it comes to poop for me a normal bowel movement has

to just two things one it should be effortless shouldn't have to be straining shouldn't spend 20

minutes in there sweating straining your eyeballs out too it should occur at a socially appropriate

time what does that mean socially appropriate meaning you shouldn't be worried about going out to

have lunch with your girlfriends you shouldn't be at work panicking when you're in the middle of a

meeting and then not being able to give your presentation because of this you'll notice for me

i didn't say your bowel movement has to be once a day and that's what everybody seems to have in

their mind like once a day we have it in our minds that this is holy this is like the only pat to

god it doesn't have to be that way there is a whole range of what would be considered normal in

terms of frequency okay and what is that range so my colleagues at Beth Israel did a study where

they looked at this national sample of americans who thought they had normal bowel movements and just

said well how many times are you going and it turns out anywhere from three times in one day to

once every three days is in the range of normal okay so if you fall in that happy comfortable

i am really happy for you if you're comfortable okay it turns out too that if you're meeting your

fiber goals which for women over 50 is 21 grams a day or under 50 25 grams per day you're going to

start to have fluffier more frequent bowel movements it's not going to be once a day and you should

embrace that new you it's okay let me show you a couple models okay okay oh my god okay now if

you're listening uh she is hold the doctor press reach uh is holding up poop but i but i have to

give a shout out to our team oh my god because our team creative geniuses ordered play dough and i

cannot believe how realistic this is it's almost i can can smell it on the right you're seeing a log

that is this is embarrassing you're you're seeing a log that's maybe it's like a brat worst it's

like about the size of a fat hot dog and it's you can see there are lines in it so it's almost like

parts of pieces of poop have come together to create the brat worst and then the one on the

other the other one because there's two here is about four inches long but that there's it has

like a sharpen tip and then it's got a thicker end so it's more like a you know like one of those

things you'd throw into a pool that sink to the bottom that kids die for torpedo okay yeah i think

what you're described first of all could you do a full description thank you let's move the model

over so that those of you on youtube can really see this and if you're listening just keep listening

i'm going to narrate if you want to see what this all looks like the link to the youtube version of

this is also in the show notes you can find it or just google you know melrabans and dr

pus reach uh there we go you know i think most people would consider this type of bowel movement

to be normal to be the ideal and you know like this one right here the like smooth sausage

some people call that a whipeless wonder yeah i think that's nice i think it's great when you

have this bowel movement i don't think that's the only path to god like i said i think when you

have more fiber in your diet you start to get fluffier and fluffier and that's okay so is that

is that what you would consider is the smooth torpedo shape yeah is that like that's is that

evidence of somebody who's got a lot of fiber that's a fluffy bowel movement this is this is a

lovely poop so these are these are good you're giving this an A like either one of these are

acceptable you totally you get an A for this you also in my books could make an A or an A

minus if it's even softer i can see why the team might not have been able to really show softer

stool in their clay model you mean what do you mean like it's got kind of some water with it yeah

it's a little like a little bit less formed a little bit more floaty okay softer you could

still get an A for those two um it's when it's like pure liquid or it's just like really frequent

that i think we can all agree that's not ideal okay um but if there's some shape to it and it's

even fluffier than this beautiful sausage you're still winning um do you want it in one piece is that

like a thing that that is important or is it okay if it's in a couple like i think if it comes out

in a few small pieces that's okay when it comes out in one long piece like that what it's telling

you is that you were able to efficiently expel it and all the muscles in your pelvic floor

were moving in this nice coordinated dance to get it out in one try okay so hold on a second

so when you have one of those ones it's like oh my god that came out of me you feel like you've lost

a couple pounds you like stuffed the toilet yes does that mean that you from the mechanics of it

you've actually emptied out the length of the rectum like you've you've really like you've just

like because they're always like kind of satisfying it and let's a little

you should have been a gastroenterologist but yeah it's if it's long like that it means it didn't

have time to sit and collect in your rectum and full and form this like larger clump so it just

means it's coming out more quickly more efficiently it's not a bad thing I mean your rectum is

built to accommodate increased spaces for more poop so that's fine but it means that you caught it

the right time it's passing through you gave it a little push and it all just came right out

now on the other hand I'm going to show you another set of models that that that's fallen right

off I would tip that just like that there we go let me show you the other amazing model that your

team put together oh my god these are like rabbit pellets on the bottom so little pieces that are

