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这个数字让我意识到我们正面临一场隐藏的肠道健康危机。40%的美国人表示他们的肠道功能会影响日常生活。15%的美国人患有肠易激综合征。四分之三的美国人无法在公共卫生间排便。三分之一的人在度假时排便困难。多年来我一直想做一期关于这个话题的节目。肠道问题、腹胀、便秘、胃胀气、肠易激综合征，还有，是的，你和我。我们要谈论排便。哦，是的，我们要涉及这个话题。今天的嘉宾是世界上最顶尖的肠脑连接专家之一，研究你的身体如何影响你的心理健康、压力和决策能力。我说的是特里莎·帕西卡医生。帕西卡医生是董事会认证的神经胃肠科医生、医学科学家，也是哈佛医学院的医学助理教授。
Here's a number that made me realize that we have a gut health crisis hiding in plain sight. 40% of Americans say that their bowels disrupt their daily lives. >> 40% >> 15% of Americans have irritable bowel syndrome. Three out of four Americans can't poop in a public restroom. One out of three struggle to go to the bathroom on vacation. I have wanted to do an episode on this topic for years. gut issues, bloating, constipation, gas, IBS, and yes, you and I. We're gonna talk about poop. Oh, yes, we're going there. Today's guest is one of the world's leading experts on the gut brain connection, and how your body influences your mental health, stress, and decision-making. I'm talking about Dr. Trisha Paca. Dr. Pasicha is a boardcertified neurogastroinologist, a physician scientist and an assistant professor of medicine at Harvard Medical
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肠道具体指的是什么？你的肠道就是一个大脑。你会只把肠道看作消化器官，但它远不止于此。如果是肠道功能障碍导致了我们的焦虑呢？如果是肠道功能障碍导致了抑郁症呢？如果是肠道功能障碍导致了神经退行性疾病呢？这完全改变了我们的领域，而且至今仍在塑造医学。好的，现在有个问题。哦天哪，我不敢相信我要问你这个。我太兴奋了。嗨，我是梅尔。在我们开始这一集之前，我的团队告诉我在YouTube上观看梅尔·罗宾斯播客的你们中有57%还没有订阅。你能帮我一个小忙吗？只需点击订阅，这样你就不会错过我们在YouTube上发布的任何节目。这让我知道你喜欢我们为你带来的嘉宾和内容，因为我想确保
School. What is the gut specifically? Your gut is a brain. You will think about the gut just as a digestive organ and it is so much more than that. What if it is gut dysfunction that's responsible for our anxiety? What if it's gut dysfunction that causes depression? What if it's gut dysfunction that causes neurodeenerative disorders? And that completely changed our field and it's still shaping medicine today. Okay, now here's a question. >> Yeah. >> Oh god, I can't believe I'm going to ask you this. >> I'm so excited. >> Hey, it's Mel. And before we get into this episode, my team was showing me 57% of you who watch the Mel Robbins podcast here on YouTube are not subscribed yet. Could you do me a quick favor? Just hit subscribe so that you don't miss any of the episodes that we post here on YouTube. It lets me know you're enjoying the guests and the content that we're bringing you because I want to make sure
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你不会错过任何东西。我很高兴你在这一集里，因为这真的很不错。好吧，让我们开始吧。特里莎·帕西卡医生，我很兴奋你在这里。非常感谢你邀请我，梅尔。哦天哪。好的，我们要深入探讨这个。我等不及了。我真的等不及要谈论排便。我知道我们稍后会涉及这个话题，但嗯，我想先问你，如果我把你接下来要教我们的一切都放在心上，把它应用到我的生活中，和朋友们分享，我的生活会有什么不同？你的生活会以两种重要方式改变。首先，你会停止把肠道看作消化器官。你会开始把肠道看作大脑，因为它就是大脑。你的肠道是一个大脑。它的神经细胞数量比整个脊髓还多。它产生所有相同的神经递质，比如多巴胺、血清素。它不断通过这条叫做迷走神经的信息超级高速公路向你头部的大脑发送信号。而且许多我们最害怕的疾病，从某些癌症到帕金森病，这些都可能始于肠道。
you don't miss a thing. And I'm so glad you're here for this episode because this is a really good one. All right, let's dive in. Dr. Trisha Pria, I'm so excited that you are here. >> Thank you so much for having me, Mel. >> Oh my gosh. Okay, we are going to dig into this. I cannot wait. I I really can't wait to talk about poop. I I know that that we're going to get into that a little bit later, but um I'd like to start by asking you, how would my life be different if I take everything that you're about to teach us today to heart? I apply it to my life. I share it with my friends. What's going to change about my life? Your life is going to change in two big ways. First, you're going to stop thinking about your gut as a digestive organ. You're going to start thinking about your gut as a brain because that's what it is. Your gut is a brain. It has more nerve cells than the entirety of your spinal cord. It is creating all the same neurotransmitters like dopamine, like serotonin. And it is constantly sending signals up to the brain in your head through this information
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一旦你意识到这一点，一切都会改变，因为那样你就能意识到你可以改变你的健康，不是十年后，而是今天，你可以开始通过肠道控制你的健康。这给了你真正的控制权。第二个将改变的是你会意识到这整个时间你的症状从来不是心理上的。所有那些胃肠道症状，腹胀、消化困难、排便问题，都不是单纯的压力。我认为这么多人长期以来不被相信的原因是因为有些人不太熟悉我今天将与你分享的所有数据和研究。一旦你拥有了那些知识和认可，它会给你力量和主动权去获得你需要的帮助。
superighway called the vagus nerve. And also so many of the diseases that we're most afraid of from certain cancers to Parkinson's disease, these can all start in the gut. Once you realize that, everything changes because then you can realize you can change your health, not 10 years from now, but today, you can start to take control of your health through your gut. And that gives you real control. The second thing that's going to change for you is that you're going to realize this whole time your symptoms were never all in your head. All of those GI symptoms, the bloating, the trouble with digestion, the going to the bathroom, none of that was ever just stress. And I think the reason that so many people for so long haven't been believed is because some people aren't as familiar with all of the data and all of the research that I'm going to share with you today. And once you have that knowledge and that validation, it's
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哇。那么，帕西卡医生，让我们从基础开始。肠道具体指的是什么？好的。让我拿出这个模型。好的，好的，现在我们都在医学院了，各位。你已经拿出了一个人体塑料模型，基本上我看到的是，如果你在听的话，我们会为你讲述这个。我们有一个展示人体内部的模型。我能认出肺。我看到一些像卷曲的东西，我想是肠子。但帕西卡医生会为我们很好地讲述这个。是的。首先，我要做的是，我要把肺取出来。我要把心脏取出来，这样我们可以看得更清楚。我保证我不是那么无情的。没有双关语意。好的。所以现在我看到什么了？
going to give you power back and agency to get the help that you need. >> Wow. So, Dr. Pasich, let's just start with the basic level. What is the gut specifically? >> Yeah. Let me bring out this model here. >> Okay, >> let's walk through it. >> Okay, so she's pulling out Okay, now we're all in medical school, everybody. She's you've pulled out a plastic model of a human being and basically what I'm looking at if you're listening we're going to narrate this for you. We have a model that shows the insides of a human being. I can I recognize the lungs. I see like a bunch of squiggly stuff which I guess are intestines. But Dr. Pasa is going to really narrate this for us. >> Yeah. And first thing I'm going to do is actually I'm going to take the lungs out. I'm take the heart out just so we can see better. So, I promise you I'm not that heartless. >> No pun intended. Okay. So, now I'm seeing Whoa. What am I seeing? >> Yeah. So, this what I'm going to walk you through is the gut. The gut is our
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是的。所以这个，我要为你讲述的是肠道。肠道是我们指胃肠道的方式。那是从嘴一直到肛门的一切。好的。等等。你已经教了我一些东西。当我听到肠道这个词时，我想的是从我的肚脐到我的私处。我想的是会肿胀的那一部分。我想的是垂在裤子外面的那一部分。是的。我想的只是那一部分。所以，首先你要真正改变的框架是，当你使用肠道这个词时，至少在医学上，它是你的嘴和所有从你的嘴一直连接到另一边排出的东西。那就是整个胃肠道。所以，作为那个真正，真正长的复杂管道一部分的所有东西，那就是你的肠道。嗯。那么，让我们走一遍。所以假设你咬一口食物。它通过你的嘴进去。现在跟随。它通过你喉咙后面的这个管子。你看到这块肌肉了吗？那条长管叫食道。
way of referring to the gastrointestinal tract. That is everything from the mouth all the way back to the anus. >> Okay. Hold on a second. You've already taught me something. When I hear the word gut, I think from my belly button to my private parts. I think about the part that swells. I think about the part that hangs out over my pants. Yeah. I think about just that section. >> So, the first thing that you want us to really reframe is that when you use the word gut, at least medically speaking, it's the mouth and all the things that connect your mouth all the way through until it goes out the other side. >> That is the entirety of the gastrointestinal tract. So, everything that's part of that really, really long complicated tube, that's your gut. >> Huh. >> Mhm. So, let's walk through it. So suppose you take a bite of food. It goes through your mouth here. Y >> and now follow along. It goes through this tube at the back of your throat. Do you see this muscle? That long tube is called the esophagus. >> Okay? >> And it goes from the esophagus down. >> You know what's interesting? >> Yeah. >> I don't know if you feel this way as
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好的？它从食道下去。你知道什么有趣吗？是的。我不知道你现在听这集时是否有这种感受，但我一直认为食道实际上是沿着前面下去的。比如在你前面。你看到我说什么了吗？不过。它躲在后面。所以，我必须实际上取出心脏，这样你才能好好看一下。是的，它在你胸部的后面。出于某种原因，我认为它在它前面。是因为像如果它伤害你，你会感觉到前面的胸部疼痛。这很奇怪。是的。当
you're listening to this episode right now, but I've always thought the esophagus actually goes down the front >> like in front of Do you see what I'm saying? >> Not. though. It's hiding out in the back there. So, I had to actually remove the heart for you to be able to get a good look. >> Yeah, it's in the back of your chest. >> For some reason, I thought it was in front of it. Is that because like if it hurts, you like feel it in the front of the chest. It's weird. >> Yeah. When you get heartburn, right, it's all kind of in that same area because the esophagus travels through your chest cavity on its way down to the abdominal cavity. Okay. And then when you have heartburn, you're sort of referring it to that general area and you're you don't know exactly where it's coming from. Is it the back or the front? You perceive it as just being from your chest, but actually your esophagus is hiding all the way in the back. >> Wow. >> Mhm. I'm going to take this liver out here too, just so you can see better where the esophagus is going. So, goodbye. >> Okay. So, it's behind the liver. >> So, it goes all the way back and then it connects here to your stomach. So, this organ here is your stomach. That's where the food gets broken down and acidified
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and broken into these really small pieces. From the stomach, that piece of food is going to enter the small bowel first. That is this long windy tube that goes all the way around and is kind of bunched up in your abdominal cavity. That's where all the nutrients get absorbed. So everything that your body wants, everything that it needs. >> Why is it called the small bowel? Cuz it looks pretty big. Like long. >> Yeah, it's long. You're right. It's long, but it is uh smaller in caliber. The large bowel, sometimes called the colon, is this larger C-shaped organ here. So, it is shorter than the small bowel, the colon, but it's wider. >> Okay. I just want to describe this for you in case you're listening cuz I'm standing here or sitting here rather kind of surprised because I thought the intestines, you know, like if you think about your intestines, you think all this squiggly stuff, right? And so, you know what's interesting is it looks kind of like a brain. >> The intestines really have the same like macaroni shape. >> You're starting to get it >> as the brain. But here's where you got
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me and I'm surprised. The colon isn't just the tail end of the macaroni. The colon is going up and around all of the like small intestine. I thought it was just like the last foot or the last like little section. I thought really >> yeah it has a long way to go. And that's because one of the jobs of the colon is that it sucks water out of at this point the waste that's there cuz everything that you don't again you absorb the nutrients you need in the small bowel now it's the waste that reaches the colon all the water is getting sucked out. So as it goes along this way it's getting drier and firmer and harder. Eventually now it makes its way to the back all the way to the back to your pelvis. So this is a female model. I'm going to hold this up. This is a cross-section of your pelvis. A female pelvis. Okay, so this is your bum. Right here is the colon, the last part of the colon called the rectum. So this is where all that food you've eaten that has now become waste, that has now been
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fermented by your microbiome, it hangs out here in the rectum until you're ready to release it back into the free world. >> A lot of times we're ready. I know we're going to get into this. A lot of times we are ready for it to be released, but it is not releasing. And I know we're going to talk about all of this. >> And thank goodness for those sphincters, >> the sphincters are >> the sphincters that hold it tight. You have control over your external sphincter. So if you say we are not ready, you can shut the door. You can shut that door most of the time. >> Yeah, there are times where you can't. >> And then you can see so this is the back of your colon and the part that's called the rectum. For in women, we have our uterus here and then our bladder up front. So it's all the way at the back. >> Wow. So how long should it take for the piece of food? So I had I had scrambled eggs this morning. >> Yeah. So, how long should it take for the eggs that I ate to go? Like, if I if if things are working as they should, how long should it take from chewing it up and swallowing it for it to make the
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它应该在4小时内离开你的胃。4小时。是的。如果食物较软，容易消化，不需要像纤维食物那样进行大量分解，比如鸡蛋这样软的食物，它会更快地通过胃。但从它离开胃到你决定再次排出它，这个过程可能需要几天。因为对很多人来说，它会在接下来的一两天内通过小肠，在结肠里停留。但你知道，我们对最后这一步有控制权。有些人出于各种原因会比其他人保留更长时间。所以可能需要一天、两天，有时甚至更长。太棒了。但它几小时内就离开胃了。几小时内。是的。有时甚至在30分钟内，取决于你吃了什么。这绝对令人着迷。
