You’ve Been Pooping All Wrong: A gastrointestinal doctor’s guide to the brain-gut-microbiome connection

by Trisha Pasricha

A GI’s guide to the brain-gut-microbiome connection; including research on why people develop IBS, and how anyone can achieve poophoria.

Welcome to the easy-to-digest user’s manual for your body’s unsung the gut. Leading Harvard gastroenterologist, Dr. Trisha Pasricha takes us on a riotous deep dive into our own bowels with new insight from neuroscience, enteric biology, and physiology for an actionable framework to make pooping a breeze.

No one would expect you to have stunning teeth if you were never shown a toothbrush. You would struggle to fall sleep if you never knew how to turn off the bedroom lights. But no one talks about the fundamentals of pooping, and so many—even the highest of achievers—spiral into a quagmire of poor habits and toilet-anxiety.

You’ve Been Pooping All Wrong will teach

What is a “normal” bowel movement? What can I learn from the colour of my poop? Is there a wrong way to sit? Is there a better way to wipe?The intricate connection between your brain and your Why do you suddenly need to find the bathroom right before your turn at karaoke and why does stress make you constipated?How to harness your gut’s microbiome to boost your How does your lifestyle influence your microbiome and how can your microbiome, in turn, reshape you?The three Ps of having a perfect A simple framework to transform your bowel habits based on years of gastroenterological expertise. And much more…
Here, you’ll learn the tools to achieve bowel consistency, ease, and—yes, joy—so that your gut flows on autopilot and you live your life without obsessing about the in short, poophoria.

Genres: Nonfiction, Health, Science, Audiobook, Self Help, Medical, Biology

251 pages, Kindle Edition

First published April 7, 2026

About the author

Trisha Pasricha, MD, MPH is an instructor of medicine at Harvard Medical School and the “Ask A Doctor” columnist for The Washington Post where she translates complex medical topics into must-read insights—with a touch of humor—for millions each week. A graduate of Harvard College, Dr. Pasricha earned her medical degree from Vanderbilt University School of Medicine and a Master of Public Health from the Harvard T.H. Chan School of Public Health. Her training includes an internal medicine residency at The Johns Hopkins Hospital and gastroenterology and motility fellowships at Massachusetts General Hospital. Currently, Dr. Pasricha serves as director of the Institute for Gut-Brain Research at Beth Israel Deaconess Medical Center, leading an NIH-funded research laboratory at the forefront of gut-brain science. Her work has been published in The New England Journal of Medicine, JAMA Network Open, and Nature Reviews.

Reviews

[Booksblabbering || Cait❣️ · Rating 4 out of 5]

This is your PSA to bring up pooping at the dinner table.💩

Told with humour, relatability, and respect, this book plunges (lol) into common misconceptions, doubts, worries, and tips for making sure your bowel movements are as easy as you can make them be. 

What stood out to me was how we ALL go to the toilet AND we are all aware how widespread awkwardness around pooping is; yet bathroom anxiety and poor toilet habits still persist due to a general lack of open discussion around bowel health.

It explores how fibre, exercise, coffee, sleep, even the shape of the toilet can impact our need to go, and the ease of going.

Importantly, we should never feel awkward or silly for going to our health provider if something feels off. 

Let’s just normalise talking about what comes out - I mean, we all love talking about what we eat.
Saying that, I probably won’t be bringing this up in my work meeting tomorrow…

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[TL *Humaning the Best She Can* · Rating 4 out of 5]

Libby app, Overdrive was better.
----

Interesting read, only mildly gross and learned some new things 🤔.

Trigger warnings ⚠️ for parts talking about experimentation on rats for medical studies stuff (I tuned those parts out)

[Zac McCray · Rating 4 out of 5]

Short and sweet, I recommend this book to anyone who has ever pooped.

[Jeff Moreau · Rating 5 out of 5]

What a different and interesting book! It starts out trying to remove some of the stigma around the discussion of poop. It has been a taboo topic for so many of us for so much of our life, and yet it is a natural reality that has real impacts on your day-to-day life. Throughout the book, Dr. Pasricha shares her expertise while passing on knowledge that she wishes her patients had been taught elsewhere.

Interested in learning a little more about the gut microbiome?... curious about women's gut health and how it can be altered?... feel like you have "unique" poo problems that separate you from everyone else? (this book says they're less unique than you think)... want to know what causes silver poop?... or just want to potentially prevent the passing on of generational toilet trauma? Well, this book covers all those topics and more :)

Note: I found this book because it was recommended by John Green (the author, vlogger, and humanitarian). After starting it, I also saw it mentioned on SNL.

