{"id":378298,"date":"2026-04-06T18:33:12","date_gmt":"2026-04-06T18:33:12","guid":{"rendered":"https:\/\/www.newsbeep.com\/il\/378298\/"},"modified":"2026-04-06T18:33:12","modified_gmt":"2026-04-06T18:33:12","slug":"are-your-bathroom-habits-normal-harvard-gazette","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/il\/378298\/","title":{"rendered":"Are your bathroom habits normal? \u2014 Harvard Gazette"},"content":{"rendered":"

When you\u2019re an expert on the gut, you\u2019re used to conversations others might shy away from. So a book on pooping and what can go wrong in the process is on brand for Trisha Pasricha<\/a>, a second-generation gastroenterologist whose childhood was marked by matter-of-fact directness.<\/p>\n

In her new book, \u201cYou\u2019ve Been Pooping All Wrong: How to Make Your Bowel Movements a Joy,\u201d the Harvard Medical School assistant professor of medicine at Beth Israel Deaconess Medical Center shares her sometimes humorous perspective on normal and abnormal bathroom habits. In this edited conversation, Pasricha \u2014 who also is the director of research for the Institute for Gut-Brain Research at BIDMC and writes The Washington Post\u2019s \u201cAsk a Doctor\u201d column \u2014 discussed emerging knowledge that may illuminate poorly understood conditions like irritable bowel syndrome, the damage a doctor\u2019s doubt can do to patients, and her optimism about her fast-changing field.<\/p>\n

In addition to your clinical and research work, you author The Washington Post\u2019s \u201cAsk a Doctor\u201d column. Did that help in writing this book?<\/p>\n

Yes, every time we write about gut health it vastly outperforms any other health topic. Even an embarrassing topic like fecal incontinence or farting would do well. That tension is partly why I wrote the book. I think people want good, accurate information and want it without having to make eye contact with their doctor. And we want people to engage early, especially in this age of early onset colorectal cancer.<\/p>\n

It seems like you went through some effort to find the right words. Is it poop? Is it a bowel movement? How did you settle on your language?<\/p>\n

A dash of humor helps when you\u2019re talking about something that makes people feel ashamed and vulnerable. Medical school trained me to say \u201cbowel movement,\u201d then I started shadowing a gastroenterologist who would go on to become a mentor for me. A patient came in \u2014 a younger guy, college-age \u2014 and my mentor\u2019s opening line was, \u201cSo, tell me about your poop.\u201d The patient had been awkward and nervous, but as soon as my mentor said that, the whole atmosphere changed. I thought, \u201cThis is what I should be doing.\u201d This person immediately opened up. He was relieved, and he told the doctor exactly what was going on.<\/p>\n

With our reluctance to talk about it, do people really know what normal is?<\/p>\n

I don\u2019t think so. When I was starting out on my own, people would tell me about their specific problem, but if you gave them the chance to step back, what they were really curious about was the basics. How many times a day is normal? What colors are normal? How mushy or soft or hard is stool supposed to be? I worry that when people don\u2019t know what normal is, especially what normal for them is, how will they know when something is abnormal?<\/p>\n

\u201cI hope it\u2019s validating to people who have ever felt that they haven\u2019t been believed that there\u2019s a whole world of scientists and doctors who are working on this problem.\u201d<\/p>\n

You point out that there\u2019s wide variety within the \u201cnormal\u201d range. What should people look out for?<\/p>\n

It\u2019s not just once a day or bust. The range of normal is going between once every three days and three times a day. You can live a full, healthy life anywhere in that range and be fine. What\u2019s important is when there\u2019s a change. If you are somebody who generally goes two or three times a day and now you\u2019re going every other day, even though that is somebody else\u2019s normal pattern, this is a change for you. And colors are important. It\u2019s not always a healthy shade of brown. When you see red, when you see maroon, when you see something black, tarry, sticky, it\u2019s important that you don\u2019t just brush it off. Let your doctor know about it the day it happened.<\/p>\n

What are specific conditions these changes might be signaling?<\/p>\n

There are lots of different diseases that start in the gut. And there are a lot of gut conditions that may or may not get a diagnosis or a name but are causing you trouble. Most urgent is cancer, but there are other things that cause bleeding and pain, like inflammatory bowel disease. Diverticuli can bleed, hemorrhoids can bleed. There are also things that probably won\u2019t kill you but are difficult to live with. There\u2019s irritable bowel syndrome and other causes of constipation and chronic diarrhea. And there are people who have GI issues, but no diagnosis: Three out of four people can\u2019t poop in public and one in three can\u2019t go to the bathroom on vacation.<\/p>\n

