Can you trust your gut? with GI doctor Trisha Pasricha

Summary

Podcast Summary: ReThinking with Adam Grant

Episode: “Can you trust your gut?” with GI doctor Trisha Pasricha

Date: April 7, 2026
Host: Adam Grant
Guest: Dr. Trisha Pasricha, Harvard gastroenterologist and “Ask a Doctor” columnist

---

Overview

In this lively and engaging episode, Adam Grant explores the science and cultural lore behind “trusting your gut” with Dr. Trisha Pasricha, a leading GI doctor and author of the new book You’d Have Been Pooping All Wrong. Together, they unpack the brain-gut connection, debunk common digestive health myths, and discuss how our gut’s physiological signals interact with conscious decision-making. Alongside science, the episode bursts with relatable stories, candid advice, and memorable, sometimes hilarious moments about poop, gut instincts, and bodily joy.

---

Key Discussion Points

1. What Is a "Gut Feeling"?—The Science Behind the Phrase

[01:25], [04:46]

• Dr. Pasricha clarifies that gut feelings are real physiological responses, rooted in neurogastroenterology.
  • “Digestion begins in the brain... The gut is unlike so many other organs; our thoughts and feelings can so strongly influence what our gut is doing.” (Pasricha, 03:03)
• Gut contractions are modulated by emotional triggers, causing sensations like “butterflies” or a “sinking feeling.”
• The gut rapidly responds to perceived changes—sometimes before we’re consciously aware—via hormonal signals such as corticotrophin releasing hormone.

2. Should You Trust Your Gut?

[04:21], [07:29], [15:06]

• Culturally, gut instincts are valued as almost prophetic, but both Grant and Pasricha urge skepticism:
  • “A gut feeling has a true physiological basis, but it’s not an oracle. It’s just a message. And that message... is that you need to slow down.” (Pasricha, 04:46)
• They argue it’s best to interpret bodily signals with context—especially in unfamiliar settings where intuition may not be accurate.
  • “Blindly trusting your gut is in the same category as looking for answers in the stars. It seems very objective but it’s not valid.” (Grant, 15:06)

3. The Appeal and Pitfalls of Gut Decisions

[09:59], [10:12], [11:18], [12:35]

• Gut feelings are emotionally compelling because they’re our first physiological response, especially in states of stress or novelty.
• There’s a cognitive bias to remember times our gut was right and ignore when it failed.
  • “It’s unforgettable when you have this gut instinct, do not trust this person, and then they end up screwing you over... The message is not, I should always trust my gut.” (Grant, 11:32)
• Discomfort shouldn’t be automatically equated with danger—sometimes it signals positive novelty or growth.

4. Expertise, Intuition, and When to Trust Your Gut

[13:32]

• Grant references research showing that intuition works best in predictable domains, honed by experience (e.g., an expert detecting a fake handbag).
• In major life moments (business, romance), “gut” intuition is unreliable for most people due to limited prior experience.

5. The Gut–Brain Relationship & Digestive Myths

Lightning Round Begins [18:44]

• Worst GI advice: Over-relying on probiotics—“The data is far murkier... I find it really concerning when people are spending hundreds and hundreds of dollars on these.” (Pasricha, 18:50)
• Best GI advice: “Treat your gut like a brain”—high-fiber diet, less processed food, prioritize sleep and exercise.
• Medical mindset shift: Rise in GI cancer among younger patients has changed how doctors approach new symptoms in young people.

6. Medical Gender Bias and Pain Communication

[21:45]

• Women’s pain is frequently dismissed in medicine, especially with gut-brain disorders.
• Grant recommends making pain descriptions concrete and relatable, e.g., “This hurts worse than stepping on a Lego.”
  • “If you say it’s a 7, and my 7 is this, and you give the concrete example... I think that would be helpful.” (Pasricha, 24:36)

7. Combating Health Misinformation

[25:21]

• To counter false beliefs, focus on building trust and teaching patients how to evaluate evidence, not just facts.
  • “What you want to do is establish a relationship whereby they trust your thought process, not just your conclusions.” (Grant, 27:03)

---

Memorable Quotes & Moments

• “Blindly trusting your gut is in the same category as looking for answers in the stars.” —Adam Grant [15:06]
• “Discomfort is not inherently bad. Sometimes what pushes you...can be an incredibly good thing.” —Trisha Pasricha [12:48]
• On “pooforia”:
  “People feel such immense joy when they have a good bowel movement... there’s both a physiological basis and this sense of relief.” —Trisha Pasricha [37:39]
• “Joy equals sex plus shit.” —Adam Grant quoting a professor on sources of animal exuberance [37:13]

---

Timestamps for Important Segments

• Understanding the Gut-Brain Link: [03:03]–[07:29]
• Why We Trust Gut Feelings (and Why We Should Pause): [07:41]–[15:17]
• Lightning Round – GI Myths, Advice, and Dinner Party Guests: [18:44]–[21:37]
• Medical Pain Advocacy for Women: [21:45]–[25:04]
• Changing Minds on Health Misinformation: [25:21]–[27:12]
• The Science (and Joy) of Pooping: [32:36]–[39:59]
• Advice for “Pooforia”: [40:44]–[42:56]

---

Practical Takeaways & Advice

• Don’t “trust” gut feelings blindly—interpret them as physiological signals meant to prompt reflection, not automatic action.
• Question probiotics hype: Most aren’t proven solutions for gut health.
• Treat both your gut and brain as vital organs; what’s good for one is good for the other.
• Describe pain in doctor visits with concrete, relatable comparisons for more empathy and advocacy.
• If struggling with GI embarrassment (e.g., incontinence), know you’re not alone—discuss symptoms with your doctor. Treatments exist, but stigma and silence prevent help.
• Avoid colon cleanses and detox rituals—your liver is the ultimate natural detoxifier.