very very hard and then the one on top so it says like lots of little like pieces we've all had

yeah and then there's one on the top that is that looks like pieces that are just barely held

together and these guys are hard as rocks these are the chunky pebbles yeah I've almost never met

somebody who has one of these the chunky rabbit pellets and felt like they had a good poop never

you're not satisfying if you just drop a couple of those in you're like I'm not done I'll be

hopefully I'll be back here in an hour or two but this is just that's not even an appetizer

like that's the minus yeah I don't know if you're going to pass but what is that telling you when

you have those little like you know it's like beep beep and you're like that's it yeah it can

tell us one of two things one what we know absolutely is that this poop the one that's the rabbit

pellet has been sitting in your colon longer than any of these other poops because that is your

colon's whole job it sucks water out of it so the longer poop sits in there whether it's because

you decided this was not the right time to go to the bathroom I have a I'm on a hot date I'm

gonna hold it until tomorrow well the poop that you need to have tomorrow is gonna look very

differently than the poop you would have had today because you've held it in and now more and more

water is gonna get sucked out and it's gonna look differently so if you're a person you're one of

those you said Dr. Pristreja that three out of every four people do not go number two at work

yeah if you're somebody that is clenching yeah all day at work which could be 10 to 12 hours you got

to be in your own bathroom yeah are you causing yourself to have harder poop because you're not

allowing your body to just do what it needs to do yeah I mean when you feel that call that's usually

your body's way of saying hey I'm helping you I'm doing some of the work right now your muscles

are contracting it is providing you the propulsion if you ignore that call and this is why I I mean one

of the most fundamental things I teach people is don't ignore the call go bring some nice bathroom

spray with you if that's what bothers you but go at work it's good for you if you ignore it you try

to go later that night now you don't have that urgency because you've suppressed it your colon is

not doing that work for you so you've got to do all the work yourself by doing a harder and harder

valve salvage straining because it sucked all the water out of it and now you are looking at a

different poop than you had 12 hours ago it was already going to be hard it's going to be way harder

now huh and what is the one on top that is kind of in a long shape but it's like hard pellets

together I've seen some people who think that they're living their best life and this is how they

poop every day and it could be normal I hate those because they come on chunks I hate those

yeah yeah everyone's a little different but this one to me if you were to say oh yeah I do this

every other day and I feel fine in between I'd let you live your best life I wouldn't interrupt

that but this one I'd like to have a little longer conversation about now this way

beginning to graphic but I do have some questions I'm a GI dog okay so what if you have like you know

you go number two and the bowel movement has one section that's darker round and then it kind

of you know has the umbrae effect of changing color does that make sense perfect I know you're a

GI dog you know you know you know all about this stuff okay yeah well let me tell you a fun fact

we think that we're pooping just whatever we ate most of your poop they've confirmed this on

electron microscopy is your bacteria ew what I know so take a look next time you're in there

and say hello it's your microbiome that you're pooping the majority of it is not what you ate

you've absorbed all the goods wait a minute so when I have but unless there's corn because you see

the corn yeah all of it why does corn make it through yeah everything you can't absorb we cannot

absorb and digest and break down corn why because it's fiber and am I not chewing yet enough

you can chew your heart's content but we don't contain the enzymes

and the machinery to break down fiber now listen that's a good thing we need to eat more fiber

because all the fiber that we're not absorbing we are giving as a gift to our microbiome and they love

it they thrive off of the corn off of the cruciferous vegetables all the high fiber foods

and it's not a surprise to me that it's sometimes those little chunks and pieces come out and we say

oh there must be a problem with night digestion no no it's normal it's not like we can't

even bean shells like these things are all normal when I do colonoscopies on people

half the time I can tell them what they had for dinner two nights ago you we can see bits of it

especially if they've eaten a lot of salad or something like that that's normal what we poop

first of all the brown color that comes from billy rubin that's something that we produce as part

of our digestion it gives it that brown color different at different time points it's going to be

a little more concentrated than others and at different time points as it's moving through your

colon more and more water is going to be sucked from one end a little bit less from the other end

the bacteria is going to concentrate on one side so it's okay to see a little bit of a gradient

that's just how your body moves things along got it let's talk about color please all right we can

move the poop good job team that looks so realistic I feel like I can smell poop I know I don't