(I would score this as a 4.5/5, but I'm rounding up to a 5 for Goodreads and their whole-number rating)

[Sonya · Rating 5 out of 5]

This book is amazing!Dr Pasricha is a witty storyteller who also clearly cares for her patients. So informative for anyone who has been told their GI issues are all in their heads. I found myself laughing out loud so many times while also learning so much about gut health. Can’t wait to recommend to others!

[Evelyn DS · Rating 4 out of 5]

I get a pass for reading this because I am a healthcare professional lol. I thought this book was very readable and emphasized the importance of gut health for more than JUST pooping well. I do recommend this book to everyone as a fun and informative read. However, if you’re wanting more specific treatments for conditions like IBS or Crohn’s, this book will not provide it. But you will have fun facts to share at the dinner table!

[Camelia Rose · Rating 4.75 out of 5]

Trisha Pasricha is a medical doctor, a researcher and medical journalist. This book is about normalizing the talk of gut health, and to achieve “poophoria” in your daily life. Information included in the book is perhaps not all but mostly new (to me).

I am interested in the gut-brain connection. I understand the connection bi-drectional but underestimate how strong the connection is. Rheumatoid Arthritis is highly linked to stress, so are many gut health conditions, not only the Irritable Bowel Syndrome. Jetlag is not only in your brain, but also in your gut. The biomarker, α-Synuclein, a protein linked to Parkinson’s disease, can be found in the gut 10 years before the person is diagnosed with Parkinson's disease.

A few facts: Pelvis floor dysfunction is a real thing, especially for perimenopausal and menopausal women or women after hysterectomy. Pooping anxiety on holidays and in other unfamiliar situations is surprisingly common. Modern toilet seats are not helping. Consider lifting your legs up to your chest when sitting if you have constipation. Using a bidet is a lot better and healthier than the wiping method. Persistent bloating could be a sign of ovarian cancer. Pre-symptomatic stages of Alzheimer's have a different mix of gut bacteria than healthy individuals

[Heinrich DuBose-Schmitt · Rating 5 out of 5]

This book represents the very apex of all human literature. I believe every man and woman should read it. Filled with insights and humor you will be regularly moved ... and maybe join #teambidet. Here's a summary: pooping once every one to three days is normal; talk about this topic; more fiber, even supplements; don't sit too long; leave your phone out of the bathroom; and remember that poophoria is achievable -- butt above all, discuss pain with your doctor immediately; that's not "all in your head".

[Ash McG · Rating 5 out of 5]

Everybody 💩 so everybody should read this book.

[Grace H · Rating 5 out of 5]

Gut microbiome health starts the very day we are born. What I loved about this book is how it relies heavily on science to give very simple steps for reducing the chance of colon cancer, Parkinson’s, and many more serious medical issues.

If I was to give the briefest synopsis:
- increase fiber consumption
- reduce sodium and deli meats
- completely cut ultra processed foods and alcohol
- create a regular rhythm when you first wake up of going to the bathroom (even if nothing happens)
- get a bidet

[Tara DuBose-Schmitt · Rating 5 out of 5]

Informative and quite funny

[Misti · Rating 4 out of 5]

My goodreads friends read the most interesting books, which means I find out about the most interesting books. This one was right up my alley. Perfect for fans of Mary Roach. It’s on the short side, the science wasn’t over my head, and was written with humor. I felt like I should have been eating fiber or walking the entire time I was reading it.

[Zoe Zeid · Rating 4 out of 5]

Round up to 4.5. A super cute book about the science and social stigmas of poop. I learned a lot about the science aspect and will be more considerate with my diet. I also will think more about the gut/brain connection. If you want to follow along on my poop journey, friend me on PoopMap!!

[Stacy · Rating 5 out of 5]

This book was fantastic.  It was fun to read, not too long, and it was full of really interesting information.  As the author addresses, poop is somewhat of a taboo subject.  As a society we typically don't discuss anything to do with it in polite society.  Yet we all do it.  So I appreciated getting this high level overview of what's going on in our bodies, and then what's going on when the poop comes out.  