---

Fun Facts & Mythbusting

• 7% of adults “poop their pants” regularly: It’s common and treatable—don’t be ashamed to tell your doctor. [28:30]
• Most people are curious about their poop—even if it seems gross. “Disgust” keeps us safe, but curiosity helps spot health problems. [32:36]
• You can reduce fart odor: Bismuth (e.g., Pepto-Bismol) before social events can neutralize sulfur compounds. [27:31]
• To achieve happier, healthier pooping (“pooforia”):
  • Squat or raise knees above waist while on the toilet.
  • Avoid smartphones—lingering leads to hemorrhoids. [40:44]

---

Tone & Final Thoughts

The episode blends serious science with levity and candor, turning taboo or “gross” topics into opportunities for learning and laughter. Dr. Pasricha’s expertise and humor make complex science relatable, while Adam Grant keeps things accessible and thoughtful, inviting listeners to rethink both their instincts and their habits—right down to using the bathroom.

---

Next Time You Get a Gut Feeling—pause, interpret, and, if needed, bring a footstool to the bathroom. Your gut (and brain) will thank you!

Transcript

[Jackson Financial Representative]

This message comes from Jackson. Taxes aren't something you can only think about once a year, with investments planning for tax days year round. Fortunately, Jackson offers tax efficient products. Visit Jackson.com for more information on how our products can make your tax bill a little bit less painful. Jackson is short for Jackson Financial Incorporated, Jackson National Life Insurance Company, Lansing, Michigan and Jackson National Life Insurance Company of New York Purchase, New York.

[Podcast Host (Planet Visionaries Promo)]

This episode is brought to you by Planet Visionaries, a podcast in partnership with the Rolex Perpetual Planet Initiative. If you've been feeling overwhelmed by climate headlines lately, here's something worth your time a show focused on solutions. It's called Planet Visionaries, hosted by Alex Honnold. Yes, the climber from Free Solo now turning his attention to protecting the only planet we've got. What makes this show stand out is the people you you'll hear from scientists, explorers and storytellers who are actually building a better future and making it feel tangible, human and possible. One conversation features coral restoration leader Tituan Bernacote along with legendary oceanographer Sylvia Earle, sharing what it really takes to restore our oceans in partnership with the Rolex Perpetual Planet Initiative. This is Planet Visionaries. Listen or watch on Apple, Spotify, YouTube, or wherever you're listening to this podcast.

[Dr. Tricia Posricha]

A gut feeling has a true physiological basis. I think the way we get it wrong, though, is that we take that gut feeling and then we say, okay, this gut feeling is good or this gut feeling is bad, and we assign some value to it. But if you jump to label it too quickly, I think we can get this entirely backwards.

[Adam Grant]

Hey everyone, it's Adam Grant. Welcome back to Rethinking My Podcast with Ted on the science of what makes us tick.

[Jackson Financial Representative]

I'm an organizational psychologist and I'm taking you inside the minds of fascinating people to explore new thoughts and new ways of thinking.

[Adam Grant]

Trisha Posricha is a gastroenterologist at Harvard and the writer behind the Washington Post's Ask a Doctor column. She's been interested in the gut since

[Jackson Financial Representative]

she was a teenager. Now she has a new book out

[Adam Grant]

called you'd've been Pooping all wrong. I have to admit, this isn't the kind of topic we usually cover on this show.

[Jackson Financial Representative]

Show Patricia and I had a fascinating conversation about the brain gut connection, understanding what butterflies in your stomach might actually mean, and yes, some things you didn't know. You wanted to know about bowel movements.

[Adam Grant]

So this is an unusual conversation for us and definitely for me. And I can't believe that we're doing it without children present because this is a topic that every kid loves. But I think there are some things that I need to rethink based on this conversation. So let me just ask you to start at the top, Tricia. Where does digestion actually begin? I've always thought about it as something that happens in the gut via the mouth.

[Dr. Tricia Posricha]

Yeah, I think that's how most people think about it. But digestion begins in the brain, and we've known that digestion begins in the brain for a very long time. And in a way, the gut is unlike so many other organs that our brain and our thoughts and our feelings can so strongly influence what our gut is doing. There's almost no other organ where the main thing, one of the main things it does can be completely controlled by your thoughts. Right. Like your heart is going to keep on beating. You might think about a scary movie, and you can kind of get it to ramp up, but it's not going to fundamentally change what it does. Whereas, like, right now, if you or I picture this, like, nice, warm, gooey chocolate cake, and you can picture that chocolate sliding down the plate, like, soon you might start salivating, and actually your pancreas is going to start secreting insulin, and your whole gut starts to rev up purely because of your thoughts. And that is something that we had observed even as far back as, like, Ivan Pavlov and that famous experiment with his dogs. But it really is those set of experiments that birthed this whole field called neurogastroenterology, which is the study of the gut brain connection. And that's what I study, and that's what I am now. And it's an exciting field because we now know how deep that connection is between the gut and the brain.

[Adam Grant]

Okay, so this bothers me as a psychologist, because whenever people say, trust your gut, I have a few reactions. The first one is, no, test your gut, because I don't know where you got your gut instincts and whether they're valid in the situation you're in or not. But secondly, I prefer to trust my brain. That's where I do my cognitive processing. And I'm afraid you're gonna tell me it's a little more complicated than that.

[Dr. Tricia Posricha]