exit? >> It should exit your stomach, that first part, within 4 hours. Four hours. >> Yep. And if it's softer, easier to move through, doesn't have to do a lot of hard breaking down like fibrous foods. If it's something soft like eggs, it'll move through the stomach even quicker. But from the point from when it exits the stomach until you decide to release it into the world again, that process can take days. Because for a lot of people, it moves through the small bowel over the next day or two, hangs out in the colon. But, you know, we have control over that final step. And there are some people for any number of reasons who are going to hold on to it a little bit longer than others. So it can take a day, two days, sometimes even longer. >> Wow. But it's out of the stomach >> within hours. >> Within hours. >> Yeah. And sometimes even again within 30 minutes if depending on what you've eaten. >> Huh. That is absolutely fascinating. >> The thing about this though is that if you think about the gut just this way, and this is the way that I think a lot of us have learned about the gut in school, you will think about the gut just as a digestive organ. And it is so much more than that. So the gut is also
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一个免疫器官。你身体70%的免疫系统在肠道里。那是什么意思？这意味着你身体70%的免疫细胞和保护屏障，用来抵御外部世界抛向你的一切，都在肠道里。所以这是你对抗外部世界最重要的防御之一。我认为人们没有充分认识到这一点。所以流感在传播。是的。对。你呼吸空气，或者有污染。你呼吸空气。你站在吸烟的人旁边，你呼吸像是通过你的嘴进去，对吧？是的。所以你是说从你的嘴一直到食道、胃、小肠、结肠，这些都在保护你免受外部世界的影响？
an immune organ. 70% of your body's immune system is here in the gut. >> What What does that even mean? >> It means that all 70% of the immune cells and the protective barrier for you against everything the outside world is throwing at you is in the gut. So, it's one of the most important defenses you have against the outside world. And I think people don't appreciate that. So, the flu is going around. >> Yeah. >> Right. You're breathing in air or there's uh maybe some pollution. You're breathing in air. you're in uh standing next to somebody who's smoking, you're breathing in the like it's going in through your mouth, right? Yeah. >> And so are you saying that from your mouth all the way down the esophagus into the stomach, the small intestine, the colon, the that that is protecting you from whatever was in the outside world? >> Yeah. >> That you then either breathed in through your mouth or you ate in food that might have some sort of count. Is that what you're saying? That's exactly right. And
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是的。当然，我们吃的很多东西显然不是无菌的。我们把各种各样的东西放入我们的身体。我们烹饪它。你知道，相对干净，但它显然有来自外部世界的许多不同的东西，化学物质、细菌，无论是什么。大多数时候有人阻止你生病，那就是你的肠道。当涉及呼吸道感染时，很多免疫反应确实始于肺部，也始于其他地方。但想想我们很多呼吸道疾病，比如流感。很多人在患流感时会腹泻，因为你的肠道会被激活，这是反应的一部分。没错。所以肠道免疫功能只是保护你免受肠道内的东西，还是也与你身体的其他部分交流？它与身体的其他部分交流。
a lot of what we eat is obviously not sterile, right? Like we're putting all kinds of different things into our body. We cook it. It's, you know, relatively clean, but it's obviously got so many different things from the outside world, chemicals, bacteria, whatever it is. Someone is stopping you from getting sick most of the time, and that's your gut. When we when it comes to respiratory infections, a lot of the immune response does start in the lungs, and it starts elsewhere. But think about a lot of our respiratory illnesses like flu. So many people get diarrhea with the flu because your gut does get activated and that's part of the response. That's right. >> Wow. Okay. So, is the immune piece of the gut is that simply protecting you from what's in the gut or does it also talk to the rest of your body? >> It talks to the rest of the body. So, it helps coordinate the entire response. But you can think about it like we think of the skin as being that first barrier against the outside world. But really, the gut, if you look at the cross-sectional area of your gut, I mean, you pointed out this small bowel, it's huge. If you think about if you
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它有助于协调整个反应。但你可以这样想，我们认为皮肤是对抗外部世界的第一道屏障。但实际上，如果你看肠道的横截面积，我是说，你指出的小肠，它是巨大的。如果你想象把它全部展开，它是巨大的。它一直与来自外部世界的东西接触。所以它保护你免受外部世界的影响。肠道还在做更多事情。它也在产生激素。所以它负责调节你血糖的激素，例如，也影响你的情绪。然后另一个大事件我一直在讨论的是你的肠道是一个大脑。它是肠神经系统的家。肠神经系统。你可能听说过中枢神经系统。那是你头部的大脑。但你的肠道有自己的神经系统。数百万个神经细胞相互交流。它们对来自外部世界的信号做出反应。然后它们通过一条长长的神经与你头部的大脑交流。
were to spread it all out, it's huge. It is in contact all the time with things that we've come from the outside world. And so, it's protecting you against the outside world. The gut is also doing more. It's also producing hormones. And so, it's responsible for the hormones that regulate your blood sugar, for example, and also influence your mood. And then the other big thing which I talk about all the time is that your gut is a brain. It is the home to the entic nervous system. >> Entic nervous system. >> Entic nervous system. You've probably heard of the central nervous system. That's the brain in your head. But your gut has its own nervous system. Millions of nerve cells that are in communication with each other. They're in responding to signals from the outside world. And then they're communicating with the brain in your head through this long I want you to imagine a long windy nerve coming down from the brain making its way to every organ inside your chest cavity your abdominal cavity and all through your gut. That's the vagus nerve. >> So Dr. Pasicha there's you know you're
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想象一条从大脑蜿蜒下来的长神经，延伸到你胸腔内的每个器官，腹腔内的器官和整个肠道。那是迷走神经。所以帕西查医生，你知道你在讨论它是第二个大脑，肠道和大脑通过所有这些称为迷走神经的东西在不断交流。但你能谈论科学吗？以及研究人员和医学专家何时意识到存在双向交流以及这种连接如何在一个人身上形成。是的。我们已经知道肠道和大脑已经通信超过一个世纪。如果你回到1890年代，1890年代，你会在医生的日志中看到，他们在谈论情绪压力似乎会导致肠道内各处的这种反应。
talking about it being the second brain and that the gut and the brain are in constant communication through all of these things that are called the vagus nerve. Y >> but can you talk about the science and when researchers and medical experts realize there is a two-way communication and how that connection gets formed in a person. >> Yeah. We've known that the gut and the brain have been in communications for over a century. If you go back to the 1890s, 1890s, you'll see in doctor's journals, they were talking about how it seemed like things like emotional stress seemed to cause this response of all places inside the gut. >> And there was a famous set of experiments that was done in the 1950s at Cornell and the researchers had participants talk about really stressful emotional experiences. So they would talk about an argument they had with their spouse or the financial troubles they were h having. And while they were
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有一个著名的实验是在20世纪50年代在康奈尔大学进行的，研究人员让参与者谈论真正压力的情感经历。他们会谈论与配偶的争执或他们正在经历的经济困难。当他们讨论这些心理压力事件时，研究人员使用了殖民地镜的原型。他们从内部直接观察结肠。当这些人在说话时，他们会看到结肠开始痉挛、挤压和移动。这些人会经历胃痉挛和肠痉挛。我认为这与我在现实生活中的经历相符。如果我和我丈夫吵架，虽然不经常发生，但如果我吵架，我有时会感到胃痉挛。这是一种非常不愉快的感觉。问题是数十年来，这就是我们完全描述肠脑连接的方式。
discussing these psychologically stressful events, the researchers used a prototype of a colonoscope. So they looked directly at the colon from the inside. And as these people were talking, they would see the colon start to spasm and squeeze and move. And these people would experience stomach cramps and gut cramps. And I think that tracks with what certainly what I experience in real life. If I'm having an argument with my husband, which doesn't happen that often, but if I'm having that, I sometimes feel cramps in my stomach. It's like a very unpleasant feeling. The problem is that for several decades, that was the way we framed the gut brain connection entirely. We thought about that gut brain connection as the brain talking down to the gut. And it wasn't until the 1980s, 1990s, that my field, which is neurogastroenterology, the study of the gut brain connection, really crystallized. And that's when people said, "Wait a minute. This vagus nerve, this large nerve that's the conduit between the brain and the head and the brain and the gut, most of the signals, 80% of those signals, they're
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我们认为肠脑连接就是大脑向下对肠道说话。直到20世纪80年代、90年代，我的领域，神经胃肠学，肠脑连接的研究，才真正成形。那时人们说，"等等。这条迷走神经，这条连接头部大脑和肠道大脑的大神经，大部分信号，80%的这些信号，它们不是从头部的大脑向下到肠道。它们从肠道到大脑。所以如果迷走神经上大部分通信发生在从肠道到大脑，它完全改变了情况。对你来说，80%的信息从我们的肠道开始告诉我们的大脑意味着什么？它让我想知道，这正是研究人员开始问的问题，如果我们搞反了呢？
not going from the brain and the head down to the gut. They're going from the gut to the brain. So if most of the communication on the vagus nerve is happening from the gut to the brain, it completely flipped the script. What does it mean to you that 80% of the messaging begins in our guts telling our brains something? >> It makes me wonder, and this is what researchers then started to ask, what if we had it backwards? What if it is gut dysfunction that's responsible for our anxiety? What if it's gut dysfunction that causes depression? What if it's gut dysfunction that causes neurodeenerative disorders? And that completely changed our field and it's still shaping medicine today. >> Wow. I mean, that's a both radical and a crazy amazing thing to believe. I mean, I think it's true. I really do.
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如果是肠道功能障碍导致我们的焦虑呢？如果肠道功能障碍导致抑郁症呢？如果肠道功能障碍导致神经退行性疾病呢？这完全改变了我们的领域，它仍在塑造医学。哇。我是说，这既激进又令人惊奇。我认为这是真的。我真的相信。这不仅仅是信念。我是说，谢天谢地。在这一点上，我们现在有数十年的数据表明这是真的。好吧
>> It's more than a belief. I mean, thank God. At this point, we have decades now of data that's showing that this is true. Well, I think it's like something that's super amazing to consider because that means there are other ways that you can treat those symptoms or really go after those conditions and feel better in your life. >> Yeah, that's exactly right. I mean, if your whole life you've been told that your gut symptoms are due to stress, they're due to your anxiety, they're due to your depression, then you're left only with this set of tools and medications and treatments that are going to address the brain in your head. That's all you have. So, you're going to be taking things like anti-depressants, anti-anxiety medicines, maybe you'll do cognitive behavioral therapy. All of these tools are important and they have a really important place in treatment of these disorders. However, once you realize that the gut can be the source of the problem, it opens this door to this whole other toolkit of treatments that will primarily target the gut to
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interrupt that vicious cycle. So, it gives you options back. >> And even if it's not the actual source, it certainly is contributing to the extent to which the symptoms feel even worse. >> Absolutely. I mean we don't think of the gut brain connection as just the brain talking to the gut or just the gut talking to the brain. We have seen so many times it's a vicious cycle right like if you have horrible gut symptoms as many people are living with every day that can give you anxiety and then the anxiety can fuel the gut symptoms and vice versa and it's not sometimes just intervening at the level of the brain and the head that can stop them. Sometimes you need to stop the upstream source and shut off the faucet and that's looking at the gut. >> Well, what I love about this is that if you're somebody that really struggles with anxiety or you're a ruminator and you're constantly up in your head or you're feeling extremely depressed right now, going up in your head and wrestling your thoughts feels like an overwhelming
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thing to do. knowing that you're going to talk to us about ways we can take better care of our gut that are clinically and researchbacked in terms of helping alleviate those symptoms. That's amazing. So, from a medical standpoint, when I say I have a gut feeling, >> yeah, >> or I've got butterflies in my stomach, what does that mean? Like, what's the science behind that? >> Yeah, those are that's real physiology. Those aren't just metaphors. So stress, fear, excitement, these can all trigger our amygdala. That's a certain part of the brain that's an important emotional processing hub. It causes the amygdala to signal to another part of the brain to release a hormone called corticotrofen releasing hormone or CR. CR does two things. It acts on the stomach to slow it down and then it moves down to the colon and it speeds it up. So that's why when we are on a first
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约会时，我们可能会感到胃里有蝴蝶在飞舞，或者当我们要做演讲时，就像在我们突然必须现在就去洗手间之前。是的。>> 那为什么会这样呢？为什么我在即将做演讲或即将走进来和你做这个采访之前，总是要去洗手间或大便呢，为什么我现在非得去洗手间呢？>> 是的。好吧，在我职业生涯早期，我发现了导致这种情况发生的机制之一。所以我所做的是使用了一种叫做电胃图仪的机器。不，它非常类似于人们用来测量心率的心电图，对吧？所以心脏以每分钟约60次跳动的规律节奏跳动。嗯，事实证明你的胃实际上有它自己的节奏，它以约每分钟3次的规律速率收缩。但我发现的是，当你在撒谎时，那种每分钟3次的规律节奏会完全混乱。它不再以每分钟3次的速率收缩。它进入了一种叫做心律不齐的混乱节奏，没有可辨别的规律。
date, we might feel butterflies in our stomach or when we have to give a presentation like right before we suddenly have to go to the bathroom right now. Right. >> Yes. Why does that happen? Why do I always have to pee or go number two right before I'm about to give a speech or I'm about to or I'm about to walk in here and do an interview with you which like why do I have to go to the bathroom right now? >> Yeah. Well, early in my career, I discovered one of the mechanisms by which this happened. So what I did was I used a machine called an electro gastrogram. That's no, it's very similar to an EKG which people use to measure the heart rate, right? And so the heart beats at this regular rhythm of 60 beats per minute or so. Well, it turns out your stomach is actually has its own rhythm and it's contracting at a regular rate of about three beats per minute. But what I found is that when you're telling a lie, that regular rhythm of three beats per minute, it goes into total chaos. It doesn't contract anymore at three beats per minute. It enters this chaotic rhythm called arrhythmia where there's no discernable pattern.
