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Can you trust your gut? with GI doctor Trisha Pasricha

ReThinking

Tue Apr 07 2026

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!

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Transcript

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Dr. Tricia Posricha (1:25)

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 (1:44)

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 (1:50)

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 (2:02)

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 (2:10)

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

Adam Grant (2:13)

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.

Dr. Tricia Posricha (4:46)

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.

Jackson Financial Representative (15:55)

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Dr. Tricia Posricha (34:10)

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.

Dr. Tricia Posricha (37:39)

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.

Dr. Tricia Posricha (40:44)

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.