Well, I'm with you that I don't necessarily jump to trust my gut either, which may also be surprising. As a gastroenterologist, I'm sure all my GI colleagues are like, how dare she? The gut is the superior organ. And, you know, let me just say that I think what we consider to be gut feelings in pop culture has taken on almost the role of, like, an oracle, like, your gut can predict the future, can tell you the way things really are in a way that your brain may not be able to tell you. And this is something I've studied really, really closely for more than 20 years. And a gut feeling has a true physiological basis. And this is something that I studied when I was in high school, and I developed a lie detector that could use your stomach to detect when somebody's telling the truth versus telling a lie. And physiologically, what I found is actually a little bit boring and a little bit simple, and that is this. Your gut actually contracts at a predictable cycle. Just the way your heart contracts at around 60 beats per minute, give or take, is for your heart, for your stomach, it's about three cycles per minute. And when you tell a lie, that cycle gets completely disrupted. It goes into this chaotic rhythm called arrhythmia. And physiologically, that rhythm. And that rhythm disturbance which starts in the brain is being driven by this molecule called corticotrophin, releasing hormones, and it comes through the bloodstream, and it immediately tells your stomach to halt and stops it from emptying. And if you think about it that way, what's cool is that it means that your gut is often quickly responding to some change, some threat, some excitement that your amygdala is processing, sometimes maybe before your conscious brain in your head has pieced together why. And so your stomach can be this first herald of, like, wait, there's something off about this environment. It can be like, for example, I used to be a theater kid. If I blew my lines on stage, I would get this, like, sinking feeling in the pit of my stomach, right? Or maybe it's butterflies and you're on a date. We know. We all intuitively know what I'm talking about, and we talk about that gut kind of feeling. I think the way we get it wrong, though, is that we take that gut feeling and then we assign some value to it. And I usually tell people, like, if we just think about what is happening physiologically, that change in your gut's rhythm which is giving you that gut feeling, that true gut feeling, it's not an oracle. It's just a message. And that message is just that. You need to slow down. You shouldn't act on it immediately. But just think, what is it about my environment that my conscious brain may not have perceived yet, but that I understand.

[Adam Grant]

I love that. I mean, that. That's a really elegant physiological explanation of why I don't want people to blindly trust their gut instincts. Because you're right there, there is a message, but the message has to be deciphered.

[Dr. Tricia Posricha]

Yeah, exactly. And it has to be translated in the context of everything. You know, I mean, the amygdala, I think in popular science it gets a little bit dumbed down into saying like, oh, this is the fear processing hub. And it's really like a. More of an emotional processing hub. And sometimes what you're reacting to is not some fear or some deep feeded concern, but it actually might just be the novelty of a situation that you're not used to. And then conversely, I've seen happen, and this is very classic. You say you go on a date and you're with someone new, and then you don't get that butterflies in your stomach with that person, you know, and then I have, I've had girlfriends come to me and be like, oh, we didn't have that spark, you know, like my gut was telling me, like, I didn't, I didn't have it. And like, sure, maybe this person is not the right person for you. Very valid. However, I don't think you should make that decision based on whether you had butterflies in your stomach, whether you had a gut feeling about it right then and there without understanding the bigger context of why. Because maybe you didn't have that gut feeling. Because again, physiologically there was nothing unsettling about this experience. It might have actually just been a person with whom you felt very safe and comfortable. Is that such a bad thing? And I think maybe you need another date or two to know, is he really boring or is he really just a nice person that you feel happy with?

[Adam Grant]

And your next date should be structured more like the Bachelor. Bachelorette. You're going bungee jumping, right?

[Dr. Tricia Posricha]

Obviously. God, Only if only.

[Adam Grant]

This reminds me of something that happened in grad school. I invited a bunch of people to, I think it was a Valentine's Day gathering.

[Dr. Tricia Posricha]

Nice. Bold.

[Adam Grant]

Afterward, one of the attendees gave me feedback that a guy there had creeped her out.

[Dr. Tricia Posricha]

Oh, gosh.

[Adam Grant]

And I was really. I was surprised and disappointed. And I asked her why and she said, you know, I can't locate it, but there was something about his eyes that just gave me a bad feeling. I knew I couldn't trust him. And I said, you know he's gay, right? And she was shocked because she thought he was hitting on every woman there. And it turned out that there was

[Jackson Financial Representative]

something about his eyes that reminded her

[Adam Grant]

of a creepy guy that she'd known. And the dots hadn't connected until that moment.

[Dr. Tricia Posricha]

Ugh. That is a Classic example. And obviously, you know, they weren't meant for each other anyway. But, like, goodness, that is exactly what can happen, I think, when we just. We jump to a conclusion.

[Adam Grant]

Yeah, you know, it's. It's interesting to me when we talk about the role of the gut in decision making. I. I just want to. I want to build on your oracle observation a little bit. Why do you think people are so eager to trust their gut?

[Dr. Tricia Posricha]

Yeah, I. I think it's for a couple reasons. Like, one, it is the first place that we respond emotionally in a lot of places. And that's something that we've known intuitively since we were kids. Like children, when they're feeling sick or where they're feeling nervous, they feel it in their stomach. They'll say, I have a tummy ache. That's often the first place. And that, again, very physiologically valid. We know how stress, how different kinds of emotional triggers can cause these real changes. And so it does feel like you might put this all together and say, yeah, my gut is this oracle. It knows. And I also think that in some ways, the gut is a little mysterious. Right. And I do love it for that. And I think the more I learn about the gut, the more I know. We don't know, but historically, people have thought that the gut. This was Hippocrates who said, all disease begins in the gut. A lot of people think that a lot of our problems in health and in life can begin and end in the gut. So it does take on this, like, meaning greater than the organ that it is. And again, I'm not downplaying the gut. I'm like, on Team Gut here. But I think that there is a lot of misunderstanding and maybe even oversimplification about what the gut does.

[Adam Grant]

Yeah, that resonates. And I wonder if there's also a memory bias at play here where it really eats at us when we had a bad gut feeling about something and we ignored it. Whereas, no pun intended.

[Dr. Tricia Posricha]

No pun intended.

[Adam Grant]

I mean, I think it's unforgettable when you have this gut instinct, do not trust this person. And then they end up screwing you over because you didn't listen to your gut or interrogate. Where is that feeling coming from? And that sends a very strong message to change the next time. But the message is not, I should always trust my gut. It's that I should do something with that information as opposed to just disregarding it as we were talking about a moment ago. And I wonder if the times when we trust our gut and things don't work out are more easily dismissed or don't stick out in our memory as much.

[Dr. Tricia Posricha]

This is human nature. We're always going to remember a little bit of the times we got burned more than, I think, a little bit of, like, the factors surrounding how we ended up as happy as we did. You know, like when they do these studies, they look back and they say, like, yeah, people tend to remember the past with a rosier lens. And that's often the case. But I think when it comes to moments of trauma, trauma can really reshape and rewire us, especially if that trauma occurs earlier on in our lives.

