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Dr. Perlmutter’s groundbreaking new book, Brain Defenders, is now available for pre-order. Discover how to protect your brain and future health - reserve your copy today at https://www.braindefenders.com.

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On this episode of The Empowering Neurologist, I spend time with Dr. Trisha Pasricha, gastroenterologist and author of the provocative and important new book, You’ve Been Pooping All Wrong. Yes, the title makes you smile, but the science inside should make all of us pay attention.

Dr. Pasricha is part of a new generation of neurogastroenterologists exploring one of the most fascinating frontiers in medicine: the deep, bidirectional communication between the brain and the gut. Raised as the daughter of renowned gastroenterologist Dr. Pankaj “Jay” Pasricha and trained at Johns Hopkins, she brings both personal insight and rigorous science to a topic that too often lives in the shadows.

What makes this book so important is that it dismantles myths we’ve carried since childhood. For example, at one point in the book she describes how students taking an oral exam nearly doubled their intestinal permeability, simply from psychological stress. That single experiment powerfully illustrates how the brain can alter gut biology in real time.

And in another unforgettable section, she shares her early research showing that when subjects lied, their stomach’s electrical rhythm shifted into chaos, an arrhythmic pattern detectable on electrogastrogram. The stomach as a lie detector! That’s not just fascinating, it underscores how emotionally and neurologically integrated our digestive system truly is.

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00:00 Intro

03:05 Why We Need to Talk About Pooping

07:17 The Stigma Around Bowel Symptoms

09:31 Why Early-Onset Colorectal Cancer Is Rising

12:11 Should Screening Start Earlier?

14:59 Colonoscopy vs. Stool and Blood Tests

18:34 Ad: Optoceutics

20:35 Why Colonoscopy Still Matters Most

31:00 What “Leaky Gut” Really Means

34:42 What Worsens Intestinal Permeability

36:10 Ad: 3X4 Genetics

38:09 Gut Permeability, Inflammation, and Brain Disease

48:45 Could Fecal Transplants Help Parkinson’s?

56:52 The Different Causes of Constipation

1:02:23 The Myth of One Bowel Movement a Day

1:05:42 Final Takeaways on Gut and Brain Health

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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.

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