I don't even feel good like wiping this down okay if you want to talk about color yeah let's

talk about color all right so I've got a set of pan tone color cards for you okay Mel okay I'm

going to hand these over to you these are colors that people have actually told me they've seen

in their poop before so I want you to flash them over to me wow and let's talk about okay they're

normal all right all right I'm going to describe them yeah so apple green I'm looking at an

apple green pan tone so imagine a granny smith apple okay yes that to me looks like the kind of

diarrhea a baby has after they've had breast milk yeah I mean this is a lovely bucolic shade I

would say first of all Mel everyone's are allowed to have a weird colored poop every now and then

well that's that that if I saw that as an adult I would think something's very wrong if you see

this shade it's a little bit green maybe a little yellow and you have other symptoms like for

example if a fever you have diarrhea so it's coming out quickly frequently it's liquidy this is a

problem and you should talk to your doctor about it if you've been eating something high in chlorophyll

maybe your greens powders people actually can get the occasional green colored poop if it's rare you

don't actually need to panic about it if you know what you're eating that has changed the color

no need to panic but if you do have other symptoms diarrhea fever talk to your doctor oh that is

like a a color that you have you have the flu yeah exactly yes you get things are moving quickly

yeah through your system typically when it's that color that's right you tend to get diarrhea

especially with the flu A okay cool all right so this one is a pan tone red plum that I'm in hand

over and that looks like I've just eaten a beautiful beet salad I was going to ask you if you had

beats last night yes yeah if you have this color and you've had beats you're good you don't need to

necessarily panic unless you're feeling dizzy or lightheaded if you haven't had beats and you see

this color it's kind of a maroon color you should absolutely talk to your doctor because this is

bleeding until we prove otherwise oh whoa so blood can show up in our poop in any number of forms it

can be a nice bright red it can be black it can be this maroon color when it's maroon it tends to

mean that the bleeding may have come from a little bit higher up in our colon the bright red is a

little bit lower down but this is still an emergency so any amount I mean if it's something that you're

used to seeing you and your doctor have already decided this is hemorrhoids you've gone through it

comes back it feels the same all right just let them know non urgently but any amount I would talk

to them especially if you have other symptoms like feeling dizzy feeling lightheaded okay so this

next pantone is called lightest sky and this looks like a one of those white walkers from game

of thrones this is what I would call zombie horrifying like goose poop it's like really grayish white

does look like the kind of stuff that my dog used to eat you know just like the zombie walkers you

should run and not walk this is actually an emergency I've never seen white poop yeah I hope you

never do but people see it and what does it mean remember I told you that our poop is actually only

brown because we have billy rubin yes if we took that billy rubin away this is the color our poop

would be it would be like the tail clay what's surprising isn't that bizarre it's bizarre clay colored

if we took the billy rubin out so when we see this color it tells us there's a something blocking

our billy rubin it could be a gallstone it could be something more worrisome even like a cancer

if this has been going on for one day two days call your doctor immediately because this could be

a big emergency that's what color would be yeah well because I'm into kind of lovely well it is

it's a lot prettier than but you would you'd have to have a different colored toilet paper because

you wouldn't know if your poop was white whether or not you got it all but here here's what here's

what I'm going to tell you you want to know why I thought poop was brown tell me because I thought

when you eat all of this random stuff yeah and you blend it all together it just naturally blends

to just a really book kind of color like that's like I don't know that it's true when you look at

the actual signs of colors if you mix them all together they turn into poop brown but that's just

why I thought like when you eat everything it just reduces to a brown color I think that's

what a lot of people think but I think we're forgetting that again we're actually absorbing

all the foods to do why is it in there it helps with digestion it helps break down with the food

it helps break the food down so it does help you with digestion you need those bile salts that are

in there um but we're absorbing most of the hopefully most of the colorful nutrients that are

in our food and and what's left is the stuff we can't eat and then our bacteria and that's really

what makes up this nice clay colored poop okay this next one is pantone five one two five they don't

have a they didn't name this one but it looks like eggplant like it looks like a beautiful shiny

purple eggplant and I've I don't think well I feel like I may have seen like a little but it's

probably the beat it probably was not that purple specifically I've definitely seen one or two of

these in my lifetime okay it's um this is one of the ones like you're talking like a whole like long

log of that or pieces of it okay everyone's allowed to have I think one or two purple poops in

their lifetime really maybe more maybe less it can be due to something called the anthocyanins