[Adam Grant]

The other piece of this that I'm curious about is there's this seductive appeal of, well, I don't have to do the analysis. I don't have to reason my way through this decision because my body will know and it will tell me, yeah,

[Dr. Tricia Posricha]

you're getting this immediate feedback in the moment. And I do think that what is causing that physiologic change in the gut that changed the electrical rhythm? It's often discomfort. And again, I often tell people discomfort is not inherently bad. Sometimes what pushes you, what makes you uncomfortable, can be an incredibly good thing. It can be a really good challenge. And just reframing that feeling of discomfort being bad to discomfort is novel. Discomfort is, why do I feel this way? Can really open up your mind to say, like, maybe what I'm experiencing right now is not a bad sign. There's actually no prior memory that is resembling this moment. But I'm adding that layer on and I'm imagining that and putting all this stuff that's actually not there.

[Adam Grant]

Yep, I think that tracks. It reminds me of a paper by Eric Dane and Mike Pratt. They study gut feelings in terms of intuitions, and they look at whether you can trust your intuition or not when you're making decisions and predictions. And it turns out you can if you're either an expert or somebody with a lot of experience in a predictable domain. So if you, for example, are an avid shopper, you can trust your gut about whether a handbag is counterfeit or not. Whereas if you're a novice, you can, because you don't have the years of experience informing that subconscious pattern recognition process. But a lot of our decisions aren't like that. A lot of our gut feelings happen in domains where we don't have a lot of experience or there's not a stable pattern. And that's where I just want people to question, like, what is this signal coming from? And am I just uncomfortable because I'M in an unfamiliar environment.

[Dr. Tricia Posricha]

I often find that people put a lot of value on gut feelings and during big life moments for which like none of us have a ton of experience. And so then we're like we are looking for other signs from the universe telling us this is good or bad. And maybe that is things like romantic encounters. Maybe it's like taking a leap in a business venture, like situations that you might only do a couple times in your whole lifetime. And that's absolutely the moment where if you were an expert, like this would be wonderful. You'd have all of that background. But if you're not the expert, the message is let's pause and let's think about what this situation is telling me.

[Adam Grant]

Yeah, I guess I want to put then like blindly trusting your gut in the same category as looking for answers in the stars. It seems very objective, but it's not valid.

[Dr. Tricia Posricha]

It's coming from a place of like, you do want to pay attention. Like what you want to pay attention to what's happening, what's triggering that feeling. And sometimes the cue to that feeling is not fully external. Like it's important to even understand. Am I being internally triggered too, from something that is playing out in my mind that's causing these thoughts for which there's nothing about the environment or the risks or the stakes that are actually the issue. The issue is my own biases that I'm bringing to the table. So there is something that's pulling this reaction to your gut. But I agree it's not quite as bad as astrology, maybe, but it's getting there.

[Jackson Financial Representative]

Today's episode is sponsored by NerdWallet's Smart Money podcast. Navigating your finances can be stressful, and sometimes you just need some advice from someone you can trust. Imagine if you could have that one money savvy friend on demand for the moments when you just need a little guidance before making a big decision. NerdWallet's Smart Money podcast can be like that friend. Their team of trusted journalists breaks down financial decisions to give you research backed insights and clear pros and cons. Whether you're planning a big purchase or just want to grow your wealth, they explain the why behind tricky decisions like investing, home buying and choosing the best credit cards, all while keeping it engaging and humorous. This podcast cuts through the jargon and misinformation that's so often wrapped up with financial advice. To get to the clear, research backed answers you're looking for, make your next financial move with confidence. Follow NerdWallet's Smart Money podcast on your favorite podcast app. Support for today's episode comes from Square. If you've ever been to a local business, a cafe, a boutique, even a food truck where everything just feels seamless, from ordering to checkout, there's a good chance Square is behind it. Square just introduced a new wave of tools designed to help businesses run smarter. There's built in AI that can answer real questions about your business, tools to track cash flow, and systems that simplify everything from payments to inventory all in one place. It's designed to remove complexity so business owners can spend less time managing systems and more time focusing on what matters. And here's the important part. Square launched its most powerful tools yet, designed to give local businesses a competitive edge without the complexity. If you're ready to sell smarter, run faster, and stress less. Right now you can get up to $200 off Square hardware at square.com go rethinking. That's sq U-A-R e.com go rethinking. Run your business smarter with Square.

[Adam Grant]

Get started today.

[Sarah Gibson Tuttle]

Hi, it's Sarah Gibson Tuttle, founder of Olive and June. If you love having your nails done but you don't have the time or the money to go to a salon every week, I have something just for you. It's called the DIY Mani Challenge and it starts with one simple idea. Today is the day that you learn to do your own nails. So whether you're brand new to doing your nails or already obsessed with your at home mani routine, this is your invitation to level up your nail game with expert guidance every single step of the way. So no matter where you are in your nail journey, we've got you covered at Olive and June. Are you ready to take the DIY mani challenge? We've taught millions to mani and now it's your turn. So go to oliveandjune.com DIYlove20 for 20% off your first system using code DIYLOVE20. That's oliveandjune.com D I Y L O V E20.

[Adam Grant]

Okay, lightning round time. Are you ready?

[Dr. Tricia Posricha]

I'm so ready.

[Adam Grant]

Okay, worst GI advice you see given

[Dr. Tricia Posricha]

regularly, it would have to be probiotics. And this comes as a surprise because I think most people assume, based on the marketing, that gastroenterologists everywhere love probiotics, but we do not recommend probiotics for most conditions. The truth is that the data is far murkier, far, far less profound than you would be led to believe. And I find it really concerning when people are spending hundreds and hundreds of dollars on these probiotics. They're probably not getting the benefit they think they're getting. And they're focusing their attention on that rather than on the interventions that we know are better studied. So probiotics are like my big thing.

[Adam Grant]

Wow. All right, what's your best advice, GI wise?