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事实证明那个发现，你实际上可以使用你的胃作为测谎仪。有一颗小行星以我的名字命名。但更重要的是，它教会了我一些关于肠道和大脑非常深刻的东西，就是这个。肠道对外部信息的反应通常比你的意识大脑能处理的要快得多。有些人称之为直觉。但这是我们对直觉理解有误的地方。我们经常给直觉贴标签，把它们标记为本质上是好的或坏的。而直觉既不是好也不是坏。这是一种科学现象。这是一种生理信号，它仅仅是一个信息，那个信息是这样的。>> 这个局面的风险比你意识到的要高。>> 那就是信息。不是好的。也不是坏的。我们是给它贴标签和赋予它某种预言性的人。
And it turns out that that discovery where you could actually potentially use your stomach as a lie detector. It got an asteroid named after me. But more importantly, it taught me something really profound about the gut and the brain, which is this. The gut can respond to external information often so much quicker than your conscious brain can process. And some people call that a gut feeling. But here's what we get wrong about gut feelings. We often assign gut feelings, we label them as being good or bad inherently. And a gut feeling is neither good or bad. It's a scientific phenomena. It's a physiological signal and it's simply a message and that message is this. >> The stakes of the situation are higher than you realize. >> That's the message. It's not good. It's not bad. And we are the ones who give it this label and assign it some prophetic
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价值，它在告诉我什么。但实际上，我认为如果我们只是从科学层面来看，我们能制造、能使用的最强大的工具之一，也是我们应该学习的是，而不是仅仅冲动地根据我们所谓的直觉行动，>> 我们应该学会停下来，倾听那种直觉，而不是问，这是好还是坏？问问自己，在这个情况下我错过了什么？我的直觉感知到什么是我头脑中还没有理解的？让我给你两个例子。>> 很好。>> 比如说你是你这个小组的领导，有人提出了一个新建议，这个建议在纸面上听起来很不错，房间里的每个人都在点头。他们喜欢它。你突然感到肠子里有紧张。流行文化会说，"哦，那是直觉。这是一种坏的直觉。这个建议有什么不对的地方。你应该拒绝它。">> 是的。>> 也许这个建议很糟糕。我不确定。但我认为说这样的话还为时过早。你应该。
value that it's telling me something. But actually, I think if we're looking at this just on a scientific level, one of the most powerful tools we can make, we can use and something that we should learn is that instead of just impulsively acting on what we're calling a gut feeling, >> we should learn to pause, listen to that gut feeling, and instead of asking, is this good or bad? Ask yourself, what am I missing about this situation? What is my gut perceiving that my brain in my head has not yet understood? Let me give you two examples. >> Great. >> So suppose you're a leader in your group and someone's presenting a new proposal and that proposal sounds great on paper and everyone in the room they're nodding along. They like it. You suddenly get this tightening in your gut. Popular culture would say, "Oh, that's a gut feeling. It's a bad gut feeling. There's something off about this proposal. You should reject it." >> Yes. >> And maybe the proposal is horrible. I'm not sure. But I think it would be premature to say that. What you should
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想知道和思考的是，如果你得到的直觉反应的不是某种内在风险，而是新奇感呢。如果这个建议以你从未做过的方式挑战你的思维方式呢？也许那是一件很棒的事情。>> 我喜欢这个观点，即无论何时你得到直觉，不要立即说，"哦，有直觉，好的或坏的。"我听你说的是，当你有直觉时，就像嗡嗡嗡。注意。>> 没错。有什么东西我需要注意。第二个例子是什么？>> 嗯，假设我们在约会。>> 是的。>> 你遇见了这个新男人。>> 顺便说一下，我喜欢你在这个约会上穿的衣服。>> 我很感激你。我已经在约会，已经进行得很顺利。>> 酷的西装。她看起来很棒。好的。>> 谢谢。所以，约会显然进行得很顺利。他们在恭维你。是的。>> 嗯，对话进行得很顺利。然后也许在约会的某个时刻，就像你的手伸出来，他们的手伸出来，手指接触手指。刺痛。>> 是的。除了什么都没有发生。假设你。
wonder and consider is what if you're getting a gut feeling that's responding not to some inherent risk but to novelty. What if this proposal is challenging your way of thinking in a way you've never done before? Maybe that's a wonderful thing. >> I love this idea that that whenever you get a gut feeling, don't immediately go, "Oh, there's a gut feeling, good or bad." What I'm hearing you say is when you get a gut feeling, it's like ding ding ding. Pay attention. >> That's right. There's something that I need to pay attention to. What's the second example? >> Well, suppose we're on a date. >> Yes. >> And you've met this new man. >> I love what you're wearing, by the way, on this date. >> I appreciate you. I'm already date is already going so well. >> Cool suit. She looks amazing. Okay. >> Thank you. So, date is obviously going well. They're complimenting you. Yes. >> Um and the conversation's going fine. And then maybe suppose that moment in the date comes where like your hand reaches out, their hand reaches out, fingers touch fingers. Tingling. >> Yep. Except nothing happens. Suppose you
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互相接触>> 就是这样。你没有感到心中有蝴蝶。>> 得到蝴蝶。>> 是的。现在，当然，我们来了。流行科学跳进来说，"哦，没有火花。没有化学反应。他不是那个人。她不是那个女孩。"你可能会赋予那种直觉缺失很大的价值，说，"你知道吗？在火花处。它就是不在那里。我这不值得。>> 我认为很多人都会。>> 完全同意。我想提醒你的是，生理学再次说明，你的直觉不是在预测未来。当你有那种感觉或没有那种感觉时，这不是好的或坏的事情。因为如果在那一刻发生的只是你感到安全，>> 你感到完全平静。那不是很棒吗？也许，对吧，像也许这个家伙不是适合你的人。我无法告诉你那个。你的直觉没有告诉你那个。它在要求你也许再约一次。也许收集更多信息，看看他是否是合适的人。他可能仍然不是。实际上有很多。
touch each other >> and that's it. You don't get butterflies. >> Get butterflies. >> Yeah. Now, of course, here we go. Pop science jumps in and says, "Oh, there's no spark. There's no chemistry. He's not the guy. She's not the girl." And you might assign a lot of value to that absence of a gut feeling and say, "You know what? at the spark. It just wasn't there. I It's not worth it. >> I think a lot of people do. >> Totally. And what I'd like to remind you is that the physiology again, your gut is not telling the future. It is not a good or bad thing when you have that feeling or when you don't have that feeling. Because what if what is happening in that moment is simply that you feel safe, >> that you feel completely regulated. Is that not a wonderful thing? And maybe, right, like maybe this guy is not the right guy for you. I can't tell you that. Your gut is not telling you that. It's asking you to maybe go on one more date. Maybe gather more information and see if he's the right guy. And he may still not be. There's actually a lot of
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关于他们所谓的缓慢燃烧关系的研究，一开始没有太多的火花，但你与某人花在一起的时间越多，你就越意识到平静和这种只是还好的状态实际上是真正美好的事情。我们中的很多人都冲向那个兴奋的东西并将其理解为好事。也许很多兴奋啊东西有时实际上是你的身体在说，"哦，这就像其他六个幽灵般对待你的人一样。请不要倾向于这个。">> 是的。而且你不知道这个人可能会不同，因为只要记住你的直觉，它不是在为你写故事。它只是在要求你更仔细地阅读你自己的故事。>> 我喜欢那个。所以不再是我有直觉。我在做。这是我有直觉。哦，我
research around what they call the slow burn relationship where there's not a ton of sparks in the beginning, but the more time you spend with somebody, the more you realize it's the calmness and this state of just being okay that is really the beautiful thing. And a lot of us race towards that like excitement thing and read it as a good thing. And maybe a lot of the excitement ah thing sometimes is actually your body going, "Oh, this is just like the other six people that ghosted you. Please don't lean into this." >> Yeah. And you don't know this person could be different cuz just remember your gut, it's not trying to write the story for you. It's simply asking you to read your own story more closely. >> I love that. So no more I got a gut feeling. I'm doing it. It's I got a gut feeling. Oh, I got to pay attention. Y and based on what's happening, do I do it? Do I not? Boom. >> Gather more information, don't act
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impulsively. Just take a beat. >> Now that we've talked about the gut, how many people have issues with the gut? Like, how widespread is it? And can you list off some of the common things that people can struggle with when it comes to the gut? >> Yeah. Well, here's a number that made me realize that we have a gut health crisis hiding in plain sight. 40%. >> 40% >> 40% of Americans say that their bowels disrupt their daily lives. 40%. So that means all of us know somebody, love somebody, maybe we are somebody who is dealing with this every single day. And that's just a tip of the iceberg. 15% of Americans have irritable bowel syndrome. Three out of four Americans can't poop in a public restroom. One out of three struggle to go to the bathroom on vacation. One out of 10 live with chronic unexplained pain every time they eat. One out of 10. And the kids are
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also not all right. In my own lab, we've found that college students, about a quarter of college students spend more than 10 minutes at a time trying to have a bowel movement every time they go. And the crazy thing here is that most of these people would not identify as being sick. They wouldn't think necessarily that they have a problem. They kind of would have normalized all these symptoms. And that is the entire problem. The problem is that we are not having a loud enough conversation about our gut health and acknowledging what all of us are going through. And I think part of that is due to the fact that most of what we learn about having a bowel movement comes from what our parents taught us when we were toddlers potty training. And what they taught us is pretty similar to what your grandparents taught them. And at some point we have to ask ourselves, can it really be true that grandma's method was 100% flawless? Like there's nothing else the science can teach us about how to
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have a better bowel movement. And when I started my GI clinic soon after I was done training, one of the most common questions that fully grown adults would ask me was just this. Are my bowel movements normal? And if that's the question that we're all asking as adults, it taught me that we've just been winging it for way too long and we all think everybody else has it under control, but clearly the data shows us otherwise. Okay, I want to just dig in there just a little bit >> because how do you want us Dr. Pacia when it comes to gut health and the whole system from your mouth all the way to the exit and all of the important functions that happen there from hydration to nutrients to immunity to hormone creation which impacts your mood to all this unbelievable stuff that is happening in the gut. How do you want us like medically speaking to actually think about our
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bowel movements? What what is it like? Because I think because I'll just be this might be too too much information, but you know, every one of us has a bowel movement and you have to turn around to flush the toilet and I know I'm not the only person that looks down to see what's happening down there, but I don't know what I'm looking for and I don't know how to even think about the information that could be there to tell me something. I mean, because now all the big tests that everybody's doing to figure out your full longevity and all this stuff, you got to poop in a dish and scoop it out and all. So, we're testing it. >> But I'm glad we're talking about this because I think those numbers are jaw-dropping. 40% of people >> Yeah. >> are dealing with this. 15% of people have IBS. Three out of four people cannot go number two in a public bathroom. Yeah. In fact, I was having a conversation this morning with a couple colleagues, both of whom admitted they don't go number two at work. >> Yeah. And we're at work what 8 12 hours a day. I mean, think about how many
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现在是我，我觉得我们大多数人认为这是心理问题，但我不确定也许它不是。我认为有三分之一的人在度假或旅行时不能去洗手间是疯狂的，而这时你应该是放松的。我认识很多这样的人，他们会真的在旅行，已经七天没有排便了。是的，完全同意。好的，让我们谈谈这个，比如说这是什么数据，这如何与肠道健康相关？是的，我认为你说得对。我不认为你需要很多第三方测试来声称查看你粪便中的所有这些不同的东西，当你只需要转身看一下，因为每次你去洗手间时，这有点像获得一份关于你健康的小成绩单。所以，你可以看一下，仅从你看到的和你对那次排便的了解，就能学到很多信息。好的。所以，我很高兴你看，梅尔。当我问我的患者"你的便便看起来怎么样？"而他们说"我不看"时，我觉得这很奇怪。我认为他们甚至对你作为医生都在撒谎。我们在这里是为了什么呢，你知道吗？所以你必须看。嗯，当你看的时候，这是我想让你注意的。
>> now is I I and I think most of us think it's psychological, but I don't maybe it's not. And I I think it's insane that one out of three people can't go to the bathroom when they're on vacation or traveling when you're supposed to be relaxed. I know lots of people like that who will literally be traveling and it's it's been seven days since I've gone number two. >> 100%. Yeah. Well, I >> Okay, so let's talk about the like what is is it data like how how why is this important when it comes to gut health? >> Yeah, I think you're spot on. I don't think you need a lot of these third-party tests that will claim to look at all these different things in your stool when you just need to turn around and take a look because every time you go to the bathroom, it's kind of like getting a little report card on your health. And so, you can take a look and learn so much information just by what you're seeing and what you know about that bowel movement. All right. So, I'm glad that you look, Mel. I find it so odd when I ask my patients, "Well,
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粪便的形状和一致性能告诉你很多关于粪便通过结肠速度有多快的信息。好的。颜色，我们将进入那个，能告诉你很多信息。你的感受，记下来。当你排便时感到如何？你疼痛吗？排便时你感到不适吗？排便后你感到好转了吗？你感到胀气吗？你可以从它看起来的样子、你的感受中收集很多不同的信息，然后你可以使用这些信息进行一些改变。你想对有慢性便秘的人说什么，他们是一个绷紧者，关于现实，这可能导致没有人教我们如何排便。如果你真的想想。
what did your poop look like?" And they say, "I I don't look." I think they're lying even to you as the doctor. >> Like what are we here for then, you know? And so like you have to look. Um when you look, here's what I want you to be on the lookout for. >> The shape, the consistency of the stool gives you a lot of information about how quickly that stool has been able to move through your colon. Okay. >> The color we're going to get into that gives you a lot of information. How you felt, make note of that. How did you feel when you had a bowel movement? Were you in pain? Were you uncomfortable when you had a bowel movement? Did you feel better after you had one? Did you feel bloated in between? You can gather lots of different information from what it looks like, how you felt, and then you can use that information to make some changes. >> What do you want to say to somebody who has chronic constipation and they're a clencher about the reality of that this might cuz none of us have been trained to poop. And if you really think about
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这是我突然作为一个妈妈感到难受的东西之一。因为我想到了你换过的那些尿布，你可爱的小宝宝在那里，你想"这是什么？这就像，哦天哪，芥末色的便便感到很糟糕。"所以我们对它的反应。是的。也创造了这样的，比如，尴尬和羞愧围绕着这么正常的东西。我很高兴你说了。从第一天开始，我们对待我们的身体、我们的排便就像是这个邪恶的东西。这太尴尬了。这太恶心了。这太不雅了。你不应该开便便笑话。这太可怕了。我们从小就在内心深处接受了这一点。所以突然在我们完成如厕训练后，再也没有人检查你以确保你做得正确。对的。就像我们一年去牙医几次，他们说"嘿，你每边做了两分钟吗？确保你的牙龈。你是否刷到舌头的后面？"在你完成如厕训练后，当你关上门去排便时，谁会问你做了什么？没有人在。