which are this pigment and certain nutrients like in berries for example okay those can give

you a purple poop they can give you like a bluish tinge poop even some time then actually they're

there in like red wine too if this is like a pattern though we do want to make sure we're not

confusing the color for something that's a little bit more maroon like which makes us a little more

worried for blood because that's what yeah but if you're like I just ate two cups of blueberries in

my smoothies yesterday I'm seeing this one purple poop I'm okay with that okay because you kind

of can go oh the dragon fruit oh the beads oh the blueberries okay but if that comes out of nowhere

yeah if it comes out of nowhere and again it's also think about it as part of the pattern if you're

having lightheadedness if you have any pain any other warning sign with a new colored poop that should

prompt you to say let me just what does that tell you though usually what does that mean if you like

are having purple poops it's two things it's either something in what you ate like these anthocyanin

something in the food or we want to make sure it's not blood okay got it all right this next one

is called fiesta and so this is like a cross this is like a orange a shreddish not like

fire engine red more like cherry orangey red yeah fiesta it's a fiesta although it's not a fiesta

because if you see this you should go to the emergency what does that mean this is bright red blood

usually okay and it usually means that it's coming from like close to the exit hatch like so you're

bleeding from the last part of your colon maybe from hemorrhoids it can also be due to something

called diverticular bleeding which are these small outpouchings in the colon so how much of that

color in a log I hear pellet or whatever like well because like because you know occasionally

you have might have a little streak there and it happens once but like and I'm assuming it's not

that often that somebody has an entire fiesta hot dog coming out but I don't know well I would

say that anytime you see a fiesta you just bright red even if it's a little bit you have to run

it by your dog okay now here's a question yeah okay I can't believe I'm gonna ask you this I'm so

excited should you go get like a sandwich bag or a dog bag and grab it yeah and bring it

with you if you're going to go to the doctor of the hospital well it's like I always say because

we do that for the vet but I don't know that I would ever think to do that myself but if you're

seeing one of these colors do you think would you appreciate that if when I showed up we actually had

the thing I love when my patients take a picture okay don't have to bring in the picture it didn't

happen okay take a picture get the color you don't have to bring in a sample but the color often

your word is enough but sometimes seeing the color can help me say okay this is probably more

upper GI bleeding versus lower GI bleeding helping make a decision about it but if you see this like

and I want to just make sure I'm clear bleeding can be due to hemorrhoids which are very common very

disruptive we don't want them but they're not necessarily killers but rectal bleeding is also one

of the four signs of early onset clerical cancer and that's why I'm telling you even if you see

just a little streak make sure we just double check and know that it's hemorrhoids okay I got you

okay take the photo I'm gonna leave I'm gonna leave the poop in the toilet okay

all right pantone pirate black is just like a jet black which I thankfully have also never seen

yeah thank goodness so jet black is really worrisome it means you're dying because you're dying

from the inside out is that what that means okay okay why don't I like if that came out of me I

would be like I am rotting from the inside out it can be a big emergency so this is not one that we

say oh let's just see what happens over the next couple days this is one that you go talk to your

doctor and because this is a situation when you see jet black that is the color that your blood

turns when it acidifies when it mixes with the acid in your stomach so a dark tarry black especially

if it's like sticky like it's sticking to that toilet bowl that makes me worry that it's coming

from blood it's coming from blood higher up in your gut where it's got catch the acid it can though a

nice pirate black stool can come if you've been taking iron pills iron pills can turn your poop

black no kidding yeah and ironically should you take iron I'm so confused about iron like are you

supposed to take it with food in the morning and the evening does your does your poop get harder I

mean like I started taking iron now we're going to turn this into my own personal session here

but I started taking iron because a lot of women are iron deficient a lot of us in menopause are

yes and it really screwed up my routine in the bathroom I know iron does constipate you that's like

one of the most like common side effects of iron pills so usually I tell people actually there's

two things I tell people about iron one you don't actually have to take it every single day to

replete your iron stores you can take it every other day okay and you actually like end up

getting the iron unique because you can only absorb so much at once and sometimes every day is

actually overkill that can help with the conservation but I also usually tell people at the same time

take a fiber supplement okay do both because it'll help with the absorption yeah okay great yeah

this last one pantone caramel this does look like a nice milky caramel color here isn't she a

thing of beauty yes is that the color we're going for this is a nice color I mean I think you