[Dr. Tricia Posricha]

Best advice would be to treat your gut like a brain. Like if you were gonna go bike riding, there's no way that your mom would let you do that without a helmet. Right. We protect our brain so aggressively, but we throw any old thing in our stomachs that if like we wouldn't want to cross the blood brain barrier, you know, but it actually is hitting that brain. So you would wanna eat a high fiber diet, you would wanna prioritize sleep, you would wanna prioritize exercise, eating fewer ultra processed foods, eating more whole foods. Those things are great for your brain, but they're also the same things that help protect your gut. So it's not, it doesn't have to be overcomplicated Once you start to think about it that way.

[Adam Grant]

What's something you've changed your mind about recently?

[Dr. Tricia Posricha]

Well, I will say this is like the biggest frame shift in all of gi. I used to think of cancer as a disease of older people. And if like a young person came to me and they were like, I've started having new diarrhea, Even if I've seen blood in my stool, I would have said, okay, let's, you know, like, look, maybe is this irritable bowel syndrome? Are these hemorrhoids? I wouldn't be thinking about cancer in a 20, 30 year old today. I'm thinking about it. You know, most likely it is not what is happening, but it is a huge change in how I think and I think about how all of us

[Adam Grant]

have been practicing and you get to organize the world's greatest GI dinner party to talk about the gut with anyone alive or dead. Who are you inviting?

[Dr. Tricia Posricha]

Oh, this is so good. Ivan Pavlov is making that cut. He's getting on the list. Michael Levitt, Dr. Michael Levitt was the father of flatulence research. If you don't know anything about him, you gotta google him. And not just google him, PubMed him. If you read the methods of his studies, you'll have so much respect for the scientific process and you can understand why anyone who loved fart jokes as a kid should become a gastroenterology researcher. So he would totally make the list. And then I, I'd probably include my dad. He's like, he's like, just the funniest guy I know. He's a neurogastroenterologist. He's a researcher, and he has just a very keen way of, like, pulling the threads together.

[Adam Grant]

So those three sounds like fun. All right, Office hours. Time. Do you have a puzzle problem or question for me?

[Dr. Tricia Posricha]

Yes, thank you. I have two. Okay. This first one is really relevant to my world in studying disorders of gut brain interaction. And so one of the main things I study is something like irritable bowel syndrome or diseases that don't even really have a name. They're just characterized by pain, by chronic pain, and situations where the testing is normal. And most often, these diseases happen more often in women and women's pain. This is true in my field. It's true in all of medicine. It's just. It's statistically undertreated. It's disbelieved more often than men's. And so, from a psychology standpoint, what I would love you to tell me is how to give women more of a concrete toolkit to advocate for themselves and being taken seriously by their doctor. I think a lot of people in the medical community are quick to tell women to just not believe them and tell them this is all in their heads. Like, how do we convince someone that someone's suffering is real?

[Adam Grant]

Wow. Well, I have two reactions. The first one is, this should not be on women. This should be on medical professionals, Right?

[Dr. Tricia Posricha]

Yes.

[Adam Grant]

Period. Right. So let's change medical education to do a better job recognizing this bias and then counteracting it. I don't think that helps the average female patient overnight. So I think in the meantime, you're talking about a fundamental gap in empathy. Right. A failure to be able to imagine somebody else's experience. And one of the ways that we close those gaps in psychology is we try to give people a more concrete look or direct sense of what the other person is experiencing. And so I think comparisons could be really helpful there. You know, this hurts more than when I broke my foot or when I delivered a baby.

[Dr. Tricia Posricha]

Yeah.

[Adam Grant]

Like, if you can put this on a relative scale and calibrate it against something that the provider can relate to, maybe it's a little harder to dismiss if you make it concrete that way. So maybe. Maybe we need better pain scales that say, okay, zero is, you know, this is somebody poking you in the arm. A 10 is this is somebody amputating your arm.

[Dr. Tricia Posricha]

Yeah.

[Adam Grant]

You know, and then let's anchor each number on an imaginable form of pain that people have really lived. If you Then give a seven. And the seven is anchored to, I don't know, stepping on a Lego.

[Dr. Tricia Posricha]

Oh, that is really bad.

[Adam Grant]

That really hurts. If somebody says to a physician, this hurts more than if I just stepped on a Lego, I think it's hard not to pay attention.

[Dr. Tricia Posricha]

I love this because pain scales is, like, so embedded in our culture. Like, if a patient comes in with pain, we're like, okay, where is it on a 0 to 10, and they'll give a number. And the problem is that, yeah, we have our own subjective bias of what a 10 is. It's different from this person's 10.

[Jackson Financial Representative]

Yes.

[Dr. Tricia Posricha]

But if you were to say it's a 7, and my 7 is this, and then you give this concrete example. I've actually never heard it portrayed that way. And, like, I think that would be helpful. You know, when I talk to my residents and they're like, oh, this person said they're 10 out of 10, but, like, they were sitting on their bed relaxed, like, I'm not worried. And I say, no, that if someone's saying it's 10 out of 10, then we have to take that at face value and we have to act on it. But I think it's adding a little more nuance to that so that someone else can say, this is really what that feels like.

[Adam Grant]

This is relevant to something we talked about when we talked about taste last year, which is when I tell people I don't like chocolate, they don't get it. When I tell them I would rather eat dirt than eat chocolate. Oh, okay. You must really hate it. And I think we need to do the same thing for pain. Okay, what's your other question?

[Dr. Tricia Posricha]

Okay, my other question. Something I've seen, we've all seen since the pandemic and even before that, is that health misinformation, it really sticks with people, and it spreads in a way that selling facts just don't seem to do. And so doctors often struggle when they're just seeing one on one. A patient who believes something is false. What are the tools that you think actually help change somebody's mind about health information? And if you have, like, five minutes to do that.

[Adam Grant]

Yeah, it's.

[Dr. Tricia Posricha]

That's a big question, right?

[Adam Grant]

Yeah, it's not easy. David McRaney wrote a great book that covers a lot of the relevant research. It's called How Minds Change. I also love Switch by the Heath brothers. And those would be my two go to resources on this topic. I think in terms of specific recommendations, one thing is, I think, you know, not immediately trying to make the other person feel like an idiot is always helpful.