it, one of the things I was thinking about is I all of a sudden felt bad as a mom >> because I'm thinking about those diapers that you change where your sweet little baby's there and you're like, "What is this? This is like, oh my gosh, mustard poop is felt terrible." And so our reaction to it >> Yes. >> also creates this like embarrassment and shame around something that's so normal. >> I'm so glad you said that. I from day one, we treat our bodies, our bowel movements as this nefarious entity. Like, it's so embarrassing. It's so yucky. It's so icky. You shouldn't make poop jokes. It's so horrible. And and we internalize that from when we're kids. And so suddenly after we're done potty training, nobody's checking in on you again to make sure you're doing it right. Right. Like we go to the dentist a couple times a year and they're like, "Hey, did you do 2 minutes each side? Make sure you get your gums. Are you getting the back of your tongue?" Who's asking you what you do when you shut the door to have a bowel movement after you're done potty training? Nobody's
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检查。这很常见，对吧，我有患者来到我的诊所？嗯，实际上的情况是他们被他们的伴侣拖进来，他们的伴侣会说，每次我说，你知道，我们需要去某个地方，他们会说，哦，只需五分钟。他们知道这将是60分钟后他们才会出来。我想对你说的是，如果你是一直在努力的人，你尝试了你觉得已经做了一切，你尝试了纤维素，你尝试了像Mirax，你运动，你思考，你知道，你已经做了你能做的，也许你甚至尝试过处方药，但它没有起作用。考虑到你可能属于那三分之一，这非常普遍。那是33%。嗯。所以现在这个工作室里有四个我们。嗯，应该有四个我们便秘。四个我们便秘。是的。好吧，我确定我只是为所有这些说话。我们今天都便秘。至少我们中有一个有机械问题。绝对正确。那太不可思议了。而且最妙的是，与许多医学条件不同，其中解决方案将是，我恐怕你需要这种药物。你。
checking in. And it's so common, right, that I have patients who come to my clinic? Um, and it's actually the case that they've been dragged in by their partner and their partner will be like, every time I say, you know, we need to go somewhere, they'll be like, oh, just 5 minutes. And they know it's going to be 60 minutes later that they come out. And what I want to say to you is that if you're somebody who has been struggling, you've tried what you feel like is everything, you've tried the fibroid, you've tried like the Mirax, you exercise, you think, you know, you've done what you can, maybe you've even tried a prescription medicine and it's not working. Consider that you could be in that one in three, which is so common. >> That's 33%. >> Mhm. >> That there are four of us in this studio right now. >> Well, there should be four of us with constipation. Four of us with constipation then. >> Yes. Well, I'm sure I I'll just speak for all of this. We're all constipated today. At least one of us has a mechanics issue. >> Absolutely right. >> That's incredible. And the beauty of it is a unlike a lot of medical conditions where the solution is going to be, I'm afraid you need this medication. You're
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必须每天服用。你可能需要在每天同一时间服用。它成为你生活方式的一部分。这个问题的解决方案是一种称为生物反馈的特定物理治疗。那是被证明的那种治疗。我们说的是8到12周是研究显示的80到90%的人会好转。但如果你想知道一个快速解决方案。是的。如果你还没准备好进行物理治疗。是的。一项真正重要的研究发现，似乎有盆腔底功能障碍的六分之一的人，六分之一，整个问题可以仅仅通过在排便时将他们的膝盖抬高于腰部来解决，使用像凳子、一堆书或一双漂亮的高跟鞋之类的东西。将膝盖抬高于腰部。高跟鞋。我要穿上我的高跟鞋去排便，克里斯。这会有帮助。是的。好吧，你知道，有趣的是你这样说，因为每次我们的成年孩子在家时。我走进我自己的浴室，垃圾桶就在我的马桶前面。
going to have to take it every day. You might need to take it at the same time every day. It becomes part of your lifestyle. The solution to this is a certain kind of physical therapy called BOF feedback. That's the kind of therapy that's been proven. We're talking about 8 to 12 weeks is what the studies have shown that 80 to 90% of people get better. But if you want to know a quick fix, >> yes, >> if you're not ready for the PT, >> yes, >> what one really important study found is that one out of six people who seem to have pelvic floor dysfunction like this, one out of six, the entire problem could be solved just by raising their knees above their waist when they had a bowel movement using something like a stool, a stack of books, a pair of nice stilettos. Raise their knees above their waist. >> Stiletto. I'm going to put my heels on and go go number two, Chris. >> It'll help. Yes. Well, you know, it's funny you say that because our every time our our adult kids are home, >> I walk into my own bathroom, the garbage can is right in front of my toilet
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因为他们已经把它从旁边移到了前面来垫脚。当然，他们没有把它放回去。但那是因为那个实际的。那个实际的膝盖向上的机制。所以，我想让你想象。所以，再次，这是女性解剖结构的横截面。所以，我向你指出的是这是直肠，这是结肠的末端。它有点弯曲下来。现在，想象这个管子的最后一部分周围有一条橡皮筋勒住它关闭。我们有一块肌肉，耻骨直肠肌，它勒住那块肌肉关闭。这是件好事。这块肌肉拯救了我们的臀部。这就是我们不会拉在裤子里的方式，对吧？谢谢你。完全正确。然而，我们不能进行好的排便，也不能放松那块肌肉以便它打开那个管子，坐在我们现代马桶
because they have moved it from the side to put it in front to put their feet up. Of course, they don't put it back, >> but that's because that actual >> that actual the mechanics of the knees being up. >> So, I want you to picture. So, again, this is the cross-section of the female anatomy. So, what I'm pointing out to you is this is the rectum and this is the end of the colon >> and it's kind of curved as it comes down. >> Now, imagine that there's a rubber band around this last part of the tube that is choking it shut. We have a muscle, the pubo rectalis muscle that chokes that muscle closed. That's a good thing. This muscle saves our butt. >> That's that's how we don't poop our pants, right? >> Thank you. Exactly. However, we can't have a good bowel movement and relax that muscle so it opens up that tube sitting in this 90° chair-like position that we have in our modern toilets. The best way to open up that tube is to squat, right? And squatting is something that we used to do thousands of years ago, but we've changed those mechanics. And obviously,
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squatting is a difficult thing for a lot of people to do. And I'm not ask I don't squat, but I do raise my knees above the waist. And you can just do that with something as simple as a stool. >> Don't you think your home should be a reflection of who you are? Of course it should. That's why you need to know about our sponsor, Ashley. Ashley has styles that balance timeless appeal with modern trends that will help you bring your personal look home. In fact, I was looking at the Ashley website because I know you're going to go, "Well, Mel, what do you like?" The Crystaland collection. It's a modern farmhouse look that feels warm and inviting, but it's still clean and elevated. I love clean and elevated with beautiful light brown wood tones, black hardware accents, and the dining room table's super cool. It expands from 80 to 98 in. It has this removable leaf. It seats up to 10 people. And if you look at the table, you can picture holiday dinners, family gatherings, friends, making all kinds of memories. And every Ashley piece is thoughtfully designed, built to last, so
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your home doesn't just look good, it works like it should. Plus, Ashley provides fast, reliable white glove delivery right to your room of choice, making the entire process simple from start to finish. Visit your local Ashley store or head to ashley.com to find your style. So, what are the symptoms or the things that people complain about? just cuz when we say gut issues, especially now that you're talking about mouth to the rear end, >> I would love to hear what are people coming in and actually complaining about that you can normalize >> and then we can talk about the symptoms that you should never ignore. And then we can talk about the symptoms that are simply what you're always going to experience until you understand what your body is trying to tell you. >> Yeah. One of the most common things that people come to my clinic complaining about is that they struggle to have a bowel movement. And that can mean a lot of different things. Some people can say, "I go to the bathroom every single day." Great. But it takes me 20 minutes.
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I'm straining. It's hard. How long should it take? >> Less than five. Ideally, less than one minute. It should be an in-n-out job. >> Wow. >> Yeah. But if you're having a a bowel movement every day, you might be told, you might believe that that makes me normal, but it's uncomfortable for you and you're spending 20, 30 minutes at a time. That's not normal. People complain about having discomfort, bloating, pain, cramps until they're able to have a bowel movement. And then for some people, the bowel movement helps those symptoms get better. Sometimes that's only momentarily. And then they come right back. And then they're there and they're there and they're building until the next bowel movement. Sometimes people complain about a lot of urgency like they're just interrupted by they're at work, they're out with friends and suddenly out of nowhere they have to go to the bath and they have to do it. Now there are a lot of people, one out of seven people, okay, I want to just internalize this number. One out of seven people poop their pants regularly in America. That's what the studies have shown. So people feel so isolated
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sometimes and embarrassed and ashamed when they have bowel accidents. That's actually more common than you think. And a lot of people are struggling and dealing with it. Even if nobody like brings it up at your book club, a lot of people in that room will have experienced what you're experiencing. So sometimes people talk about that bloating, just plain old bloating, which is so uncomfortable. It's this feeling of distension that you're too like you you eat just a little bit, but you feel so full and you feel gassy. That's a big complaint. And then there's another group of people who it's not so much having a bowel movement that's a problem, but eating is the problem. It feels like everything they eat causes them discomfort or even pain, maybe a little nausea, and they're not sure. They've tried everything. They've tried to eliminate all different kinds of foods. They've gone on all different kinds of diets, and they can't seem to pinpoint why. What is it about food that's giving them trouble? These are the kinds of people who come into my clinic. And of course, as I said, a lot of them have anxiety and depression. Certainly, a lot of them, stress fuels these problems and makes them worse. But
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很多时候，压力不是主要问题，或者焦虑或抑郁。确实如此。而是你的肠道出了问题，你不太确定如何解决。根据研究和你的临床实践，有一些方法可以帮助我们解决这个问题。你应该永远不要忽视哪些肠道症状，因为它们表明可能会发生更大的问题？是的，让我告诉你两个。好的。这是我想让人们注意的一个，因为我认为这可能真的能救命。所以我首先担心的是结直肠癌，我非常担心我认为现在国内和世界上的每个科学家都认为这是我们这个时代最重要的科学问题之一，为什么越来越多的年轻人患上结直肠癌。他们进行了一项研究，研究了50岁以下早发性结直肠癌的四个最常见症状，但这些症状也适用于任何年龄的结直肠癌。好的。所以这四个症状是：一是腹痛。二是直肠出血。三是缺铁性贫血。
often times it's not the stress that's the primary problem >> or the anxiety or the depression. Exactly. >> It's that your gut is going haywire and you're not quite sure how to address it. And there are things that you're about to show us based on the research and based on your clinical practice that will help us address it. What gut symptoms should you never ignore because they signal that something bigger could be happening? >> Yeah, let me tell you about two. Okay. And this is this is one that I want people to pay attention because I think this could really save a life. So the things that I worry about first for colurectal cancer and something that I'm worried about a lot I think every scientist in the country right now and in the world thinks is a a big is one of the most important scientific problems of our day is why are more and more younger people getting colorectal cancer. And so they did a study where they looked at what are the four most common symptoms of early onset meaning before the age of 50 colctal cancer but these also apply to colorectal cancer at any age. Okay. And so these four
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这是一项血液检查，告诉我们你的红细胞已经变小，这是由于铁流失。这对女性来说非常重要，因为当女性患有缺铁性贫血时，可能会感到疲劳、疲倦，你做了血液检查，很多时候人们会说，"这一定是因为你的月经，因为我们会随月经流失大量铁和血液。"如果你有这些其他症状，或者你在想，"等等，但我的月经相当清淡。"我真的希望你暂停，不要忽视这一点。第四个症状是最重要的，也是最模糊的。所以使它真正复杂的是排便习惯的任何改变。意思是新的腹泻、新的便秘、某种习惯的改变。也许突然你的排便从非常粗变得非常非常细。对你来说任何新的、似乎会持续的东西，都应该引起注意。
symptoms are one abdominal pain. Two rectal bleeding. Three iron deficiency anemia. This is a blood test that tells us that your red blood cells have become smaller and that's due to iron loss. This is really important in women because when women have iron deficiency anemia and it can feel like fatigue, you're tired, you get the blood test, oftentimes people will say, "This has to be due to your period cuz we lose a lot of iron. We lose blood with our periods." >> If you have these other symptoms or you're like, "Wait a minute, but my periods are kind of light." I really want you to pause and not brush this aside. And then the fourth symptom is the most important and also the most vague. So it it's what makes it really complicated is any change in your bowel habits. Meaning new diarrhea, new constipation, some change to the pattern. Maybe suddenly your bowel your poop went from being really thick to really really thin. Anything that's new for you that seems
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因为这项研究发现，患有我刚才提到的四个症状中的三个或四个的人，患结直肠癌的可能性是症状较少的人的六倍。六倍。六倍。所以你有胃抽筋，腹部疼痛。腹痛。你从肛门出血。是的。你有缺铁。是的。你有某种历史节律的改变。这种改变会坚持多久？比如一周。是的。我会因为任何这些症状而去寻求帮助。如果症状持续了一到两周以上，我就会去看医生。有一些名人提过，他们唯一的迹象就是第四个，只是某个习惯改变了，我以为是我的咖啡或其他什么东西，但后来我换了咖啡，它并没有消失。如果你感到担忧，如果什么事不对劲，不要等待。不要把它当作正常现象。不要为此感到尴尬。只是让你的医生看一下。
to stick around, get attention. Because this study found that people who have three or four of the four symptoms I just mentioned, they had a six-fold higher likelihood of having colarctal cancer than people who had fewer. >> Sixfold. >> Sixfold. >> So you've got stomach cramps, >> stomach abdominal pain. >> Abdominal pain. You have bleeding from your rear end. Yep. >> You have iron deficiency. Yep. And you have a change in kind of what is kind of historically your rhythm. And how long would you see that change stick around? Like a week. >> Yeah. I I would go get help for any of these symptoms. No more than one or two weeks if it's persisted. And and there have been some really high-profile cases of celebrities who have said the only sign I had was that fourth one, just that something changed in the pattern and I thought it was like my coffee or something else, but it then I changed the coffee and it didn't go away. If you're worried, if something's off, don't wait. Don't brush it aside as normal. Do not be embarrassed by it. Just run it by your doctor.