can have different shades of brown but I think we can all agree this is a pretty one okay so anything

from say caramel to dark chocolate yeah in the zone totally in the zone just be on the look out

when you get too dark chocolate that you're not viewing towards pirate black got it okay wow

so helpful the more you know yes I've heard you talk about the five minute toilet rule what is that

yes people should not spend more than five minutes at a time in the bathroom if you're in there for

five minutes you've got your knees up on the stool or feet up on the stool yep you're trying to

relax into it and nothing's happening just pull up the pants and come back later yeah and this

is really hard because we're all in there with our smartphones right and the reason this is

important last year I did this study in my lab where we looked at people coming in for their

screening colonoscopies and so we're taking a look directly with our eyes with our scope to see

what's going on in their bodies and we asked them right before they went in all about themselves

how long do you spend in the bathroom do you take your smartphone in the bathroom with you how much

fiber do you eat how much do you exercise what we found is that people who take their smartphones

into the toilet with them they are more than five times as likely to spend more than five minutes

at a time in the bathroom and they are at a 46% increase risk of having hemorrhoids we saw them

with our eyes hitting me yeah and you know what we think is happening is that I mean we get distracted

with our smartphones when we're trying to go to sleep when we're waiting in the line something like

why would we not be getting distracted beyond belief in the bathroom when we bring our smartphones in

and what that's doing is making us sit for longer than we intended on this seat that has an

open bowl so there is no pelvic floor support and our hemorrhoids are actually just engorged veins

that's all they are and so as we're sitting there in that vulnerable unprotected way those veins

are just passively filling and if we do that and we put that pressure on our pelvic floor

for longer and longer periods of time over days over years this becomes our pattern we think

that's how we get hemorrhoids holy cow so that actually makes sense let me just make sure I'm

following yep so hemorrhoids and like explain to the person listening who's never had a hemorrhoid

because there was a person our family that got one for the first time and it was a whole

I it somebody should do a sitcom episode about it and preparation age and the panic about what

one should do with it and the forer to understand that mom and dad actually had preparation age

already in the house this is normal people get these things um and so you have to put that up there

what and so I a hemorrhoid I always thought a hemorrhoid was like irritation of the skin

yeah from something but you're saying it's actually the veins around your exit

yeah that are filling it's just your body but yeah it's there's two kinds of hemorrhoids okay all

right so there's internal hemorrhoids those are just inside the sphincters you often can't feel those

we know you have them when we do your colonoscopy there's also external hemorrhoids those are the

kinds that you can feel and they're the really bothersome ones that can be itchy they can be

irritated and flamed they're very sensitive to touch and then there's actually like a cousin of

the first kind which is an internal hemorrhoid that gets so heavy pops down oh it like hangs out

you can hang out and you and people like an utter yeah people know they have those because they can

kind of push them in and out you know what do you do well there's lots of different than you can do

one you should start eating more fiber that's like always going to be my answer to most everything

we talk about but you sometimes can actually get like a simple outpatient surgical procedure if

it's the kind that has like popped out to say hello and you need to push it back in but for the

kinds that are just irritated itchy started on the outside something like preparation age or

these like mild steroid creams can like really help get you through it and then sits bad sits

bats are just like a fancy way of saying sit inside a bath of warm water and give that inflamed area

a little bit of time to heal do there's a couple times a day for a couple days now doctor

pest reach out you also talk about being very intentional about toilet paper which seems weird

but you say it matters a lot why yeah well because I because my husband I have this fight because

I think there's two types of toilet paper there's a type that stiff and like abrasive

and that frankly feels kind of cheap and then there's the kind that feels puffy and fluffy but the

problem with that one is it leads all kind of lint all over the place you know like I yeah so but it's

but it's more comfortable so what do you want us to know about toilet paper and that it's actually

mattering a lot I think what you're talking about is the difference between two ply which is this

guy two ply and then one flood yeah puffy and thin expensive cheaper yeah yeah and I don't know

who needs to hear this right now I do I want you to repeat after me now okay okay I am worthy