[Dr. Tricia Posricha]

Yeah, that feels like a good foundation.

[Adam Grant]

Yes.

[Dr. Tricia Posricha]

Love it.

[Adam Grant]

And saying, hey, you know, I really appreciate the fact that you came in here with a lot of information and you're clearly doing a lot of research.

[Dr. Tricia Posricha]

Yeah.

[Adam Grant]

And then, you know, trying to make it a dialogue and say, hey, my job is to help you separate signal from noise and really vet the rigor of these studies. So if you're open to it, can I walk you through what kind of study I would find credible versus not? And I think you're not going to change their mind in five minutes. Right. By debunking the particular conspiracy or piece of misinformation they're buying into. What you want to do is establish a relationship whereby they trust your thought process, not just your conclusions. And they want to come to you to learn how to get better at critical thinking in your domain.

[Dr. Tricia Posricha]

I really like that you have time, I think, to get them to believe that your way of thinking has some validity to it, even if you can't debunk that precise question. I like that a lot.

[Adam Grant]

Well, let me know how it goes for you.

[Dr. Tricia Posricha]

All right, I'm gonna try it.

[Adam Grant]

So in our last few minutes here, I wanna ask you a few more lightning questions if you're up for it. Cause they're just so fun.

[Dr. Tricia Posricha]

Yeah.

[Adam Grant]

One is, I did not know until I read your book that it's possible to fight the smell of a fart. How?

[Dr. Tricia Posricha]

Yeah, a lot of people think it's an inevitability, but actually 99% of the gas that you release is odorless. It's only that 1% that contains sulfur. That's the problem. Okay. Not surprising. It's the simplest solution. Bismuth subsalicylate, found in products like Pepto, Bismol. It can neutralize the odors. So I don't think that we need to be like taking this every day the rest of our lives, because I actually don't think we need to live with that level of embarrassment. Once you know that people on average fart 10 to 20 times per day, you might realize you're not so different from everyone else. But I think if you have like a high risk social event, like you're visiting your in laws for Thanksgiving, or you're like, you know, in this, like intimate work and you just, you, you need that for your confidence. Like go ahead and take it like a day or two beforehand and you actually will be able to neutralize it. You have to work a little bit harder about the sounds, but you can definitely get rid of the odor.

[Adam Grant]

Speaking of reassuring information, what percent of adults poop their pants?

[Dr. Tricia Posricha]

Gosh, 7%. Like that's a big number if you think about the activity we're talking about. We don't talk about it. What it does tell me is that you're not alone. If that's you, 7% poop their pants, like regularly. The kind of, again, encouraging part of that is that for a lot of the reasons why this happens, we have really good treatments. This, we call it fecal incontinence is one of the things that of everything we've talked about today that people listening are like, well, this is so embarrassing. It is so embarrassing that we know because we've done these studies in gi, if the doctor doesn't ask the patient very specifically, do you have this? Do you poop your pants? Patients do not bring it up on their own. Like that is very rare. Even though they'll come to that visit. That is the most distressing. It is this thing that makes them say, I can't leave my house. So if anyone hears this, it's common. Talk to your doctor if your doctor has forgotten to ask you about it. Because the good news is that we can actually treat it. It's not inevitable.

[Adam Grant]

Great. Okay, one other myth to bust here. A lot of people have, I think, become fans of doing a colon cleanse or a detox ritual because they think there's poop or toxins lurking in their gut.

[Dr. Tricia Posricha]

Yeah, not true, not true. There is this cult of detoxification around. It's like detox culture is everywhere. And I actually I of get where it comes from. Like both in our current moment, which is like, you know, we think they're chemicals in the environment and our foods and pesticides and toxins. And I think it can feel really overwhelming like we're putting poison in our bodies and that's not the case. Like the awesome news is that everything that comes through your gut, it gets filtered first by your liver before it hits the rest of your circulation. Your liver is the cleanse that you need. Like there is no celery juice, you could say sip that is going to do a better job than your liver. And so like just I wouldn't worry so much about detoxing with like a quick fix. What I would worry about is like, what is my long term dietary habits? What are the patterns that will over time stress my liver? And that is things like alcohol and ultra processed foods and things that your doctor has been like beating you on the head over for like the last 50 years of your life that you kind of already knew.

[Adam Grant]

That's actually really encouraging.

[Dr. Tricia Posricha]

Yeah, cancel that colon cleanse.

[Adam Grant]

Yeah, I wasn't planning to do one, but I'm glad to know that that was not a bad call.

[Capital One Bank Advertiser]

With no fees or minimums on checking accounts, it's no wonder the Capital One bank guy is so passionate about banking. With Capital One, if he were here, he wouldn't just tell you about no fees or minimums. He'd also talk about how most Capital One cafes are open seven days a week to assist with your banking needs. Yep, even on weekends it's pretty much all he talks about in a good way. What's in your wallet? Terms apply. See capitalone.combankCapital1NA Member FDIC

[Jackson Financial Representative]

this podcast is brought to you by Wise, the app for international people using money around the globe. With the Wise account, you can send, spend and receive in over 40 currencies with no markups and no hidden fees. Whether you're sending pounds across the pond, spending rials in Rio, or getting paid in dollars for your side gig, you'll get the mid market exchange rate on every transaction. Plus most transfers arrive in less than 20 seconds. Join 15 million customers internationally. Be smart. Get Wise. Download the Wise app today or visit wise.com Ts and Cs apply think Verizon is expensive?

[Podcast Promo Announcer]

Think again. Anyone can bring their AT&T or T mobile bill to a Verizon store today and we'll give you a better deal. So bring us your bill, walk in running pogo stickin' teleport if you can ride on the back of a rollerblading yak or flyin on the wings of a majestic falcon. Any way you can bring your AT&T or T mobile bill to a Verizon store today and we'll give you a better deal on the best network based on RouteMetric's best overall mobile network performance. US second half 2025 all rights reserved. Must provide very recent postpaid consumer mobile bill in the name of the person redeeming the deal. Additional terms, conditions and restrictions applied.