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弗里尔医生，你认为为什么会出现这种令人不安的趋势，许多年轻人不仅患上结肠癌，而且死于结肠癌？是的，这是一个重要的问题。这是一个大问题。我们过去常常认为癌症总体上是我们遗传和吸烟的结果，对吧？但作为一个社会，我们已经减少了吸烟。显然我们的遗传没有改变。但随着代的变化可以改变的是所谓的表观遗传学，或发生在实际基因本身之上的基因变化，这可能是由于我们环境的影响。随着这些病例的增加，我们越来越得出结论，我们的环境中必然有什么东西在改变。那个环境可能是我们呼吸的空气。它可能是我们接触到的化学物质。它也可能是我们吃的食物。是的。你不认为这是超加工食品和所有化学物质，那些包装食品中的垃圾，特别是在美国这里的人们吃的吗？我真的这样认为。有一些主要研究将结直肠癌，特别是在年轻时与超加工食品消费联系起来。
>> Dr. Frier, why do you think there is this very troubling trend of so many young people not only getting but dying of colon cancer? >> Yeah, it's it's a important question. It's a big question. We used to think about cancer in general as being a function of our genetics and smoking, right? But we've stopped smoking so much as a society. And obviously our genetics aren't changing. But what can change with generations is something called epigenetics >> or changes to our genes that occur on top of the actual gene itself that can be due to influences from our environment. So as these cases have been rising, we're arriving more and more at the conclusion that there has to be something in our environment that is changing. And that environment could be the air we're breathing. It could be chemicals we're introduced to. It could also be the foods we're eating. >> Yeah. Don't you think it's ultrarocessed foods and all the chemicals, the crap that's in food that's packaged and that people are especially here in the United States? >> I really do. And there have been some major studies that have linked
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结肠癌在年轻患者中的上升是否在美国这样的国家中更高，我们在超加工食品方面有可怕的监管？这是一个全球趋势，这真的很令人担忧。当然，超加工食品的增加并不仅限于美国。它一直在世界各地发生。我们也发现了，哈佛进行了一些非常大的研究，在护士健康研究中。他们发现，例如，那些作为儿童、青少年时期喝更多含糖饮料的人，当他们成为年轻人时，更可能患上早发性结直肠癌。作为一个社会，我们喝的含糖饮料越来越多。自1980年代以来，我们看到这种趋势与超加工食品一起随时间发生。所以，它可能是许多不同事物的组合。我也告诉所有患者，特别是当我做出这个诊断时，首先，癌症不是你的错。它永远不是别人的错。癌症是许多事物的结果。
colurectal cancer specifically at a younger age to ultrarocessed food consumption. are is is the rise in colon cancer in younger patients is that higher in a country like the United States where we have like horrible regulations when it comes to ultrarocessed foods. >> It's a global trend and that's what's really worrisome. And of course the rise of ultrarocessed foods has not just been isolated to the United States. It's been happening all over. What we've also found and they've done some really big studies here at Harvard in the nurses health study. They found that people who drink more, for example, sugarsw sweetened beverages as children, as teenagers, they're more likely to develop early onset colarctal cancer once they become younger adults. And we've been drinking more and more of these sugar sweetened beverages as a society. We've seen that trend happen over time since the 1980s alongside with ultrarocessed foods. And so, it's probably a combination of a lot of different things. I I also, you know, I tell all of my patients, especially when
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其中一些我们可以控制或有一定控制，许多我们不能。对吧？有时你对自己说，不能是超加工食品。我经常听到这个。不能是酒精。不能是超加工食品，因为怎么可能不呢？说实话，比如人们会说，好吧，我的姑姑，你知道，喝了，你知道，像每天七杯饮料之类的，她活到了90岁。我试图向人们解释的是，把癌症想象成建造一座用积木建造的塔。嗯，有些人开始生活时有五个积木堆积在他们身上，只需要十个就能得癌症。你，你的姑姑，可能一开始只有一两个积木，然后假设你每天吃很多加工肉类。又多了一个积木。你在一个空气污染非常严重的城镇长大。又多了两个积木。然后突然你达到了十个积木，而某个拥有其他行为模式的人。他们比你更久坐不动。无论是什么，他们从未达到那十个积木的阈值。这感觉不公平。很难想象为什么，但仅仅是因为我们开始的地方不同。
I'm making this diagnosis, that first of all, cancer is not your fault. It is never someone else's fault. Cancer is the result of so many things, some of which we have control over or some control over, many of which we do not. Right? And sometimes you say to yourself, it can't be ultrarocessed food. I hear this a lot. It can't be alcohol. It can't be ultr processed food because >> how can it not? Honestly, like people will say like, well, my aunt, you know, drank, you know, seven drinks, you know, like a day or whatever and and she lived to be the age of 90. And what I try to explain to people is that think about cancer as building a tower of building blocks is how I explain it. Um, some people start out life with five blocks stacked against them and it only takes 10 to get cancer. You, your aunt, may have started out with just one or two blocks and then suppose you eat a lot of processed meats every day. there's one more block. You grow up in a town where air pollution is really severe. There's another two blocks. And then suddenly you've hit 10 blocks and somebody who's had other patterns of behavior. They're
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许多结直肠癌的风险因素和我
more sedentary than you. Whatever it is, they never hit that 10 block threshold. And it feels unfair. It feels hard to imagine why, but it's simply because we're starting at different places. And a lot of the risk factors for colorectal cancer and these cases that we've been seeing rising, >> they start in our childhoods. They start at a time when we may or may not have had that kind of control over our lives. >> Yeah. Wow. So, your bestselling book, You've Been Pooping All Wrong: How to Make Your Bowel Movements a Joy. Congratulations. It focuses on how much you can learn by just focusing on your bowel movements. So, can you explain to the person listening all the things that you can learn about your health just by turning around and taking a look at the information that is in the toilet bowl? Yeah. Like I said, that information that you get just by looking is like a report card on your health, your poop. Just having a look and just thinking about that experience of when you had the
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bowel movement will tell you about the food you've eaten, the quality of the food that you've eaten. It's going to tell you about inflammation and possibly infections or the kinds of inflammation that come from our environment in our food. It's going to tell you about how the brain in your gut is working. You're going to get information by asking yourselves, how often did I go in one day? How did I feel when I went? Was it hard? Did I strain? Is the consistency rock solid or is it soft and floating? All of these pieces of information tell you about how your gut is functioning as a brain, as an immune organ, as a hormone producing organ, and that has an influence on your entire health. >> I am so excited to talk about our bowel movements. >> Me too. >> Let's start with what is normal, Dr. Pasicha, and what is not normal when it comes to poop. For me, a normal bowel movement has to do just two things. One, it should be effortless. You shouldn't have to be straining. You shouldn't
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spend 20 minutes in there sweating, straining your eyeballs out. Two, it should occur at a socially appropriate time. >> What does that mean, socially appropriate? >> Meaning, you shouldn't be worried about going out to have lunch with your girlfriends. You shouldn't be at work panicking when you're in the middle of a meeting and then not being able to give your presentation because of this. You'll notice for me, I didn't say your bowel movement has to be once a day. And that's what everybody seems to have in their mind that like once a day we have it in our minds that this is holy. This is like the only path to God. It doesn't have to be that way. There is a whole range of what would be considered normal in terms of frequency. >> Okay. And what is that range? >> So my colleagues at Beth Israel did a study where they looked at this national sample of Americans who thought they had normal bowel movements and just said, "Well, how many times are you going?" And it turns out anywhere from three times in one day to once every 3 days is in the range of normal. >> Okay? >> So if you fall in that happy comfortable range, I am really happy for you if you're comfortable. >> Okay? >> It turns out too that if you're meeting
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your fiber goals, which for women over 50 is 21 grams a day or under 50, 25 g per day, you're going to start to have fluffier, more frequent bowel movements. It's not going to be once a day. You should embrace that new you. It's okay. Let me show you a couple models. >> Okay. >> Okay. >> Oh my god. Okay. Now, if you're listening, >> uh she is hold Dr. Pria is holding up poop. But I but I have to give a shout out to our team. >> Oh my god. >> Because our team, >> Creative Geniuses >> ordered Play-Doh. And I cannot believe how realistic this is. It's almost I can can smell it. On the right, you're seeing a log that is this is embarrassing. You're re you're seeing a log that's maybe it's like a broughtwurst. It's like about the size of a fat hot dog and it's you can see there are lines in it. So, it's almost like parts of pieces of poop have come together to create the broughtwurst. And
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那么另一个，另一个，因为这里有两个，大约4英寸长。但是它有一个尖锐的尖端，然后有一个更厚的末端。所以它更像是你知道的，那种你会扔进游泳池让孩子潜水找的东西，一个鱼雷。是的，是的。我认为你描述的首先非常漂亮。谢谢。让我们把模型移过来，这样YouTube上的人可以真正看到这个。如果你在听，继续听。我会讲解。如果你想看这一切的样子，这个的YouTube版本链接也在节目笔记中，所以你可以找到它，或者只是谷歌一下，你知道，梅尔·罗宾斯和帕萨博士。好的。你知道，我认为大多数人会认为这种肠道运动是正常的，是理想的。你知道，就像这个，光滑的香肠，有些人称之为无纸擦奇迹。是的，我认为这是
then the one on the other the other one cuz there's two here is about 4 in long. But the there's it has like a sharpened tip and then it's got a thicker end. So it's more like a you know like one of those things you'd throw into a pool that sink to the bottom that kids dive for a torpedo. >> Yeah. Yeah. I think what you're desri first of all beautiful description. >> Thank you. Let's move the model over so that those of you on YouTube can really see this. And if you're listening just keep listening. I'm going to narrate. If you want to see what this all looks like, the link to the YouTube version of this is also in the show notes so you can find it or just Google um you know Mel Robbins and Dr. Pasa. There we go. >> You know, I think most people would consider this type of bowel movement to be normal, to be the ideal. And you know, like this one right here, the like smooth sausage, some people call that a wipeless wonder. Yeah, I think that's
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很好。我认为当你有这样的肠道运动时很棒。我不认为这是唯一通往上帝的路。就像我说的，我认为当你的饮食中有更多纤维时，你开始变得越来越蓬松，那没关系。所以，那是什么，你会认为那是光滑的鱼雷形状吗？是的。那是，那是高纤维的证据吗？那是蓬松的肠道运动。这是美丽的便便。所以，这些是，这些很好。你给了这个一个A。这两个中的任何一个都可以接受。你完全，你为此得到A。在我的书中，你也可以得到A或A减，如果它更软的话。我可以看到为什么团队可能无法真正在粘土模型中显示更软的粪便。你是说什么？就像它有一点水在里面。是的，有点柔软，有点不成形，有点浮动，有点软。你也可以为这些得到A。嗯，当它纯粹是液体或只是经常性很高时，我认为我们都同意那不是理想的。好吧。嗯，但如果它有某种形状
nice. I think it's great when you have this bowel movement. I don't think that's the only path to God. Like I said, I think when you have more fiber in your diet, you start to get fluffier and fluffier and that's okay. >> So, is that is that what you would consider is the smooth torpedo shape? Yeah. >> Is that like that's is that evidence of somebody who's got a lot of fiber? That's a fluffy bowel movement. >> This is this is a lovely poop. >> So, these are these are good. You're giving this an A. Like either one of these are acceptable. You totally you get an A for this. You also in my books could make an A or an A minus if it's even softer. I can see why the team might not have been able to really show softer stool in their clay model. >> You mean what do you mean? Like it's got kind of some water with it. >> Yeah, it's a little fl like a little bit less formed, a little bit more floaty, a little softer. You could still get an A for those, too. Um, it's when it's like pure liquid or it's just like really frequent that I think we can all agree that's not ideal. >> Okay. >> Um, but if there's some shape to it and
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它甚至比这美丽的香肠更蓬松，你仍然在赢。嗯，你想要一块吗？那是，那是一件重要的事情吗，还是如果它分成几块没关系？就像我认为如果它分几小块出来，那没关系。但当它像这样一长块出来时，它告诉你的是你能够有效地排出它，你骨盆底的所有肌肉都在进行这种很好的协调舞蹈，在一次尝试中将其排出。好吧，稍等一下。所以，当你有其中一个时，就像，"天哪，那是从我身上出来的。"你感觉你已经减了几磅吗？你已经像堵住了厕所。是的。那是否意味着从机制来说，你实际上已经清空了直肠的长度？就像你真的就像，因为他们总是有点令人满意。我不喜欢它有点你应该成为胃肠病医生。但是是的，如果它像这样长，这意味着它没有时间坐下来
it's even fluffier than this beautiful sausage, you're still winning. >> Um, do you want it in one piece? Is that like a thing that that is important or is it okay if it's in a couple? Like >> I think if it comes out in a few small pieces, that's okay. But when it comes out in one long piece like that, what it's telling you is that you were able to efficiently expel it and all the muscles in your pelvic floor were moving in this nice coordinated dance to get it out in one try. >> Okay. So, hold on a second. So, when you have one of those ones, it's like, "Oh my god, that came out of me." You feel like you've lost a couple pounds >> and you've like stuffed the toilet. >> Yes. Does that mean that you from the mechanics of it, you've actually emptied out the length of the rectum? like you've you've really like you've just like because they're always like kind of satisfying. I don't like it's a little >> You should have been a gastronologist. >> But yeah, it's if if it's long like that, it means it didn't have time to sit and collect in your rectum and f and form this like larger clump. So, it just
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意味着它出来得更快，更有效。这不是坏事。我是说，你的直肠是为了容纳更多的便便而建造的。所以，那很好。但这意味着你在正确的时间抓住了它。它正在通过。你推了一下，它就全出来了。另一方面，我将向你展示另一套模型。那已经掉下来了。我会像这样倾倒那个。好的。让我向你展示你的团队放在一起的另一个惊人的模型。哦天哪。这些就像底部的兔子颗粒。所以，非常、非常硬的小块。然后顶部的那个。所以，就像很多小的像块。我们都有过那些。然后有一个在顶部，看起来像块刚好粘在一起。这些家伙硬如岩石。这些是分块的鹅卵石。是的。我几乎从未见过有其中一个，分块的兔子颗粒的人，感觉他们有了很好的便便。从不。他们不令人满意。如果你
means it's coming out more quickly, more efficiently. It's not a bad thing. I mean, your rectum is built to accommodate >> increased spaces for more poop. So, that's fine. But it means that you caught it at the right time. It's passing through. You gave it a little push and it all just came right out. Now, on the other hand, I'm going to show you another set of models. >> That that's fallen right off. I would tip that one just like that. There we go. >> Let me show you the other amazing model that your team put together. >> Oh my god. These are like rabbit pellets on the bottom. So, little pieces that are very, very hard. And then the one on top. So, it's just like lots of little like pieces. We've all had those. And then there's one on the top that is that looks like pieces that are just barely held together. And these guys are hard as rocks. These are the the chunky pebbles. >> Yeah. I've almost never met somebody who has one of these, the chunky rabbit pellets, and felt like they had a good poop. >> Never. They're not satisfying. If you
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只是扔几个，你就像，我还没完。希望我在一两个小时后回来。但这甚至不是开胃菜。就像那是一个C减。我不知道你是否会通过。但这告诉你什么，当你有那些小的，你知道的，就像嘟嘟嘟嘟，你就像，就这样。是的。它可以告诉我们两件事中的一件。一个，我们绝对知道的是这个便便，那个是兔子颗粒的，在你的结肠里比这些其他任何便便都坐得更久，因为那就是你的结肠的整个工作。它吸出水。所以，便便在那里坐的时间越长，无论是因为你决定这不是去洗手间的合适时间。我有一个我在一个热约会。我会坚持到明天。好吧，你明天需要有的便便看起来会与你今天本会有的便便非常不同，因为你坚持了，现在越来越多的水会被吸出，看起来会不同。所以，如果你是一个人，你是那个之一，帕萨博士说四分之三的人在工作中不排便。
just drop a couple of those in, you're like, I'm not done. I'll be be hopefully I'll be back here in an hour or two. But this is just that's not even an appetizer. Like that's >> a C minus. I don't know if you're going to pass. But >> what what is that telling you when you have those little like, you know, it's like beep beep and you're like that's it. >> Yeah. It can tell us one of two things. One, what we know absolutely is that this poop, the one that's the rabbit pellet, has been sitting in your coloner than any of these other poops because that is your colon's whole job. It sucks water out of it. So, the longer poop sits in there, whether it's because you decided this was not the right time to go to the bathroom. I have a I'm on a hot date. I'm going to hold it until tomorrow. Well, the poop that you need to have tomorrow is going to look very differently than the poop you would have had today because you've held it in and now more and more water is going to get sucked out and it's going to look differently. >> So, if you're a person >> you're one of those, you said Dr. Pria that three out of every four people do not go number two at work.
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是的。如果你是整天在工作中收缩的人，可能是10到12小时，你必须在你自己的浴室里。是的。你是否在导致自己有更硬的便便，因为你不允许你的身体做它需要做的事情？是的。我是说，当你感到那个召唤时，那通常是你的身体说，"嘿，我在帮你。我现在在做一些工作。你的肌肉在收缩。它在提供你推进力。"如果你忽视那个召唤，这就是为什么我是说我教人们的最基本的事情之一是不要忽视召唤。如果这让你困扰的话，带上一些好的浴室喷雾，但要在工作中去。这对你有好处。如果你忽视它，试图在那天晚上去。现在，你没有那种紧迫感，因为你已经压制了它。你的结肠不会为你做那项工作。所以，你必须通过进行更难更难的估值来自己做所有的工作。因为它吸出了所有的水。现在你看的便便与12小时前
>> Yeah. If you're somebody that is clenching >> Yep. >> all day at work, which could be 10 to 12 hours, you got to be in your own bathroom. >> Yeah. >> Are you causing yourself to have harder poop because you're not allowing your body to just do what it needs to do? >> Yeah. I mean, when you feel that call, that's usually your body's way of saying, "Hey, I'm helping you. I'm doing some of the work right now. Your muscles are contracting. It is providing you the propulsion." If you ignore that call, and this is why I mean one of the most fundamental things I teach people is don't ignore the call. Go bring some nice bathroom spray with you if that's what bothers you, but go at work. It's good for you. If you ignore it, you try to go later that night. Now, you don't have that urgency because you've suppressed it. Your colon is not doing that work for you. So, you've got to do all the work yourself by doing a harder and harder val by straining >> because it's sucked all the water out of it. And now you are looking at a different poop than you had 12 hours ago. It was already going to be hard.