Here are some of my main take aways from the book.  (and this is my summary, so there is a good chance I've misinterpreted or misunderstood something).  In no particular order:

Poop colors.  This fascinated me.  Your body's bile and gut bacteria make the typical brown color.  But Yellow, Green, Blue, Purple are all fine.  (and brown of course).  But if you have Red, black, white, or silver there is something probably something seriously wrong and you should go to your doctor.  

There are three P's to pooping.  Propulsion, Pliability, and Pelvic Floor.  

There is a poop scale (The Bristol Stool Form Scale) that ranges from 1 to 7.  1 being like rabbit pellets, and 7 being watery.  #4 is considered the ideal (like a sausage, smooth and soft)

Your colon is removing liquid from your poop as it journeys through.  The longer the journey, the drier/harder it will be.  Which can be very painful uncomfortable.  When the urge to poop hits, don't ignore it.  

You can condition (or train) your body to poop at a certain time.  Like pavlov with the dogs, you can positively reward your body (either by drinking coffee or taking a laxative) to poop, and then continue until it does it on its own.

Pooping just a few times a week is normal.  So is pooping 3 times a day.  Everyone is different but in this 'range' it's considered normal.  

There is a connection between trauma as a child (injury, illness, abuse) that manifests into a higher likelihood of IBS or other issues.

There seems to be a correlation between having ulcers as a young adult (or mid adult) and developing Parkinson's.  

Stress or anxiety is a clear cause of IBS.

Positioning is a huge key for an easier poop.  If having trouble start by getting your knees over your waist (prop your feet on something to elevate them)

Bidets are highly recommended instead of wiping.  Or use a 'dabbing' technique to minimize irritation.  

Almost 50% of women experience some form of IBS during their periods.  And of course the amount of studies focusing on just women is incredibly low. 

olderl women, if you have 'new bloating' see your doctor.  This is a top indicator of ovarian cancer.
It's relatively common for people to become constipated while traveling. 

Your colon isn't as active at night so you shouldn't be waking up to poop. (talk to your doctor if you do).  Your colon is most active up to an hour after you wake, best time to poop.

Medications to help you go (or to prevent) are safe to use and you don't become addicted or dependent on them.  If you need them, use them.  Don't take antibiotics BEFORE you get diarrhea.  (In fact, don't take them at all and let it run it's course).  Instead use bismuth subsalicylate.  This is also good to use to help prevent gas.

Hemorrhoids are very common, most everyone has them. They usually resolve on their own. If you get it surgically removed it will likely leave a skin tag. Fiber helps (take psyllium)

There was a lot of other interesting information. Studies. Stories. And Dr Pasricha’s humor was top notch. I really enjoyed the tone of this book and I wish I had listened to it on audiobook. I learned so much about a regular body function, and it’s shocking that so much of it was new information. I’d recommend this book to anyone.

[Christine The Uncorked Librarian · Rating 4 out of 5]

My husband and I listened to this one on the way up to MGH for my colonoscopy...the irony, LOL.

As someone with IBD—ulcerative colitis—I knew much of the information from 22+ years of experience, so it was nice to feel a bit heard and validated. I appreciate the author's knowledge and passion while also trying to break the stigma around talking about poop and women's health (and the gaslighting and lack of research that comes with being a woman, still, even in 2026).

I also have family members who think my disease is "embarrassing," which is hurtful but also a bummer since they suffer from digestive issues but won't talk to anyone about them/seek medical or professional support.

If you struggle with IBS, IBD, stomach problems, or ya know, pooping in general, this is a solid, informative, and empathetic read. The author will also help guide you if your bathroom habits are healthy or not—and when to seek medical care.

Lastly, the anecdotes shared have the potential to make you feel not so alone or atypical. Even with IBD, I didn't realize how many people still suffer from many of my symptoms. The stats are a bit surprising.

A quick note on the audiobook: I would have preferred a physical copy (none of my libraries had one) over the audiobook to skip sections that weren't relevant to me (running marathons and pregnancy). Of course, I just "fast forwarded" a bit through them. The audiobook read slowly for me, maybe because I knew much of the info, but I listened to it at a higher speed just fine. It’s pretty short and fast.

I am grateful for books and research like this. They help support people and change their lives.

[JC · Rating 4 out of 5]

[4.25/5]

The best book about shit you will ever read. Genuinely, this is very well-written and crafted with intention to cover pretty much every common (and uncommon) question you might have about your gut health. I picked this up for two reasons. First, I have become extremely paranoid about colon cancer; it seems like it is everywhere with young, big name celebs passing from it. With more and more news stories about its increasing diagnoses among young people, people in my weightlifting class are swapping fiber tips... The colon is the thing right now. So get educated! Second, John Green recommended it, and, as you can maybe tell from the reviews, Nerdfighters really will take any book rec.