I am worthy I am enough I am enough I deserve two ply toilet paper I deserve two ply toilet paper

means look at this this is one ply all right this is pathetic you don't need this on the most

delicate part of your body and that's your rear end the tissue down there is so thin so delicate

do not give it this pathetic one ply and for the more if you start to date somebody new you go

over to their house you like them and then you go inside their bathroom for the first time

and horror upon horrors you see this inside their bathroom you gotta run for the hills that's a red flag

we've talked about red flags forget about a gut feeling if you see this how are they gonna ever fall

in love with you because they don't even love themselves well they don't know they that's why

you're here I see I didn't even know this people think that they're getting one ply because the

little cheaper but the fact is when you use one ply you have to bunch up such a thick wad that you

are breezing through that pathetic thin roll more so it's true you use less you use less yes I also feel

richer when I buy two ply it just feels like morx it doesn't even necessarily have to be it just

feels like fancy toilet paper I mean it's the least you deserve but I will say my dirty little secret

about this which is actually quite clean is that I don't think toilet paper is the answer here uh-oh

I think what we really need is bidets okay yeah and I know a lot of people in this country

not ready for that conversation explain what of a day is for somebody who doesn't know because

that was in that was another eye-opening experience recently when we went to a very nice hotel

and whatever kids were like whoa this just sprayed me what was that yeah a bidet is gonna change

your life okay I changed a lot like they in in the US they surged in popularity during the pandemic

and people's lives changed but other countries are way ahead of us on this so bidet the simplest

form of a bidet is simply a nozzle that sprays your exterior okay that's all it can be now if that's

one end of it these simple nozzle attachments are like pretty cheap you can install them yourself

on the other end there are beautiful luxury bidets where you have a heated seat so well then I'm

gonna spend more than five minutes in there if I've got a heated seat that's a problem it also has

like an air dryer built in different like sort of frequency and intensity of the water all of this

is for external use only by the way but bidets clean your bum in a way that toilet paper can't so

somebody did this study back in 2023 there was a study that showed that your hands when you wipe

after having a bowel movement have more microbes on them than people who use a bidet really

even if your hands don't touch your butt they just touch the tissue paper you think that's what's

happening even with two plastic even actually I don't remember what ply it was but the point

but toilet paper is not as clean as we think it is and I mean think about it this way and I know

every parent can relate to this suppose you somehow get a little bit of poop on your hand a little

bit of poop on your arm yeah would you in that moment consider it acceptable to just like

smear it off with a little paper towel and go about your day no no you would absolutely put I hope

you would absolutely put some running water on that thing and make sure it was clean but for some

reason again with the most delicate tissue in our body we think wiping is okay let me ask you

question yeah is there a wiping technique I think women are sometimes taught that it should be

front back and that's the idea is that we don't want to mix the bacteria from our rear end up front

to decrease the risk of UTIs your narytract infections there have been some studies that show that

that's the case the best way to wipe upfront is a gentle dab and I think that that if you have

the ability to do that in the back that's the best way to a gentle dab keeps you from

creating these microscopic hairs smearing it in I really think that like sometimes when we're

like just scraping our bombs a lot of people have sensitivity in that area so people who have

features who have hemorrhoids women who are postpartum I tell all of my postpartum patients

is just a gentle dab is all you need so Dr. Pussrecha what are the biggest gut health myths

that social media is pushing that you're just like I am so sick of seeing this yeah there's

two big ones for me one is leaky gut okay leaky gut started as a very sound scientific phenomena

in neuro gastroenterology this is what we study what we study is increased intestinal permeability

and that's where this idea of leaky gut first started so increase intestinal permeability is

simply this our guts are aligned with these cells on the surface and those cells are usually

pretty tightly close together but different things happen throughout the day that cause the junctions

between the cells to just slightly open up when they open up other cells can travel through back

and forth chemical signals can move that's happening to all of us we have increased intestinal

permeability multiple times during the day stress can do it what we eat can do it infections can

do it this is happening all the time there are very few known from start to finish situations where

we can at this point conclusively say part of the problem and the mechanism was the increased

intestinal permeability in this medical condition so for example one of those is liver fibrosis liver

disease alcohol increases intestinal permeability and then those chemicals and toxins hit your liver

and cause damage that's probably one of the cleanest stories in in GI that we have for what increase

intestinal permeability does okay it has been implicated in irritable bowel syndrome and there's some

emerging data there however when you go on social media you'll hear these people who will say

do you have brain fog are you bloated all the time sounds like leaky gut and everyone will say

wait a minute yeah of course I brain fog I am bloated all the time I've never heard of this thing

called leaky is that what this is because these are symptoms bloating brain fog that are notoriously