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It's going to be way harder now. >> Huh. And what is the one on top that is kind of in a log shape, but it's like hard pellets together. >> I've seen some people who think that they're living their best life and this is how they poop every day. And it could be normal. >> Oh, I hate those cuz they come out in chunks. I hate those. >> Yeah. Yeah. Everyone's a little different, but this one to me, if you were to say, "Oh, yeah. I do this every other day and I feel fine in between." I'd let you live your best life. I wouldn't interrupt that. But this one, I'd like to have a little longer conversation about. >> Now, this may be getting too graphic, but I do have some questions. >> I'm a GI doc. >> Okay. So, what if you have um like, you know, you go number two and the bowel movement has one section that's darker brown and then it kind of, you know, has the ombre effect of changing color. Does that make sense? >> Perfect. >> I know you're a GI doc. You know, you know all about this stuff. Okay. >> Yeah. Well, let me tell you a fun fact.
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We think that we're pooping just whatever we ate. Most of your poop, they've confirmed this on electron microscopy is your bacteria. >> Ew. What? >> I know. So, take a look next time you're in there and say hello. It's your microbiome that you're pooping. The majority of it is not what you ate. You've absorbed all the good stuff. >> Wait a minute. So when I have But unless there's corn cuz you see the corn in your >> Yeah. All of this. >> Why does corn make it through? >> Yeah. Everything you can't absorb. We cannot absorb and digest and break down corn. It's fiber. >> Because it's fiber. >> Am I not chewing it enough? >> You can chew your heart's content, but we don't contain the enzymes and the machinery to break down fiber. Now listen, that's a good thing. We need to eat more fiber because all the fiber that we're not absorbing, we are giving as a gift to our microbiome. And they love it. They thrive off of the corn, off of the cruciferous vegetables, all the high-fiber foods. And it's not a surprise to me that it sometimes those
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little chunks and pieces come out and we say, "Oh, there must be a problem with my digestion." No, no, no. It's normal. It's nor like we can't even bean shells. Like these things are all normal. When I do colonoscopies on people, half the time I can tell them what they had for dinner two nights ago. You you can see bits of it, especially if they've eaten a lot of salad or something like that. That's normal. What we poop, first of all, the brown color that comes from Billy Rubin. That's something that we produce as part of our digestion. It gives it that brown color. Different at different time points, it's going to be a little more concentrated than others. And at different time points as it's moving through your colon, more and more water is going to be sucked from one end, a little bit less from the other end. The bacteria is going to concentrate in one side. So, it's okay to see a little bit of a gradient. That's just how your body moves things along. Got it. Let's talk about color, >> please. All right, we can move the poop. Good job, team. That looks so realistic. I feel like I can smell poop. >> I know. I don't I don't even feel good like wiping this down.
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>> Okay, so you want to talk about color? >> Yeah, let's talk about color. All right. So, I've got a set of panone color cards for you. Okay, Mel. >> Okay. >> I'm going to hand these over to you. >> Okay. Okay. Yep. >> Have a look at them. >> Yes. >> These are colors that people have actually told me they've seen in their poop before. So, I want you to flash them over to me. >> Wow. >> And let's talk about if they're normal or normal. >> All right. I'm going to describe them. >> Yeah. >> So, uh, apple green. I'm looking at an apple green panone. So, imagine a Granny Smith apple. It kind of matches my skin. >> Yes, that to me looks like the kind of diarrhea a baby has after they've had breast milk. >> Yeah. I mean, this is a lovely bucolic shade. I would say first of all, Mel, everyone's allowed to have a weird colored poop every now and then. >> Well, that's that if I saw that as an adult, I would think something's very wrong. If you see this shade, it's a little bit green, maybe a little yellow, and you have other symptoms, like for
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例如，你发烧了，你腹泻了，所以它排出得很快，很频繁，而且很稀，这是个问题，你应该和你的医生谈谈。如果你一直在吃富含叶绿素的东西，也许是你的绿色粉末，人们实际上可能会偶尔排出绿色的粪便。如果很少见，你不一定需要惊慌。如果你知道你吃的什么东西改变了颜色，不用惊慌。但如果你确实有其他症状，腹泻、发烧，要和你的医生谈谈。哦，那就像你患流感时会有的那种颜色。是的，没错。因为东西在通过你的系统时移动得很快。通常当是那种颜色时。没错。你往往会腹泻，尤其是患流感时。好的。很好。所以，这个是彩通红李色，我要把它交给你。这看起来就像我刚刚吃了一份漂亮的甜菜沙拉。我想问你昨晚是否吃了甜菜。是的。是的。如果你有这种颜色，而且你吃过甜菜，那没事。你不一定需要惊慌，除非你感到头晕或头昏眼花。如果你没吃过甜菜，你看到这种颜色，这有点像栗色。
example, you have a fever, you have diarrhea, so it's coming out quickly, frequently, it's liquidy, this is a problem, and you should talk to your doctor about it. If you've been eating something high in chlorophyll, maybe your greens powders, people actually can get the occasional green colored poop. If it's rare, you don't necessarily need to panic about it. If you know what you're eating that has changed the color, no need to panic. But if you do have other symptoms, diarrhea, fever, talk to your doctor. >> Oh, that is like a a color that you have if you have the flu. >> Yeah, exactly. That's >> Yes. Because things are moving quickly. Yeah. >> Through your system typically when it's that color. >> That's right. You tend to get diarrhea, especially with flu. >> Okay, >> cool. >> All right. So, this one is a panone red plum that I'm going to hand over. And that looks like I've just eaten a beautiful beet salad. >> I was going to ask you if you had beets last night. >> Yes. >> Yeah. If you have this color and you've had beets, you're good. You don't need to necessarily panic unless you're feeling dizzy or lightheaded. If you haven't had beats and you see this color, it's kind of a maroon color. You
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你应该绝对和你的医生谈谈，因为这是出血，直到我们证明否则。所以，血液可以以多种形式出现在我们的粪便中。可能是很漂亮的鲜红色，可以是黑色，可以是这种栗色。当它是栗色时，往往意味着出血可能来自结肠的更高一点的地方。鲜红色来自稍微低一点的地方，但这仍然是紧急情况。所以任何数量，我的意思是，如果这是你习惯看到的东西，而且你和你的医生已经决定这是痔疮，你已经经历过了，它回来了，感觉是一样的，好吧，就让他们知道，不用紧急处理，但任何数量我都会和他们谈谈，特别是如果你有其他症状，如感到头晕或头昏眼花。好的，所以这个下一个彩通被称为最浅的天空，这看起来像是《权力的游戏》中的那些白鬼之一。这是我所说的僵尸恐怖的狗一样的鹅粪。这看起来真的是灰白色的。
should absolutely talk to your doctor because this is bleeding until we prove otherwise. >> So, blood can show up in our poop in any number of forms. It can be a nice bright red, it can be black, it can be this maroon color. When it's maroon, it tends to mean that the bleeding may have come from a little bit higher up in our colon. The bright red is a little bit lower down, but this is still an emergency. So any amount >> I mean if it's something that you're used to seeing you and your doctor have already decided this is hemorrhoids you've gone through and it comes back it feels the same all right just let them know non-urgently but any amount I would talk to them especially if you have other symptoms like feeling dizzy feeling lightaded >> okay so this next panone is called lightest sky and this looks like a uh the one of those white walkers from Game of Thrones. This is what I would call zombie horrifying dog like goose poop. It's like really grayish white.
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看起来就像我的狗过去常吃的那种东西。你知道，就像僵尸行走者一样，你应该跑，不要走。这实际上是一个紧急情况。我从来没见过白色粪便。是的，我希望你永远不要看到，但人们会看到。这是什么意思呢？还记得我告诉你的，我们的粪便之所以是棕色，是因为我们有胆红素吗？是的。如果我们去掉那个胆红素，这就是我们粪便的颜色。它会是这样的淡粘土色。这不是很令人惊讶吗？不是很奇怪吗？这很奇怪。这是粘土色的。如果我们去掉胆红素。所以，当我们看到这种颜色时，它告诉我们有什么东西阻挡了我们的胆红素。可能是胆结石。可能是更令人担忧的东西，比如癌症。如果这已经持续了一两天，立即打电话给你的医生，因为这可能是一个大紧急情况。那会是什么颜色。是的。好吧，因为我。这不是很可爱吗？好吧，它是的。它比但你必须，你必须有不同颜色的卫生纸，因为你不知道你的粪便是否是白色的，你是否把它都擦干净了。但这里，这就是这就是我要。
>> It does look like the kind of stuff that my dog used to eat. You know, uh just like the zombie walkers, you should run and not walk. This is actually an emergency. >> I've never seen white poop. >> Yeah, I hope you never do, but people see it. And >> what does it mean? >> Remember how I told you that our poop is actually only brown because we have Billy Rubin? Yes. If we took that Billy Rubin away, this is the color our poop would be. It would be like this pale clay. Isn't that surprising? Isn't that bizarre? It's bizarre. >> It's clay colored at If we took the Billy Rubin out. So, when we see this color, it tells us there's a something blocking our Billy Rubin. It could be a gall stone. It could be something more worrisome even like a cancer. If this has been going on for one day, 2 days, call your doctor immediately cuz this could be a big emergency. >> That's what color would be. >> Yeah. Well, cuz I'm >> Isn't it kind of lovely? >> Well, it is. It's a lot prettier than But you would you'd have to have a different colored toilet paper cuz you wouldn't know if your poop was white whether or not you got it all. But here here's what here's what I'm going to
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告诉你的。你想知道我为什么认为粪便是棕色的吗？告诉我吧。因为我认为当你吃了所有这些随机的东西。是的。然后你把它们混合在一起，它自然混合成一种真正的颜色。就像我不知道那是不是真的。当你看颜色的实际科学时，如果你把它们混合在一起，它们就变成了粪便褐色。但那只是我的想法，就像当你吃了所有东西时，它就简化为棕色。我想很多人都这么认为。但我认为我们忘记了，我们实际上是在吸收。它有什么作用？为什么它在那里？它有助于消化。它有助于分解食物。它有助于分解食物。所以它确实有助于你消化。你需要其中的那些胆盐。但我们吸收的是大部分，希望是我们食物中的大部分彩色营养物质，剩下的就是我们无法进食的东西，然后是我们的细菌，那真的就是组成这种美丽粘土色粪便的原因。好的，这个下一个是彩通5125。他们没有，他们没有给这个命名，但它看起来像茄子。就像它看起来像一个美丽的闪闪发光的紫色茄子。我有，我，我不认为，好吧，我觉得我可能见过一点，但它可能是甜菜。它可能不是那么紫色的。
tell you. You want to know why I thought poop was brown? >> Tell me. >> Because I thought when you eat all of this random stuff >> Yeah. >> and you blend it all together, it just naturally blends to just a really kind of color. Like that's like I don't know that it's true. When you look at the actual science of colors, if you mix them all together, they turn into poop brown. But that's just what I thought like when you eat everything, it just reduces to a brown color. >> I think that's what a lot of people think. But I think we're forgetting that again we're actually absorbing. >> What does do? Why is it in there? >> It helps with digestion. It helps break down with the food. It helps break the food down. So it does help you with digestion. You need those bile salts that are in there. Um, but we're absorbing most of the hopefully most of the colorful nutrients that are in our food and and what's left is the stuff we can't eat and then our bacteria and that's really what makes up this nice clay colored poop. >> Okay, this next one is panone 5125. They
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我肯定在我的一生中见过一两个这样的。这是其中之一，就像你说的，一整根还是零碎的。就像每个人都允许在他们的一生中有一两个紫色粪便。真的吗？也许更多，也许更少。这可能是由于一种叫做花青素的东西，这是一种色素，以及某些营养物质，比如浆果中的营养物质。那些可以给你紫色粪便。他们甚至可以给你像蓝色的色调粪便。而且它们实际上也在红葡萄酒中。如果这是一种模式，我们确实想确保我们没有将颜色与更栗色的东西混淆，这让我们对血液有点担心，因为那是血液。是的。但如果你像我昨天在我的冰沙中吃了两杯蓝莓。我看到这个紫色粪便。我对那个没意见。
don't have a they didn't name this one, but it looks like eggplant. Like it looks like a beautiful shiny purple eggplant. And I've I've I don't think Well, I feel like I may have seen like a little, but it's probably the beat. It probably was not that purple specifically. >> I've definitely seen one or two of these in my lifetime. It's um this is one of the ones >> like you're talking like a whole like long log of that >> or pieces of it. Like everyone's allowed to have I think one or two purple poops in their lifetime. >> Really? >> Maybe more, maybe less. It can be due to something called the anthocyanins which are this pigment and certain nutrients like in berries for example. Those can give you a purple poop. They can give you like a bluish tinge poop even sometimes. And they're actually they're there in like red wine too. >> If this is like a pattern though, we do want to make sure we're not confusing the color for something that's a little bit more maroon like which makes us a little more worried for blood cuz that's blood. >> Yeah. But if you're like I just ate two cups of blueberries in my smoothies yesterday. I'm seeing this one purple poop. I'm okay with that.