I highly recommend this as a straightforward, dense but approachable guide to keeping your body healthy. She covers topics from color, formation, fiber intake, preventing the runs during your runs (lol), the brain-gut connection, and more. I do wish she had covered a bit more around cancer screenings (like, many practitioners skepticism around send-away tests, etc.) but I also have a specific paranoia around this. Either way, this is where to start to make sure your insides are running properly, highly recommend on audio.

[Caitlin · Rating 5 out of 5]

A short, very accessibly written pop-science look at how we can talk about and improve our gut health and poop!

None of the chapters go into depth on any of the research but it's meant to be a conversation starter more than anything.

I'm about to become the very annoying friend who makes half the people she knows read this too.

[Kate · Rating 3 out of 5]

Entertaining and fascinating. I’ll never look at poop the same again!

[Savannah · Rating 4 out of 5]

Absolutely fascinating!!!!

[Jason McCracken · Rating 3 out of 5]

It turns out I already know way more about shit than I realised.

[Michaela Wright · Rating 5 out of 5]

if you wanna learn how to help your gut health and have some laughs at the same time, this book is for you

[Nicole Kamrass · Rating 5 out of 5]

Phenomenal. Funny, educational, and accessible. If, like me, you're already super interested in this topic, you will love it. If you're not, I think by the end you just might want to talk about your gut and poop a lot more. I am recommending this book to everyone I know.

[Margaret Heller · Rating 4 out of 5]

What a charming book. And many interesting pieces of information I certainly will not be sharing with you so you better read it yourself.

[Joe · Rating 5 out of 5]

Despite the topic, this is not a bathroom read. The content is too detailed to really help with relaxing your external anal sphincter, but this is not a criticism. It is incredibly interesting and the neurogastric connections are so promising for future treatments and the understanding of nebulous symptoms. I immediately purchased psyllium husk and set a timer for potty time so I don’t sit too long. I have not ordered a bidet yet, but I’m using my time on the throne to think about it. The biggest impact is positive visibility for a topic that is often taboo and embarrassing for most people, but if we suffer in silence or resign to it being all in our heads, then no forward “propulsion” will ever get made.

[Ismay · Rating 4 out of 5]

:-D I don't usually read this type of thing but author and her father are our NIDDK funded physician-scientists so gotta support. She does a good job making biology accessible via humor.

[Nikhil · Rating 4 out of 5]

In many ways, we are a Piku family! Poop has been part of our family conversations (to the chagrin of my mother and my wife) for as long as I can remember! So when I came across Dr Trisha Pasricha’s book, ‘You’ve been pooping all wrong’, I just had to pick it up!

Dr Trisha is a 2nd generation gastroenterologist and eminently qualified for writing this book! Her father, Dr Pankaj Pasricha, is a renowned leader in the field of neurogastroenterology. As she explains, she has had enough context on this topic through dinner table conversations growing up. Not to mention that she is a physician-scientist, runs the Institute for Gut-Brain Research at Beth Israel Deaconess Medical Center, is an Asst. Prof. at Harvard Medical and has been a medical journalist for 15+ years, including with The Washington Post.

The first part of the book (titled: The Secrets) explains the process of pooping in reasonable detail, starting with the mechanics of poop formation and leading to its eventual excretion (the 3Ps - propulsion, pliability and pelvic floor). Along the way, the book explores and busts common known myths about poop e.g. early-morning, once-a-day is not the only way to poop in a world where ‘normal’ poop habits vary from thrice a week to more than thrice a day. It introduces the poop form scale that helps classify poop into 7 types based on shape and texture. And being an Indian, one does feel a small tinge of pride when the Dr Pasricha highlights the superiority of the traditional Indian form of squatting (over the increasingly common western style).

The second section (titled: The Science), focuses on the gut-brain connection. In hindsight, this linkage should’ve been apparent e.g. digestion starts in the brain even before food actually flows into the alimentary canal, through the thought / sight / smell of food. As a junkie for aha’s, I was fascinated to learn about the potential 2-way connection between the gut and the brain like when stomach issues lead to stress and stress leads to stomach issues, via the corticotropin releasing hormones. Equally interesting was the gut microbiota’s role beyond digestion - how specific microbiota trigger specific receptors and send signals through the enteric nervous system to the brain (a reverse flow rather than the usual brain telling the gut what to do!). The most promising aspect, though, was the discussion on the potential positive correlation between intestinal ulcers in early years with neurological diseases like Parkinson’s. Dr Pasricha hints at the potential role of dopamine deficit in both instances. If validated, this could herald new treatment / palliative options for such life-changing illnesses.