Is this a field that\u2019s advancing rapidly?<\/p>\n

Definitely. Neurogastroenterology is the most exciting field in GI, though I\u2019m obviously biased. For the longest time we weren\u2019t getting deep enough into the enteric nervous system, into those deep muscle layers of the gastrointestinal tract. So, for about a century, what we were studying was how the brain influenced the gut and what we could observe with our naked eye about its effects on the gut. But now that we\u2019re more and more able to look at those neurons and cellular changes, the whole field is exploding. Every few years there\u2019s a profound breakthrough that upends everything we\u2019ve learned.<\/p>\n

Is the new understanding of the gut-brain connection both cutting-edge and misunderstood, even within the medical profession?<\/p>\n

That\u2019s exactly right. One of the most common diseases of our specialty, irritable bowel syndrome, is probably one of the most common disorders in all of medicine. It affects 15 percent of the population and yet is poorly understood by the public and by a lot of doctors because these advances are new enough to have happened after many of them got out of medical school. We haven\u2019t done a fantastic job disseminating that knowledge to people outside neuro GI. That was one of the other reasons I wanted to write this book, to make sure people knew everything that I knew about irritable bowel syndrome and how the gut\u2019s communicating with the brain. Because if you don\u2019t know the data, it can sound really fringe.<\/p>\n

Some of the stories you tell, particularly about your interactions with your father \u2014 you have to trust the patient \u2014 seem like important messages for other doctors to hear.<\/p>\n

That was a lesson that stuck with me for life. It\u2019s why I decided to end the book on that note. I recognize that we doctors struggle when we don\u2019t know the answers. It\u2019s hard to be a doctor whose patient is suffering. Not only do you not have a treatment for their suffering, but you don\u2019t even understand where the pain is coming from. So I hope the book shifts our thinking when tests come back normal in a patient with IBS. Instead of simply saying, \u201cYou need antidepressants,\u201d we change the way we talk to them. We accept that they have abnormalities even though they\u2019re not being captured by the test. That\u2019s when the conversation changes and trust between doctor and patient is transformed. It\u2019s powerful and may point you toward making the right referral or thinking outside the box for medications that you wouldn\u2019t have thought of before.<\/p>\n

Is not believing patients a big problem in medicine? It\u2019s cited by IBS sufferers quite a bit and I\u2019ve heard the same thing about long COVID.<\/p>\n

I think about this all the time. It\u2019s not just irritable bowel syndrome, although irritable bowel syndrome is a big part of long COVID. It\u2019s other conditions like migraines. All the brain scans and blood tests are negative and yet they\u2019re living with this difficult condition. They feel dismissed. We are taught in medicine to think algorithmically: Here are the set of abnormalities, here\u2019s the pattern, put that puzzle together. When you feel like there are no pieces to put together because there\u2019s no clue you can latch onto, it\u2019s easier to say this is in the patient\u2019s head rather than it\u2019s something that we might not be capturing yet. But we will start to capture those things in tests in the next 15 years and suddenly we\u2019re going to stop telling people \u201cThis is all in your head\u201d simply because we\u2019ll see it.<\/p>\n

What are the main takeaways for readers of this book?<\/p>\n

I hope people walk away from it feeling reassured, feeling like, \u201cYou know what? I\u2019m not weird or abnormal. There are a lot of people dealing with exactly the same thing I\u2019m dealing with.\u201d I hope, too, that they feel reassured by the practical tips I give for the day-to-day problems that more people suffer from than we might know because we don\u2019t ask about it, don\u2019t talk about it. I also hope it\u2019s validating to people who have ever felt dismissed or felt that they haven\u2019t been believed, that there\u2019s a whole world of scientists and doctors who are working on this problem.<\/p>\n","protected":false},"excerpt":{"rendered":"When you\u2019re an expert on the gut, you\u2019re used to conversations others might shy away from. So a…\n","protected":false},"author":2,"featured_media":378299,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[412,114,165,4140,521,85,46,4718,3929,1360],"class_list":{"0":"post-378298","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-business","8":"tag-books","9":"tag-business","10":"tag-cancer","11":"tag-faculty","12":"tag-healthcare","13":"tag-il","14":"tag-israel","15":"tag-microbiome","16":"tag-qa","17":"tag-research"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/378298","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/comments?post=378298"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/378298\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media\/378299"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media?parent=378298"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/categories?post=378298"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/tags?post=378298"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}