difficult to understand difficult to treat difficult to get help for and now somebody's offering

you an answer which is leaky gut which is the bane I think of every gastroenterologist existence

when we hear that brought up not because it's not real not because intestinal permeability is real

but because that's not the root cause people treat leaky gut as the root cause of their problem

and the second half of that real will be like and this is my three step supplement that will

fix your leaky gut and actually what you want to ask yourself is what is it about my lifestyle that

might be increasing intestinal permeability is that thing in any way linked to the problems that I

have because I've seen these cases malware somebody will come in to me having self-treated for leaky

gut for a year and the entire time what they had was celiac disease so you know which also causes

brain fog which also causes bloating and I hate to see us miss a medical diagnosis that we know how

to treat that we can diagnose because we've sort of attached on to something we've seen on

socially so leaky gut that's a big one for me as a gastroenterologist second is probiotics

there's this idea out there you would think this based on the marketing that every gastroenterologist

wants everyone to be on a probiotic that we all need probiotics for your health these supplements

that's not true in fact the American gastroenterological association does not recommend probiotics

for most medical conditions really I know I know it comes as a shock because you always see like

recommended by most gastroenterologist or all gastroenterologists recommend that's not the case

it's not because I'm going to tell you if you've come to me and you've been taking this probiotic

for years that you've loved you digest better you poop now once a day easily that your

probiotic is not working it could be working but we don't have enough robust data to say in whom

it's always going to work consistently that we can make a good recommendation for it and feel

ethical about doing that yeah I mean I hear something that I think people don't understand

about the microbiome so if you think about your microbiome as a garden and the microbes that

are living there they are like flowers or maybe they're like weeds and probiotics are supposed

to give you in theory the good bacteria yeah meaning the bacteria that we've seen in some studies

that seem to be associated with health and then there's some bacteria we label is bad because

they seem to be higher in people who have diseases the problem is that we actually don't know

if something that we're labeling as a bad bacteria or good bacteria is the cause of that

condition or is the cause of your health because what if the bacteria we're seeing that we're calling

bad are actually just a bacteria that are naturally growing in response to the fertilizer you're

giving it and they're actually trying their best to help you but that's just what grows in that

environment and the problem is not that you need to sprinkle probiotics on them but you need to

focus on prebiotics prebiotics are like the fertilizer and the conditions that allow certain

kinds of bacteria to grow and that's things like fiber it's the things that you don't digest that

become the food for those bacteria so sometimes the solution is not necessarily a probiotic supplement

but to say what have I fed my gut microbes today have I given it a high fiber meal have I had fruit

today I've had vegetables have I eaten something fermented and sometimes that's the way that you

can nudge the bacteria populations in your gut one way or another amazing now Dr. Pasaricha is a

neurogaster researcher and medical doctor what is one thing that you stopped doing that has had a

huge impact on your gut health I stopped pretending like I was going to get enough fiber through my diet

and I'm a gut health researcher like you said and I think about my gut health like way more than

most people and so I thought for a really long time that I should I have to get all my fiber needs

which for women over 50 is 21 grams per day for under 50 25 grams per day that I should get it

through my diet that I should be like making these beautiful bento box lunches with like this colorful

different like five different vegetables and fruits and it would happen for me like several days

a week and then it just like wouldn't I have two kids I have like three jobs I'm just a normal

person who's trying to get through the grocery store cereal aisle like everybody else and and then

some some days I would just find myself like with my husband leaning over the kitchen sink like picking

off the macaroni of my kids plate and just saying like I'm full like let's call it a day right here

and that's what we did and when I kind of let go of being so virtuous about how I was going to meet

my fiber needs I said okay let us just like plan on me not meeting my fiber needs through my diet

what am I going to do then and then it clicked and then I found the laziest possible solution

to just give my gut the the exact thing that it needed and so I started taking a fiber supplement

so I take sillium every day sillium is this powder it's a plant-based fiber supplement

