Mistake number 1: How we sit on the toilet – and how we scroll when we’re there
The design of modern toilet seats isn’t helping us poo better, Pasricha says.
“You’re sitting at this 90-degree angle. Physiologically, that’s not how we’re supposed to poop, but we’ve designed the seat this way.
“If you think about your colon as this long tube, at the very end, our pelvic floor, there’s this muscle called the puborectalis muscle [that] goes like a sling around the colon and chokes it shut.”
That’s a good thing when you’re sitting on your couch, at your desk or in the car.
“But when we’re sitting on the toilet, we’re in the exact same position and so we’re basically trying to fight against this kinked muscle.”
Raising your knees above your waist when sitting on the toilet can help this muscle do its job properly, as well as improving your pelvic floor strength, she says.
This can be helped with a stool to rest your feet on.
Another habit that isn’t great for the pelvic floor is scrolling on your phone while on the loo, as it can mean we end up spending much more time on the toilet than we really need to.
We know we shouldn’t bring our phones into bed or to the dinner table, so we shouldn’t bring them into the bathroom either, Pasricha says.
“We are sitting on this open toilet bowl [for even longer] with no pelvic floor support for no reason … if you do it every day over weeks, over years, eventually the connective tissue around your haemorrhoids weakens.”
Haemorrhoids are cushions of veins in the anal canal. When the tissue around them weakens, they protrude and can become very uncomfortable or start bleeding.
“We did this study in my lab in 2024 … we found that people who brought their smartphones in [to the bathroom] had a 46% increased risk of having [thrombosed] haemorrhoids.”
Maybe a trip to the bathroom is time for a mindful moment instead of mindless distraction.
“We need to feel relaxed to have a bowel movement,” Pasricha says.
Reaching for a magazine, or the back of a bathroom product to read, might just help you feel more relaxed than scrolling social media. These aren’t endless sources of information like your phone is.
Dr Trisha Pasricha’s book You’ve Been Pooping All Wrong contains “everything I wish I could tell a patient”, she says.
Mistake number 2: How we feed our gut
Diet has a big impact on your gut health. We’ve all been told to eat more fibre, but that’s not just because it will help you with your bowel movements.
“It’ll help your brain, it’ll help your heart, and all of that is mediated by your gut. Your gut and the microbes living there have a profound impact on every other organ in your body. If we neglect our gut health, we’re neglecting our overall health,” Pasricha says.
She is “100% here for” the social media trend of “fibre-maxxing”; increasing your fibre intake to meet your daily requirements.
“For women under 50, it’s 25g of fibre per day, and for men that’s 38g. That’s a lot of fibre, it’s more than you think.”
For example, a standard serving of Weet-Bix (two biscuits) contains a little over 3g of dietary fibre.
But it’s not just the amount of fibre that’s important for your health, it’s the variety of types of fibre too.
“The goal really should be to get a diversity of plant-based foods. There are lots of different types of fibres, and they’re all made up of slightly different molecular structures. The reason that matters is because different microbes that live in your microbiome thrive on different kinds of fibre sources … the more diverse your diet, the more diverse your microbiome.”
Alongside a varied fibre intake, probiotics are important for a healthy gut. Think fermented foods, sauerkraut, kimchi and Greek yoghurt.
Mistake number 3: How we talk about our bowel habits – or don’t
Another mistake we make is not talking about poo.
“There is this evolutionary advantage to feeling disgust around some of our bodily waste, probably because it used to be the case that we would spread a lot of diseases through our poop,” Pasricha says.
Now with modern sewage, plumbing and proper hygiene, that’s less of a risk.
“I think we’ve swung in the opposite direction, and our aversion to thinking about, talking about poop has put us out of touch with our own bodies.
“We have such a stigma and shame around this one aspect of our health that … is the gateway to the rest of our body and the rest of our health.”
But being embarrassed about it, and teaching our kids to feel embarrassed about it, means we’re doing our health a disservice, she says.
“We’re all worried about the rise of early-onset colorectal cancer, for example. Catching it early or catching it late makes all the difference in how somebody will survive, and the problem is that we’re catching it too late in too many cases.
“A [big] reason we’re catching it late is because people are late to bring up their bowel habits to their doctors, because they’re embarrassed to talk about these kinds of changes.”
And even if your symptoms don’t lead to a cancer diagnosis, they can lessen your quality of life.
“People with IBS (irritable bowel syndrome) so often get told, ‘It’s all in your head’,” she says.
“We know there’s this close relationship with anxiety, stress, and these changes in our guts … and I hope that learning a little bit more about how that connection goes from the gut up to the brain validates people who have felt neglected, who have felt like, ‘This is all stress and there’s nothing I can do about it’.”
Often, women are less comfortable talking about bowel movements or symptoms than men are, she notes.
“Women’s health itself is kind of stigmatised … add in gut health, then you’ve got this overlapping area that people really don’t want to talk about, even though they’re really suffering from it a lot of the time.”
– You’ve Been Pooping All Wrong is available in New Zealand bookstores now.
Bethany Reitsma is a lifestyle writer who has been with the NZ Herald since 2019. She specialises in all things health and wellbeing and is passionate about telling Kiwis’ real-life stories.