The third section (titled: The Survival Guide) provides helpful tips in dealing with all things poop, especially when one is out in the world. The section covers wide-ranging from how to wipe (preferably wash) to reasons behind constipation while on vacation to haemorrhoid-risks from excessive straining to the two-way relationship between pooping and enthusiasm for exercise. Most of the insights are useful / relevant from a day-to-day perspective, though some like how to find the right loo in a public place do seem a bit forced. There is an entire chapter on women’s health and poop, which though very relevant (given the double taboo - poop + women’s health) seems out of place in this section.

In summary, the book is a good mix of myth-busting to explaining poop and its potential implications for various other aspects of our health and daily life. It also has a number of helpful tips including the obvious use of soluble fibre and many more. At times, though, the detailed descriptions do cross over into the edge into ‘gross’ territory, but then I guess thats part of the point of the book.

The book is written in a rather light-hearted style, with Dr Pasricha peppering the narrative with examples, personal anecdotes and data, where appropriate. Thus she takes the stink of what is otherwise considered a rather disgusting topic.

In conclusion, “You’ve Been Pooping All Wrong”, is a book I would recommend, even to those who don’t think they have gut-health issues.

PS: Of all the insights, the one that stood out for me was the role of caffeine in loosening the bonds of our excretory system and helping us on the path to poophoria!

[Adam DelGarbino · Rating 3 out of 5]

Eat more fiber

[Zehava (Joyce) · Rating 4 out of 5]

I simply could not resist a book with this title. This book is full of useful information and it is both informative and funny (I mean a book about poop has to be funny, right?) If you have issues in this area (or even if you don’t)I highly recommend this book. The audiobook is well narrated by the author.

[Ashley · Rating 5 out of 5]

I never write reviews, but this book is a life changer. If you're reading the title of this book and laugh, smirk, judge, or roll your eyes, then you are exactly the person this book was meant for.

I have been struggling horribly with digestive health for a little over a year. Long story short, it was discovered I had an H. Pylori infection wrecking havoc in my body, resulting in a grueling 2 week antibiotic treatment of over 20 pills each day. Pro: the infection is gone! Con: your body will never be the same again after taking that many antibiotics. Thus I have now found myself deep in the world of learning about GI health.

This book is not just about poop (get comfortable with that term), it is about how our GI systems work. One of the most important topics this book covers is the gut-brain connection. So much of what occurs in our guts is influenced in how we think and live our lives. At some stage in your life, you will have digestive issues. Every person can benefit from reading more about these processes.

Not convinced yet? Here are some crazy things I learned that this book gets into:
- Did you know humans and dogs are the only animals with bowel problems? It's because we're the only animals to restrict our bowel movement schedule, and not go whenever wherever.
- Did you know that most patients of neurological diseases, such as Parkinson's, have some sort of large GI incident in their history (i.e. viral/bacterial infection, long term antibiotic use, IBD, etc)?
- Did you know that there is a really strong connect between people who have IBS/IBD and people who had particularly stressful childhoods/formative years?

I am in immense awe of this author. Trisha is a highly talented GI doctor/instructor who started her research in this field in HIGH SCHOOL, grew up learning from a father in the same field, and had residency training at Johns Hopkins. She is so funny and witty, and I was thoroughly entertained while being educated through this whole book. If you don't want to read this to learn more, at least read it to entertain yourself. The audiobook is also amazing. 10/5 stars if I could.

[Lakmus · Rating 4 out of 5]

TLDR: MOAR FIBER!!1

Вот вы в сортах говна не разбираетесь, а доктор Пасрича, прости-господи, таки да. И вы тоже можете узнать о каком расцвете стоит уже беспокоится, как не обосраться на забеге, и *почему* в самолёте все 14 часов так бурлят газы.

Эти ценные научные знания дались гастроэнтерологам непросто, и вам расскажут как именно, но скорее всего учёные что-то кому-то куда-то впихнули (воздушный шарик, мышке, в жопку).

А если серьёзно, энтерическая нервная система это таинственный орган и мы мало про неё знаем, могу понять энтузиазм автора.