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好的。因为你有点可以说，"哦，火龙果。哦，甜菜。哦，蓝莓。"好的。但如果那莫名其妙地出
>> Okay. Cuz you kind of can go, "Oh, the dragon fruit. Oh, the beets. Oh, the blueberries." Okay. But if that comes out of nowhere, >> yeah, if it comes out of nowhere, and again, it's also think about it as part of the pattern. If you're having lightadedness, if you have any pain, any other warning sign with a new colored poop, that should prompt you to say, "Let me just >> Well, so what does that tell you, though? >> Usually, >> what does that mean if you like are having purple poops? It's two things. It's either something in what you ate, like these anthocyanins, something in the food, or we want to make sure it's not blood. >> Okay, got it. All right. This next one is called Fiesta. >> And so this is like a cross. This like a orangish reddish, not like fire engine red, more like cherry orangey red, like a fiesta. >> It's a fiesta. Although it's not a fiesta because if you see this, you should go to the emergency. What does that mean? This is bright red blood usually. Okay. Um and it usually means
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that it's coming from like close to the exit hatch like so you're bleeding from the last part of your colon maybe from hemorrhoids. It can also be due to something called diverticular bleeding which are these small out pouchings in the colon that can bleed. How much of that color in a log I or pellet or whatever? Like how much? Well, cuz cuz you know occasionally you have might have a little streak there >> and it happens once, but like and I'm assuming it's not that often that somebody has an entire fiesta hot dog coming out, but I don't know. >> Well, I would say that anytime you see a fiesta, it just bright red. Even if it's a little bit, you have to run it by your doctor. >> Okay, now here's a question. >> Yeah. >> Oh god, I can't believe I'm gonna ask you this. >> I'm so excited. >> Should you go get like a sandwich baggy
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or a dog bag and grab it? >> Yeah. >> And bring it >> with you if you're going to go to the doctor or the hospital. Well, it's like I always say >> because we do that for the vet, but I don't know that I would ever think to do that myself. But if you're seeing one of these colors, >> do you think would you appreciate that if when I showed up we actually had the thing? >> I love when my patients take a picture. >> Okay. >> Bring in the poop. A picture. It didn't happen. So, take a picture, get the color. >> You don't have to bring in a sample. Um, but the color often your word is enough. But sometimes seeing the color can help me say, "Okay, this is probably more upper GI bleeding versus lower GI bleeding." Help me make a decision about it. But if you see this like, and I want to just make sure I'm clear, >> bleeding can be due to hemorrhoids, >> which are very common, very disruptive. We don't want them, but they're not necessarily killers. >> But rectal bleeding is also one of the four signs of early onset colctal
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cancer. And that's why I'm telling you, even if you see just a little streak, Make sure we just double check and know that it's hemorrhoids. >> Okay, I got you. Okay, take the photo. I'm going to leave I'm going to leave the poop in the toilet. Okay, I got that. Okay, so all right. Pantone pirate black is just like a jet black, which I thankfully have also never seen. >> Yeah, thank goodness. So jet black is really worrisome. >> It means you're dying because you're dying from the inside out. Is that what that means? Okay. Okay. Well, I don't know. I'm like if that came out of me I would be like I am rotting from the inside out. >> It can be a big emergency. So this is not one that we say oh let's just see what happens over the next couple days. This is one that you go talk to your doctor because this is a situation when you see jet black that is the color that your blood turns when it acidifies when it mixes with the acid in your stomach. So a dark tarry black especially if it's like sticky like it's sticking to that toilet bowl that makes me worry that it's coming from blood. It's coming from blood higher up in your gut where it's got catch the acid. It can though, a
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nice pirate black stool can come if you've been taking iron pills. Iron pills can turn your poop. >> I'm no kidding. >> Yeah. And ironically, >> when should you take iron? I'm so confused about iron. Like, are you supposed to take it with food in the morning and the evening? Does your does your poop get harder? I mean, like, >> I started taking iron now. Now, we're going to turn this into my own personal session here, but I started taking iron because a lot of women are iron deficient. A lot of us in menopause are. Yes. And it really screwed up my routine in the bathroom. >> I know iron does constipate you. That's like one of the most like common side effects of iron pills. So, usually I tell people, actually there's two things I tell people about iron. One, you don't actually have to take it every single day to replete your iron stores. You can take it every other day >> and you actually like end up getting the iron you need cuz you can only absorb so much at once and sometimes every day is actually overkill. That can help with the conservation. >> Um but I also usually tell people at the same time take a fiber supplement. Okay. >> Like do both cuz it'll help with the absorption. >> Yeah. Okay. Great. This last one, Panone
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焦糖。这看起来确实像一个漂亮的乳白色焦糖颜色。是的，她不是很漂亮吗？是的。这是我们要追求的颜色吗？这是个不错的颜色。我的意思是我认为你可以有不同深度的棕色，但我认为我们都可以同意这是一个漂亮的颜色。好的。所以，从焦糖色到深巧克力色都可以。我们在范围内。完全在范围内。当你的颜色太接近海盗黑时要小心。明白了。好的。哇。这太有帮助了。你了解得越多。是的。嗯，我听你说过五分钟卫生间规则。那是什么？是的。人们一次在浴室里的时间不应超过5分钟。如果你在里面5分钟，你的膝盖或脚在凳子上。是的。你试图放松但什么都没有发生，就拉上裤子稍后再来。是的。这真的很难，因为我们都在用智能手机，对吧？这很重要的原因是
Caramel. This does look like a nice milky caramel color here. >> Yeah. Isn't she a thing of beauty? >> Yes. Is that the color we're going for? >> This is a nice color. I I mean I think you can have different shades of brown, but I think we can all agree this is a pretty one. >> Okay. So, anything from say caramel to dark chocolate. We're in the zone. >> Totally in the zone. Just be on the lookout when you get too dark chocolate that you're not veering towards pirate black. >> Got it. Okay. Wow. >> That's so helpful. >> The more you know. >> Yes. Um I've heard you talk about the fiveinut toilet rule. What is that? >> Yes. People should not spend more than 5 minutes at a time in the bathroom. >> If you're in there for 5 minutes, you've got your knees up on the stool or feet up on the stool. >> Yep. >> You're trying to relax into it and nothing's happening, just pull up the pants and come back later. >> Yeah. And this is really hard because we're all in there with our smartphones, right? And the reason this is important,
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去年我在实验室做了一项研究，研究那些来做结肠镜检查的人。我们用眼睛和内窥镜直接观察他们的身体。在他们进去之前，我们问了他们很多关于自己的问题。你在浴室里花多少时间？你会把智能手机带进浴室吗？你吃多少纤维？你运动多少？我们发现把智能手机带进卫生间的人，他们一次在浴室里呆超过5分钟的可能性高出五倍多。患痔疮的风险增加了46%。我们用眼睛看到了。你在开玩笑吗？是的。你知道我们认为发生的是什么吗？我是说，当我们试图入睡时，当我们排队等候时，我们会被智能手机分散注意力，那么当我们在浴室里带着智能手机时，为什么我们不会被严重分散注意力呢？这导致我们在这个没有骨盆底支撑的开放式碗座上坐得比预期更长。我们的痔疮其实只是充血的静脉。就这样
>> last year I did this study in my lab where we looked at people coming in for their screening colonoscopies. And so we're taking a look directly with our eyes, with our scope to see what's going on in their bodies. And we asked them right before they went in all about themselves. How long do you spend in the bathroom? Do you take your smartphone in the bathroom with you? How much fiber do you eat? How much do you exercise? What we found is that people who take their smartphones into the toilet with them, they are more than five times as likely to spend more than 5 minutes at a time in the bathroom. And they are at a 46% increased risk of having hemorrhoids. We saw them with our eyes. Are you >> kidding me? >> Yeah. And you know what we think is happening is that I mean we get distracted with our smartphones when we're trying to go to sleep, when we're waiting in the line some like why would we not be getting distracted beyond belief in the bathroom when we bring our smartphones in. And what that's doing is making us sit for longer than we intended on this seat that has an open bowl. So there is no pelvic floor support. And our hemorrhoids are actually just engorged veins. That's all
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它们就是这样。所以当我们以这种脆弱、无保护的方式坐在那里时，这些静脉只是被动地充血。如果我们这样做，对我们的骨盆底施加压力更长更长的时间，经过几天、几年，这成为我们的模式，我们认为这就是我们患痔疮的方式。天哪。所以这确实有道理。让我确保我跟上了。是的。所以，痔疮，对于那些从未患过痔疮的人来说，解释一下，因为我们家庭中有一个人第一次患了痔疮，这整个事情——有人应该为此制作一部情景喜剧剧集，关于必理痔疮膏和恐慌，关于应该对它做什么，以及恐怖之处在于理解妈妈和爸爸已经在家里准备好了必理痔疮膏。这很正常。人们会得到这些东西。嗯，所以你必须把它放进去。什么？所以我总是认为痔疮是皮肤刺激。是的。来自某种东西，但你是说它实际上是你出口周围的静脉在充血。这只是你的身体。但是是的，有两种痔疮。好的。所以有内痔。那些只是在括约肌内部。你通常感觉不到那些。当我们给你做结肠镜检查时我们会发现你有它们。还有外痔。那些是你能感觉到的类型，它们真的很烦人，可能会发痒。
they are. And so as we're sitting there in that vulnerable, unprotected way, those veins are just passively filling. And if we do that and we put that pressure on our pelvic floor for longer and longer periods of time, over days, over years, this becomes our pattern, we think that's how we get hemorrhoids. >> Holy cow. >> So that that actually makes sense. So let me just make sure I'm following this. Yep. >> So, hemorrhoids and like explain to the person listening who's never had a hemorrhoid because there was a person in our family that got one for the first time >> and it was a whole I it somebody should do a sitcom episode about it and Preparation H and the panic about what one should do with it and the horror to understand that mom and dad actually had Preparation H ready in the house. This is normal. People get these things. Um, and so you have to put that
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可能会受刺激、发炎。它们对接触非常敏感。然后实际上有点像第一种的堂兄弟，这是一个变得很重的内痔，它会弹出来。哦，它像悬挂一样。它可以悬挂，就像一个乳头。是的。人们知道他们有那些是因为他们可以有点推进和拉出。你知道吗？你怎么办？嗯，有很多不同的事情
up there. What? And so I a hemorrho I always thought a hemorrhoid was like irritation of the skin. Yeah. >> From something, but you're saying it's actually the veins around your exit >> that are filling. >> It's just your body. But yeah, it's there's two kinds of hemorrhoids. >> Okay. >> All right. So, there's internal hemorrhoids. Those are just inside the sphincters. You often can't feel those. We know you have them when we do your colonoscopy. There's also external hemorrhoids. Those are the kinds that you can feel and they're the really bothersome ones that can be itchy. They can be irritated, inflamed. They're very sensitive to touch. And then there's actually like a cousin of the first kind which is an internal hemorrhoid that gets so heavy it pops down. >> Oh, it like hangs out. >> It can hang out and it's like an udder. >> Yeah. People know they have those cuz they can kind of push them in and out. >> You know >> what do you do? >> Well, there's lots of different things
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你可以做。首先，你应该开始吃更多纤维。这总是我对我们讨论的大多数事情的答案。但有时你实际上可以获得一个简单的门诊手术程序，如果它是弹出来打招呼并且你需要推回去的那种。但对于那些只是受刺激、发痒、在外部开始的类型，诸如必理痔疮膏或这些温和的类固醇膏之类的东西可以真正帮助你度过难关。然后坐浴。坐浴只是一种花哨的说法，就是坐在温水浴中，给那个发炎的区域一点时间来愈合。一天做几次，连续几天。现在，普里亚医生，你也谈到对卫生纸非常有意图，这似乎很奇怪，但你说这很重要。为什么？是的。好吧，因为我和我的丈夫为此争执，因为我认为有两种卫生纸。一种很硬，粗糙，坦率地说感觉很便宜。然后有那种感觉蓬松、柔软的，但那个的问题是它到处都散落着各种棉绒
you can do. One, you should start eating more fiber. That's like always going to be my answer to most everything we talk about. But you sometimes can actually get like a simple outpatient surgical procedure if it's the kind that has like popped out to say hello and you need to push it back in. But for the kinds that are just irritated, itchy, started on the outside, something like Preparation H or these like mild steroid creams can like really help get you through it. And then sitsbats. Sitsbats are just like a fancy way of saying sit inside a bath of warm water and give that inflamed area a little bit of time to heal. Do those a couple times a day for a couple days. >> Now, Dr. Pria, you also talk about being very intentional about toilet paper, which seems weird, but you say it matters a lot. Why? >> Yeah. Well, >> cuz I I cuz my my husband and I have this fight cuz I think there's two types of toilet paper. There's a type that's stiff and like abrasive and that frankly feels kind of cheap. And then there's the kind that feels puffy and fluffy, but the problem with that one is it leads all kind of lint all over the
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你知道的，像我一样。但它更舒适。那么你希望我们对卫生纸了解什么，以及它实际上很重要？我认为你说的是两层之间的区别，这个。两层。然后一层。是的。蓬松和薄。昂贵，更便宜。是的。是的。我不知道谁现在需要听到这个。我需要。好的。我想让你跟我重复，梅尔。好的。好的。我值得被尊重。我值得被尊重。我已经足够了。我已经足够了。我应该得到两层卫生纸。我应该得到两层卫生纸。我的意思是，看看这个。这是一层。好吧。这太可怜了。你不需要这个在你身体最精致的部分。那就是你的后面。那里的组织非常薄，非常精致。不要给它这可怜的一层。而且，如果你开始和一个新的人约会，你去他们家，你喜欢他们，然后你第一次进入他们的浴室，恐怖之上的恐怖，你看到这个在他们的浴室里
place, you know, like I So, but it's but it's more comfortable. So, what do you want us to know about toilet paper and that it's actually mattering a lot? I think what you're talking about is the difference between two ply, which is this guy. >> Two ply >> and then one ply. >> Yeah. Puffy and thin, >> expensive, cheaper. >> Yeah. Yeah. And I don't know who needs to hear this right now. >> I do. >> Okay. I want you to repeat after me, Mel. >> Okay. >> Okay. I am worthy. >> I am worthy. >> I am enough. >> I am enough. >> I deserve two ply toilet paper. >> I deserve two ply toilet paper. I >> mean, look at this. This is one fly. All right. This is pathetic. You don't need this on the most delicate part of your body. And that's your rear end. The tissue down there is so thin, so delicate. Do not give it this pathetic one play. And furthermore, if you start to date somebody new, you go over to their house, you like them, and then you go inside their bathroom for the first
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你得
time, and horror upon horrors, you see this inside their bathroom, >> you got to run for the hills. That's a red flag. >> We've talked about red flags. Forget about a gut feeling. If you see this, how are they going to ever fall in love with you because they don't even love themselves. >> Well, they don't know. >> And that's why you're here. I see. I didn't even know this. >> People think that they're getting one ply because it's a little cheaper. But the fact is when you use one ply, you have to bunch up such a thick wad that you are breezing through that pathetic thin roll more so than >> It's true. You use less. You use less. Yes. I also feel richer when I buy Tuply. It just feels like more. It doesn't even necessarily have to be. It just feels like fancy toilet paper. >> I mean, it's the least you deserve. But I will say my dirty little secret about this, which is actually quite clean, is that I don't think toilet paper is the answer here. >> Uhoh. >> I think what we really need is beday. >> Okay. >> Yeah. And I know a lot of people in this country are not ready for that conversation. explain what of a day is
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for somebody who doesn't know because that was that was another eye opening experience recently when we went to a very nice hotel and one of our kids were like whoa this THING JUST SPRAYED ME WHAT WAS that yeah a bet is going to change your life okay it changed a lot like they in in the US they surged in popularity during the pandemic and people's lives changed but other countries are way ahead of us on this so a bedet >> the simplest form of a bedday is simply a nause nozzle that sprays your exterior clean. That's all it can be. Now, it that's one end of it. These simple nozzle attachments are like pretty cheap. You can install them yourself. On the other end, there are beautiful luxury beds where you have a heated seat. So, >> well, then I'm going to spend more than 5 minutes in there if I've got a heated seat. That's a problem. >> It also has like an air dryer built in. Different like sort of frequency and intensity of the water. All of this is for external use only, by the way. But beday clean your bum in a way that
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toilet paper can't. So somebody did this study back in 2023. There was a study that showed that your hands when you wipe after having a bowel movement have more microbes on them than people who use a bedet. >> Really? >> Even if your hands don't touch your butt, they just touch the tissue paper. >> You think that's what's happening? Even with two ply, >> even actually I don't remember what ply it was, but the point But toilet paper is not as clean as we think it is. And I mean, think about it this way, and I know every parent can relate to this. Suppose you somehow get a little bit of poop on your hand, a little bit of poop on your arm. >> Would you in that moment consider it acceptable to just like smear it off with a little paper towel and go about your day? No. You would absolutely put I hope you would absolutely put some running water on that thing and make sure it was clean. But for some reason again with the most delicate tissue in our body, >> we think wiping's okay. >> Let me ask you a question. >> Yeah. >> Is there a wiping technique?