[Adam Grant]

I I have to tell you, I was not sure what I was gonna make of this book that you wrote because I think people are disgusted and grossed out by poop. Period. Yeah, but then I was reminded of this research that Paul Rosin did on disgust. So Paul's basic argument was that, you know, disgust evolved to keep us safe and we're disgusted by things that are toxic and yet some things that disgust us also intrigue us, he said. And I'm going to paraphrase here, but it stopped me in my tracks when he said, okay, so most people are grossed out by poop in all forms, and yet most people are also curious about poop to the point that after they take a dump, they will look in the toilet and observe the shape and the color. And so this is kind of my long preamble to say, I think I've come around to the idea that this thing you study that people are disgusted by, they're also sort of intrigued by as adults, not just kids. Why? Why? What's going on here?

[Dr. Tricia Posricha]

Yeah. And you're asking someone who does this for a living. So we're in their, like, right space. But now I'm intrigued, too. I mean, were you surprised because you are one of those people who takes a look or because you're one of those people who absolutely says, like, no, I don't look. I just flush and I move on with my day.

[Adam Grant]

I'd never even thought about it, and I didn't want to think about it. And it was so. It was so weird to me that somebody thought about it.

[Dr. Tricia Posricha]

Well, there's, like, a serious answer, and then there's, like, maybe the more real answer for why people study this. And like, I would say the serious answer is that your gut and your gut health is so important to your overall health. And when we take a bigger step back and we look at what's happening in the world today, where a big conversation is about these early onset cases of colorectal cancer that we're missing, and we're missing them because people aren't bringing to their doctor's attention the symptoms about their guts because they're so embarrassed by it. People aren't even looking. They're not even looking before they flush. And, like, honestly, when I hear that, and I hear that from a lot of my patients are like, oh, I don't look. Because my first question is, well, what does your poop look like? You know, then I. I find that bizarre because I think, like, how can you not look? And so then that takes me to the, like, lighter side of this whole equation, which is, you know, in my world of Neurogi, it's kind of a relatively new subspecialty, but it's also the coolest subspecialty. Like, the science is so exciting and emerging that I just think the way we've thought about our poop and about our bowels in a lot of ways, has been proven so wrong over the last decades. And that's because I think for centuries, if not longer, we thought of our digestive tract as just this plumbing system, right? And it's like you eat, you poop it out, and that's like kind of the end of the story. And then the microbiome entered the chat like, you know, 20, 30 years ago, and the whole world changed. And then we realized, and we kind of had hints that this was true earlier, that your gut is not just a set of pipes. It's a brain. It has this thing called an enteric nervous system. And if you shift that way of thinking, as I have, instead of thinking about your gut as this holding cell for your poop, and you think about it as a brain in and of itself, then one, you're not disgusted by it, you are fascinated by it. But then you also come to learn about all of the different ways that not just your brain influences your gut, but also how your gut is influencing your brain. And the science of it is so exciting.

[Adam Grant]

Okay, so I have to ask you a bunch of things. Now, the first one is I remember in grad school, we were in a seminar talking about the difference between happiness and joy. Happiness being more of a typically cognitive evaluation of how satisfied are you with your life, and joy being the momentary exuberance that you get when you have a peak experience and you know where this is going. Some psychologists had done.

[Dr. Tricia Posricha]

I. I am so sorry.

[Adam Grant]

It was an experience sampling study where you get at joy by instead of just asking people, how happy are you? And then trying to figure out, what did you do that day? Basically what they did was they texted or pinged you at different times throughout the day, and they said, right now, how much joy do you feel and what do you do?

[Dr. Tricia Posricha]

Yeah.

[Adam Grant]

And the conclusion from my colleague was, we're really just animals, because the two highest moments of joy consistently in the data were having sex and sitting on the toilet.

[Dr. Tricia Posricha]

Yep, that tracks.

[Adam Grant]

And I remember our professor saying, joy equals sex plus shit.

[Dr. Tricia Posricha]

This is like an amazing class.

[Adam Grant]

I mean, it was a weird class in a lot of ways, but I think that that foreshadowed something that you write about in your book, which is the idea that people feel some degree of extreme joy when they are having a bowel movement. Explain this to me.

[Dr. Tricia Posricha]

Yeah, that is a concept that I call pooforia. And for example, right now, I see a lot of patients with Parkinson's because that's what I study in my laboratory, the GI symptoms of Parkinson's. And as everyone knows, when you have something like Parkinson's disease, You have a lot of other very severe symptoms, things like tremors, difficulty walking, difficulty speaking. And yet when you talk to to these patients, people will tell me if they could trade away one thing, whether it's the tremors or the constipation or difficulty sleeping, it would be the constipation. Like, they would rather live with tremors than they would live with the severity of their GI symptoms. And I find that to be true almost across the spectrum that no matter how successful you are in life, no matter what else is going on, what other diseases you have, if you cannot eat the food that you love and you cannot poop it out properly, people just don't feel joy. They don't feel like they have achieved, like, a high quality of life. And what I talk about when I'm talking about pooforia is like two stages, right? And one is long term satisfaction with your bowel habits. And for me, maybe that's actually where having a bowel movement is the absolute least of your daily concerns. And 40% of Americans, this is something that disrupts their daily lives. It's a huge number for something that we actually may or may not have a diagnosis attached to. We may not be talking about enough, but that's a lot of people who are not happy because they're not pooping well. But then there's also this, like, interesting phenomena, which, again, we don't talk about that much, probably out loud on a podcast or with friends, which is that, like, people feel such immense joy when they have a good bowel movement. And I actually do think that there's two reasons why this happens. One, it can be hard work for a lot of people. Like, it's not effortless, it's not easy. And so, like, sometimes people having, like, a nice, good bowel movement really feels like a relief because they know now the rest of my day is not. I'm not gonna be thinking about this and worried about where the bathroom is and feeling that heaviness. So it's like a big sense of relief. And also there is this surge through your vagus nerve in order to have a bowel movement. That's very relaxing. That's like, you have to have that in order to have a good bowel movement. So there's both this physiological basis and this sense of, like, achievement and relief that comes with having one.