I mix it into my coffee it's a soluble fiber I'm mixing it in the liquid that I'm drinking anyway

you do have to drink it quickly and it does need to be taken with water the reason you have to drink

it quickly is because it's a soluble fiber that turns into a gel that's what also makes sillium

so wonderful the cardiologists have loved sillium for even longer than we have in gastroenterology

because it can help lower cholesterol and we have that in my family but it's also a shape shifter

so if you have diarrhea sillium will add a little bulk to your stool if you have constipation it'll

soften it up so it's great for your gut your bacteria like it it was just a shortcut that like

freed me up and is no brainer because I'm not adding any extra time one teaspoon of sillium

gives you about four grams of fiber so if you have two teaspoons you're like a third of the way

there so even on the days when I'm meeting my fiber goals I just like get an A plus on my

report card because I exceed them that day and on the days that I don't I still get an A plus

because I've met them because I'm just doing the laziest possible thing and it works

sounds like the smartest possible thing Dr. Pustrecha what are your parting words

I want people to remember that the gut is a brain remember that

we treat the brain in our head like it is the most important organ in our body and we do everything

to protect it but if you think about your gut as a brain and that's what it is then you should

treat it like your most precious organ like if you were going to go play football there is no way

your mom would let you run out there without a nice thick helmet every single day you would wear a

helmet if you rode your bike in downtown Boston traffic tour but ask yourself what have I done to

protect my gut today and not only that not only do we not really protect it but we treat its

distress signals as inconvenient and we brush them aside and it's not a coincidence at all that

so many of the things that I tell my patients are good for their gut health minimizing ultra

processed foods cutting down on alcohol eating more fiber that's incidentally the same list of

things that will reduce your risk of dementia that's not a coincidence once you realize that your

gut is a brain then treating it as the most precious organ of your body is not optional it's

foundational to your entire health doctor press reach I have loved meeting you I have loved

this conversation I not only enjoyed it and enjoyed laughing but I learned so much that I didn't

know and I feel just empowered so I just want to thank you thank you for the work that you're

doing thank you for the way in which you teach thank you for the research that you are doing in

your lab that is so cutting edge and exciting and I am just grateful that you're here so thank you

thank you for having me thank you for letting me share this with everyone of course and I got

a huge shout out to our team for the Play-Doh poop and I also want to give you a shout out for

spending time together with us and for listening to something that really is important I was a

stonest weren't you to hear those numbers the number of people that are struggling with this aspect

of your life and here's what I learned there are simple things that you can do immediately now that

you understand this there are things that you can do immediately that will help you change this

aspect of your life and your health for the better thank you for being generous with this with

your family this is going right in our family group chat at the Robin's household and in case

someone else tells you today I wanted to be sure to tell you as your friend that I love you and I

believe in you and I believe in your ability to create a better life and every single thing that

doctor has reached a told you today and taught you today and all the research that she shared today

will absolutely help you have a better life and a better bowel movement and that's going to

make your life better all right I will welcome you into the very next episode the moment hit play

I'll see you there she's trained at Harvard completed her internal medicine reticid

her internal medicine reticid well suppose one day yes and you've met this new man I love what

you're wearing by the way on this date I appreciate you I'm wearing date is already going so well

cool suit she looks amazing okay thank you now we're switching into the

okay oh I'm so here for this is there anything related to like how understanding your poop

is gonna make you healthier I want to go back to a question that I forgot to ask you so

bottle air this is going back back up top and it's really it's question number three you might

want to tip that back up because you're about to fall on the table you seem like they're sliding off

oh yeah I see the movement I see the smears okay maybe we just follow that I'm wearing black we

hold at the poop in the die are you sure yeah or the person and the yeah let's do the person

we just put her guts back in I can't believe the science experiment worked on the first

it was so good thank you oh my gosh hey you were awesome you were awesome

oh and one more thing and no this is not a blooper this is the legal language you know

what the lawyer's right and what I need to read to you this podcast is presented solely for educational

and entertainment purposes I'm just your friend I am not a licensed therapist and this podcast is

not intended as a substitute for the advice of a physician professional coach psychotherapist or

other qualified professional got it good I'll see you in the next episode

serious exam podcasts

friendly heads up taxes are due April 15th the good news tax act makes it easy to file online

and they guarantee your maximum refund you can even add expert assist if you want some help

from a real tax expert nothing beats that taxes are done feeling let's get them over with

real talent is defined by what people can do not where they learn to do it so by stopping at the

education section of a resume you might throw away the perfect hire skills first hiring helps

you see talent others miss like more than 70 million stars skilled through alternative routes

let their story unfold and gain a competitive advantage because hiring managers who start with

skills are 60 percent more likely to find a successful hire higher skills first learn why at

tetherpapercealing.org brought to you by opportunity at work and the ad council