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>> I think women are sometimes taught that it should be front to back. And that's the idea is that we don't want to mix the bacteria from our rear end up front to decrease the risk of UTI, urinary tract infections. There have been some studies that show that that's the case. The best way to wipe up front is a gentle dab. And I think that that if you have the ability to do that in the back, that's the best way too. A gentle dab keeps you from creating these microscopic tears, smearing it in. >> I really think that like sometimes when we're like just scraping our bums, a lot of people have sensitivity in that area. So people who have fissures, who have hemorrhoids, women who are postpartum, I tell all of my postpartum patients this, just a gentle dab is all you need. >> So Dr. Uh, Pasicha, what are the biggest gut health myths that social media is pushing that you're just like, I am so sick of seeing this? >> Yeah, there's two big ones for me. One is leaky gut. >> Okay, leaky gut started as a very sound scientific phenomena in
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神经胃肠学。这是我们研究的内容。我们研究的是肠道通透性增加。这就是"肠漏"概念最初开始的地方。所以肠道通透性增加就是这样的。我们的肠道表面覆盖着这些细胞，这些细胞通常紧密地靠在一起。但整天都会发生不同的事情，导致这些细胞之间的连接处略微打开。当它们打开时，其他细胞可以来回通过。化学信号可以移动。这发生在我们所有人身上。我们每天多次经历肠道通透性增加。压力可以导致。我们吃的东西可以导致。感染可以导致。这一直在发生。从开始到结束，我们目前只知道很少的情况，可以明确说出问题的一部分和机制是这种医学病症中的肠道通透性增加。例如，其中一个是肝纤维化。肝病酒精
neurogastronology. This is what we study. What we study is increased intestinal permeability. And that's where this idea of leaky gut first started. So increased intestinal permeability is simply this. Our guts are lined with these cells on the surface and those cells are usually pretty tightly close together. But different things happen throughout the day that cause the junctions between those cells to just slightly open up. When they open up, other cells can travel through back and forth. Chemical signals can move. That's happening to all of us. We have increased intestinal permeability multiple times during the day. Stress can do it. What we eat can do it. Infections can do it. This is happening all the time. There are very few known from start to finish situations where we can at this point conclusively say part of the problem and the mechanism was the increased intestinal permeability in this medical condition. So for example, one of those is liver fibrosis. Liver disease alcohol
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增加肠道通透性，然后这些化学物质和毒素击中你的肝脏并造成损伤。这可能是我们在胃肠学领域中关于肠道通透性增加的最清晰的故事之一。它曾被认为与肠易激综合征有关，那里有一些新兴数据。然而，当你上社交媒体时，你会听到这些人说，"你有脑雾吗？你总是腹胀吗？听起来像肠漏。"每个人都会说，"等等。是的，当然我有脑雾。我一直腹胀。我从来没听说过这叫肠漏的东西。那是这个吗？"因为这些是症状。腹胀、脑雾，这些都是出了名的难以理解、难以治疗、难以获得帮助的。现在有人给你一个答案，那就是肠漏，这是我认为每个胃肠病学家都害怕的东西，当我们听到这个问题被提起时。不是因为它不真实，不是因为肠道通透性不真实，而是因为那不是根本原因。人们把肠漏当作他们问题的根本原因。第二部分会说，"而这是我的三步
increases intestinal permeability and then those chemicals and toxins hit your liver and cause damage. That's probably one of the cleanest stories in in GI that we have for what increased intestinal permeability does. It has been implicated in irritable bowel syndrome and and there's some emerging data there. However, when you go on social media, you'll hear these people who will say, "Do you have brain fog? Are you bloated all the time? Sounds like leaky gut." And everyone will say, "Wait a minute. Yeah, of course I have brain fog. I am bloated all the time. I've never heard of this thing called leaky. Is that what this is?" Because these are symptoms. bloating, brain fog that are notoriously difficult to understand, difficult to treat, difficult to get help for. And now somebody's offering you an answer, which is leaky gut, which is the bane I think of every gastronologist existence when we hear that brought up. Not because it's not real, not because intestinal permeability is real, but because that's not the root cause. People treat leaky gut as the root cause of their problem. And the second half of that reel will be like, "And this is my three-step
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补充剂，会修复你的肠漏。"实际上你应该问自己的是，我的生活方式中有什么可能增加肠道通透性？那件事与我遇到的问题有任何联系吗？因为我见过这些情况，梅尔，有人来找我，自行治疗肠漏一年，而整个时间他们患的是乳糜泻。哦，你知道，这也导致脑雾，也导致腹胀。我讨厌看到我们错过一个我们知道如何治疗、我们可以诊断的医学诊断，因为我们已经有点执着于我们在社交媒体上看到的东西。所以对我作为胃肠病学家来说，肠漏是一个大问题。第二个是益生菌。有一个想法。根据营销，你会认为每个胃肠病学家都希望每个人都服用益生菌，我们都需要益生菌来维持健康，这些补充剂。这是不真实的。实际上，美国胃肠病学协会不建议对大多数医学病症使用益生菌。真的吗？我知道，我知道这很令人震惊
supplement that will fix your leaky gut." And actually what you want to ask yourself is what is it about my lifestyle that might be increasing intestinal permeability? Is that thing in any way linked to the problems that I have? Because I've seen these cases, Mel, where somebody will come in to me having self- treated for leaky gut for a year and the entire time what they had was celiac disease. Oh, >> you know, which also causes brain fog, which also causes bloating. And I hate to see us miss a medical diagnosis that we know how to treat that we can diagnose because we've sort of attached onto something we've seen on social media. So leaky gut is a big one for me as a gastronologist. Second is probiotics. There is this idea out there. You would think this based on the marketing that every gastroenterologist wants everyone to be on a probiotic that we all need probiotics for your health, these supplements. That's not true. In fact, the American Gastroenterological Association does not recommend probiotics for most medical conditions. >> Really, >> I know, I know it comes as a shock
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因为你总是看到像大多数胃肠病学家推荐或所有胃肠病学家都推荐。情况并非如此。这不是因为我会告诉你，如果你来找我，你一直在服用这种益生菌多年，你喜欢它，你消化更好，你现在每天轻松排便一次，那你的益生菌不起作用。它可能在起作用，但我们没有足够的强有力数据来说它总是对谁起作用，我们可以做出良好的建议并对此感到有道德。这是关于微生物群落，我认为人们不理解的事情。所以如果你把你的微生物群落想象成一个花园，以及那里生活的微生物，他们就像花朵或也许他们像杂草，益生菌理论上应该给你好细菌。是的。意思是我们在一些研究中看到过的细菌，似乎与健康相关，然后有些细菌我们标记为坏的，因为它们在有疾病的人中似乎更高。问题是我们
because you always see like recommended by most gastroenterologists or all gastronologists recommend. That's not the case. It's not because I'm going to tell you if you've come to me and you you've been taking this probiotic for years that you've loved, you digest better, you poop now once a day easily, that your pro probiotic is not working. it could be working but we don't have enough robust data to say in whom it's always going to work consistently that we can make a good recommendation for it and feel >> ethical about doing that. Here's the thing that I think people don't understand about the microbiome. So if you think about your microbiome as a garden and the microbes that are living there, they are like flowers or maybe they're like weeds >> and probiotics are supposed to give you in theory the good bacteria. >> Yeah. >> Meaning the bacteria that we've seen in some studies that seem to be associated with health and then there's some bacteria we label as bad because they seem to be higher in people who have diseases. The problem is that we
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实际上不知道我们标记为坏细菌或好细菌的东西是否是导致那种病症或导致你健康的原因。因为如果我们看到并称为坏的细菌实际上只是自然生长以应对你给予它的肥料的细菌怎么办，它们实际上尽力帮助你，但这只是在那种环境中生长的东西。问题不是你需要在它们上面撒益生菌，而是你需要专注于益生元。益生元就像允许某些种类细菌生长的肥料和条件。这些事物像纤维一样。这些是你不消化的东西，成为这些细菌的食物。所以有时解决方案不一定是益生菌补充剂，而是说，我今天给我的肠道微生物喂了什么？我给过它高纤维膳食吗？我今天吃过水果吗？我吃过蔬菜。我吃过发酵的东西吗？有时候那就是你可以以某种方式推动你肠道中的细菌种群的方式。
actually don't know if something that we're labeling as a bad bacteria or a good bacteria is the cause of that condition or is the cause of your health. Because what if the bacteria we're seeing that we're calling bad are actually just the bacteria that are naturally growing in response to the fertilizer you're giving it and they're actually trying their best to help you, but that's just what grows in that environment. And the problem is not that you need to sprinkle probiotics on them, but you need to focus on prebiotics. Prebiotics are like the fertilizer and the conditions that allow certain kinds of bacteria to grow. And that's things like fiber. It's the things that you don't digest that become the food for those bacteria. So sometimes the solution is not necessarily a probiotic supplement, but to say, what have I fed my gut microbes today? Have I given it a high-fiber meal? Have I had fruit today? I've had vegetables. Have I eaten something fermented? And sometimes that's the way that you can nudge the the bacteria populations in your gut one way or another.
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太棒了。现在，帕西查医生，作为一名神经胃肠学研究人员和医学博士，有什么是你停止做的，对你的肠道健康产生了巨大影响？我停止假装我会通过饮食获得足够的纤维。我是一名肠道健康研究人员，就像你说的那样，我思考我的肠道健康的频率远超大多数人。所以我长期以来认为我应该，我必须获得我的所有纤维需求，这对于50岁以上的女性是每天21克，50岁以下是每天25克，我应该通过我的饮食获得它，我应该像制作这些漂亮的便当午餐，有像五种不同的蔬菜和水果一样的彩色的，然后对我来说像一周几天那样发生，然后它就不会。我有两个孩子。我有像三份工作。我只是一个普通人，试图像其他人一样通过杂货店
>> Amazing. Now, Dr. Pasicha, as a uh neurogastro researcher and medical doctor, what is one thing that you stopped doing that has had a huge impact on your gut health? >> I stopped pretending like I was going to get enough fiber through my diet. And I'm a gut health research researcher like you said and um I think about my gut health like way more than most people. And so I thought for a really long time that I should I have to get all my fiber needs, which for women over 50 is 21 g per day, for under 50, 25 g per day, that I should get it through my diet, that I should be like making these beautiful bento box lunches with like this colorful different like five different vegetables and fruits and um it would happen for me like several days a week and then it just like wouldn't. I have two kids. I have like three jobs. I'm just a normal person who's trying to get through the grocery store
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谷物走廊。然后有些日子我会发现自己和我的丈夫靠在
cereal aisle like everybody else. And and and then some some days I would just find myself like with my husband leaning over the kitchen sink like picking off the macaroni of my kids plate and just saying, "Okay, I'm full. Like let's call it a day right here." And that's what we did. And when I kind of let go of being so virtuous about how I was going to meet my fiber needs, I said, "Okay, let us just like plan on me not meeting my fiber needs through my diet. what am I going to do then? And then it clicked. And then I found the laziest possible solution to just give my gut the the exact thing that it needed. And so I started taking a fiber supplement. So I take psyllium every day. Psyllium is this powder. It's a plant-based fiber supplement. I mix it into my coffee. Um it's a soluble fiber. I'm mixing it in the liquid that I'm drinking anyway. You do have to drink it quickly and it does need to be taken with water. The reason you have to drink it quickly is because it's a soluble fiber that turns into a gel. That's what also makes psyllium so wonderful. The cardiologists have loved psyllium for even longer than we have in
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gastroenterology because it can help lower cholesterol and we have that in my family. Um, but it's also a shape shifter. So, if you have diarrhea, psyllium will add a little bulk to your stool. If you have constipation, it'll soften it up. So, it's great for your gut. Your bacteria like it. It was just this shortcut that like freed me up and is a no-brainer because I'm not adding any extra time. One teaspoon of psyllium gives you about four grams of fiber. So, if you have two teaspoons, you're like a third of the way there. So, even on the days when I'm meeting my fiber goals, I just like get an A+ on my report card cuz I exceed them that day. And on the days that I don't, I still get an A+ because I've met them because I'm just doing the laziest possible thing and it and it works. >> Sounds like the smartest possible thing. Dr. Pasicha, what are your parting words? I want people to remember that the gut is a brain. Remember that we treat the brain in our head like it is the most important organ in our body and we do everything to protect it. But
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if you think about your gut as a brain and that's what it is, then you should treat it like your most precious organ. Like if you were going to go play football, there is no way your mom would let you run out there without a nice thick helmet every single day. You would wear a helmet if you rode your bike in downtown Boston traffic to work. But ask yourself, what have I done to protect my gut today? And not only that, not only do we not really protect it, but we treat its distress signals as inconvenient and we brush them aside. And it's not a coincidence at all that so many of the things that I tell my patients are good for their gut health, minimizing ultrarocessed foods, cutting down on alcohol, eating more fiber, that's incidentally the same list of things that will reduce your risk of dementia. That's not a coincidence. Once you realize that your gut is a brain, then treating it as the most precious organ of your body is not optional. It's foundational to your
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entire health. >> Dr. Press Reicha, I have loved meeting you. I have loved this conversation. I not only enjoyed it and enjoyed laughing, but I learned so much that I didn't know. And I feel just empowered. So, I just want to thank you. Thank you for the work that you're doing. Thank you for the way in which you teach. Thank you for the research that you are doing in your lab that is so cutting edge and exciting. And I am just grateful that you're here. So, thank you. >> Thank you for having me. Thank you for letting me share this with everyone. >> Of course. And I got to huge shout out to our team for the Play-Doh poop. And I also want to give you a shout out for spending time together with us and for listening to something that really is important. I was astonished, weren't you, to hear those numbers, the number of people that are struggling with this aspect of your life. And here's what I learned. There are simple things that you can do immediately now that you
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明白这一点。有些事情你可以立即去做，这些事情会帮助你改善生活和健康的这个方面。感谢你对家人的慷慨分享。这将被分享到罗宾斯家族的群聊中。如果今天有人告诉你，我想确保作为你的朋友告诉你，我爱你，我相信你，我相信你创造更好生活的能力。胡萨医生今天告诉你的一切、教你的一切，以及她今天分享的所有研究，绝对会帮助你拥有更好的生活和更好的排便，这将使你的生活变得更好。好的，当你点击播放时，我将欢迎你进入下一集。我会在那里见你。谢谢你。我非常兴奋你能来这里。感谢你与家人分享这个。感谢你与所有朋友分享这个。我学到了很多。这太酷了。我知道你在想，"好吧，梅尔，闭嘴。下一个视频是什么？我喜欢这个。我们在进行中。让我们继续。"如果
understand this. There are things that you can do immediately that will help you change this aspect of your life and your health for the better. Thank you for being generous with this with your family. This is going right in our family group chat at the Robins household. And in case someone else tells you today, I wanted to be sure to tell you as your friend that I love you and I believe in you and I believe in your ability to create a better life. And every single thing that Dr. Husa told you today and taught you today and all the research that she shared today will absolutely help you have a better life and a better bowel movement and that's going to make your life better. All righty, I will welcome you into the very next episode the moment you hit play. I'll see you there. And thank you. I am so excited that you were here for this. Thank you for sharing this with your family. Thank you for sharing this with all your friends. I learned so much. This was so cool. And I know you're thinking, "All right, Mel, shush. What's the next video? I love this. We're on a roll. Let's keep going." If
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你喜欢这个，你绝对会看下一个视频。当你点击播放时，我会在那里欢迎你。
you loved this, you definitely are going to watch this video next. And I'll be there to welcome you in the moment you hit play.