[Adam Grant]

Is that related to dopamine? Because you've also shattered one of my assumptions about where dopamine lives.

[Dr. Tricia Posricha]

Yeah. So most of your body's dopamine comes from the gut, and I mentioned that my laboratory studies Parkinson's disease, but what we really study is dopamine signaling in the gut. And this is true, you'll hear this of a lot of other neurotransmitters that we think of as predominantly being brain centric neurotransmitters, like serotonin. That, too is mostly produced by the gut with dopamine. Though the dopamine produced by your gut actually doesn't cross the blood brain barrier. So it's not necessarily. Though the dopamine produced by your gut is the thing that's immediately giving you that hit of, like, satisfaction. I think you get that, but I think that's predominantly coming from the experience in your mind playing out about that, like, genuine sense of relief.

[Adam Grant]

Got it. Okay. So what's your advice on how to get to Pooforia?

[Dr. Tricia Posricha]

Yeah, well, sometimes I start with just the basics of what modern life has taken from us. And sometimes that conversation starts with me just saying, how are you sitting when you have a bowel movement? Right? And everyone's like, that's a weird question. I just. I just sit on the toilet, as one would. And actually, that's not the best or most natural way to have a bowel movement. And when you sit in this, like, 90 degree angle, like you're sitting on a chair, there's a kink in your colon. That tube is not all the way open when you squat, as many people used to do in the past. Far fewer are doing that today, for all the reasons I understand. Then actually, the tube straightens up and you're able to pass stool a lot more easily. And of course, the next point is like, nobody wants to squat. I get that. But what you can do to achieve that, to open up that angle again, is just to raise your knees above the level of the waist. You can use a stool. You could use a stack of books. You could use a pair of stilettos. As long as you raise your knees above your waist, even healthy people will say, oh, my gosh, I had no idea. This is way easier than it was. Another thing I talk about often is bringing our smartphones into the bathroom. That is like a big problem with our modern life. Speaking of dopamine. But when you bring your smartphone into your bathroom, you're getting distracted by design. And, you know, we did this study in my laboratory where we found that people who bring their smartphone in the bathroom, which is everybody. Okay, there's no shame in that. But those people, about half of them, said they spent longer in the bathroom than they intended. Because they were distracted by their phone. That's not so surprising. There's no way we can expect you to focus on the job at hand in the bathroom if you have your smartphone and you're, like, in the middle of doom scrolling. And it's not so much like, oh, this is just going to waste your time. We're worried that this is what's driving hemorrhoids in a lot of people, because the longer you sit on this open commode without any pelvic floor support, the more those hemorrhoidal veins they fill. Over time, that connective tissue weakens. So this is a habit that it's probably simpler to say we should break than it actually is because we're all so addicted to our phones. But it's like one of those things. Like, just like we don't bring our smartphone to the dinner table, to the bedroom, we probably shouldn't be bringing it to the bathroom either.

[Adam Grant]

Ooh, good advice. Well, Tricia, this has been every bit as fun and enlightening as I hoped. And also less gross.

[Dr. Tricia Posricha]

Yeah, I hope you feel that way. And I hope you take a look next time.

[Adam Grant]

I can't say I plan to, but thank you for joining us and at least inviting me to rethink that. Rethinking is hosted by me, Adam Grant. The show is produced by Ted with Cosmic Standard.

[Jackson Financial Representative]

Our producer is Jessica Glaser. Our editor is Alejandra Salazar. Our engineer is Asia Pilar Simpson. Our technical director is Jacob Winick, and our fact checker is Paul Durbin.

[Adam Grant]

Our team includes Eliza Smith, Roxanne Hylash, Bambam Chang, Julia Dickerson, Tansika Sung Manivong

[Jackson Financial Representative]

and Whitney Pennington Rogers.

[Adam Grant]

Original music by Hans Dale sue and Alison Layton Brown.

[Dr. Tricia Posricha]

You know, I wash my hands after I poop like everybody else. You know, I'm a poop positive person, but, like, I have a reasonable distance, too.

[Capital One Bank Advertiser]

With no fees or minimums on checking accounts, it's no wonder the Capital One bank guy is so passionate about banking. With Capital One. If he were here, he wouldn't just tell you about no fees or minimums. He'd also talk about how most Capital One cafes are open seven days a week to assist with your banking needs. Yep, even on weekends, it's pretty much all he talks about. In a good way. What's in your wallet? Terms apply. See capital1.com bank capital1NA member FDIC.

[Podcast Promo Announcer]

This episode is brought to you by

[Dr. Tricia Posricha]

Choiceology, an original podcast from Charles Schwab, hosted by Katie Milkman. An award winning behavioral scientist and author

[Podcast Promo Announcer]

of best selling book how to Change. Choiceology is a show about the psychology and economics behind our decisions.

[Dr. Tricia Posricha]

Hear true stories from Nobel laureates, authors, athletes and everyday people about why we do the things we do.

[Podcast Promo Announcer]

Listen to [e-mail] podcast or wherever you listen.

[Dr. Tricia Posricha]

Boost Mobile is now sending experts nationwide to deliver and set up customers new phones. Wait, we're going on tour? We're delivering and setting up customers phones.

[Adam Grant]

It's not a tour, not with that attitude.

[Dr. Tricia Posricha]

Introducing store to door switch and get a new device with expert setup and delivery.

[Adam Grant]

Delivery available for select devices [e-mail] A

[Podcast Promo Announcer]

Rich Life isn't a straight line to a destination on the horizon. Sometimes it takes an unexpected turn with detours, new possibilities, and even another passenger or three. And with 100 years of navigating ups and downs, you can count on Edward Jones to help guide you through it all. Because life is a winding path made rich by the people you walk it with. Let's find your rich together. Edward Jones Member SIPC.