Rewriting the gut–brain story with Dr. Trisha Pasricha

Trisha Pasricha, MD, MPH, has intentionally built a career at the intersection of rigorous science and fearless communication. As director of the BIDMC Gut-Brain Institute, the physician-scientist is advancing understanding of the cellular and molecular mechanisms that connect the gut and brain — including groundbreaking work exploring the gut-first origins of Parkinson’s disease. Her NIH-funded research examines how gastrointestinal symptoms may precede neurologic disease by years, potentially opening the door to earlier detection and intervention.

But Dr. Pasricha’s influence extends far beyond the laboratory. As the widely read “Ask a Doctor” columnist for The Washington Post, she tackles readers’ most pressing — and often most embarrassing — health questions with clarity, humor, and unwavering scientific rigor. Her forthcoming book, You’ve Been Pooping All Wrong (Avery/Penguin Random House, April 2026), aims to normalize conversations around bowel health while grounding advice in peer-reviewed research.

Whether mentoring the next generation of neurogastroenterologists, investigating biomarkers of disease during routine colonoscopy, or challenging myths about what constitutes “normal” bowel habits, Dr. Pasricha is reshaping how patients and physicians think about the gut. In this month’s Member Spotlight, she reflects on science communication, stigma, and the future of the gut–brain axis.

What inspired you to start writing an “Ask a Doctor” column, and how has that experience changed the way you approach patient education?

Dr. Pasricha: I had always loved medical journalism. In college, I interned at the CNN medical unit in Atlanta and later worked for ABC News in New York before GI fellowship. But I had taken a bit of a break from it because of medical training — which, as everyone knows, is truly all-consuming.

When the COVID-19 pandemic hit, I saw firsthand the enormous scale of misinformation and how dire the consequences could be. I spent a lot of time thinking about the role science communication plays and how we could be engaging yet unwaveringly grounded in truth. I was post-call from a shift on the COVID wards in the early days of spring 2020 when I wrote an op-ed for CNN about my experience on the front lines. It was the first time I had written for the media in years, and the response was incredible.

Even once I returned to writing more regularly after the pandemic, the landscape of medical information had changed. I saw patients in clinic who had been suffering for years with symptoms they were too embarrassed to discuss. They were getting all their information online.

The column gave me a way to reach people before they walked into an exam room — to normalize the questions they were afraid to ask. I’ve learned that humor goes a long way in helping people remember important information. If you can make someone laugh about their bowel habits, they’re far more likely to follow your advice.

I don’t answer personal medical questions in the column, but I address the kinds of questions people want answered but may not have time to discuss during a 15-minute visit — questions like, “Are creatine supplements worthwhile?” or “Why are more young people getting cancer?” If we don’t meet people where they are, they’ll find answers elsewhere — and not always from credible sources.

Your new book, You’ve Been Pooping All Wrong, is slated for release this month. What made you want to write a book about bowel and gut health, and what do you hope readers get from it?

Dr. Pasricha: About one in three people avoid talking to their doctor about bowel symptoms because of embarrassment. We’ve been conditioned since potty training not to talk about what happens in the bathroom. It became taboo, which is why I found so many adults entering my clinic unsure of what normal bowel habits actually look like, much less how to optimize their gut health. That silence makes us sicker.

I wrote You’ve Been Pooping All Wrong to give people permission to pay attention to their gut — and to arm them with the science to understand what’s happening. I hope readers feel empowered, less embarrassed, and maybe even excited about their bodies.

You’ve built a reputation for tackling “embarrassing” topics with humor and clarity. How do you balance scientific rigor with accessibility when explaining complex GI health issues?

Dr. Pasricha: The science has to be rock-solid — that’s nonnegotiable. But the delivery is where you can have fun. I think of myself as a translator: my job is to take complex research and turn it into something patients, readers, or viewers can use.

Humor lowers defenses and makes people lean in. If someone is laughing about “poophoria,” they’re also learning about the vagus nerve and the enteric nervous system. That principle guided my book: every chapter is grounded in peer-reviewed research but wrapped in practical tools and humor that make it hard to put down.

Your work bridges clinical medicine, research, and public communication. How does your role as a medical journalist influence your research, and vice versa?

Dr. Pasricha: They feed each other in surprising ways. Writing for a public audience forces me to ask: Why does this research matter to a real person? How will it change daily habits?

As someone who works in both basic science and clinical trials, I understand why certain studies can or cannot be done. That helps me contextualize findings for readers — where the limits are and why even imperfect studies can be illuminating.

The joy of my work is that it’s a two-way street. Reader questions shape my research. For example, my study on smartphone use and hemorrhoid risk came directly from a reader question and generated real data on a topic no one had studied.

The book is the culmination of that feedback loop — bringing together lessons from patients, readers, and the lab.

The book explores the brain–gut–microbiome connection. Can you share one surprising insight?

Dr. Pasricha: One insight that surprises many people is that Parkinson’s disease may begin in the gut, not the brain. Pathology can appear in the gut’s nervous system years — even decades — before classic neurological symptoms develop. These gastrointestinal symptoms are the focus of my K23 grant from NIDDK and a major section of the book.

The gut truly functions as a “second brain,” and what happens in the intestines can affect the entire body.

You’ll be hosting an author Q&A event at AGA Central during Digestive Disease Week® (DDW) this year. What can attendees expect to hear from you?

Dr. Pasricha: I’m thrilled to be joined by my father, Dr. Pankaj Jay Pasricha, a leader in neurogastroenterology. We’ll tackle common gut health myths from a Boomer-versus-Gen Z perspective — part science, part family debate.

We’ll cover everything from daily bowel habits to probiotics and where the science stands. I’ll also have copies of You’ve Been Pooping All Wrong available.

In 2022, you received an AGA Research Scholar Award. How did that shape your trajectory?

Dr. Pasricha: The award was transformative. It gave me the runway and credibility to pursue long-term questions about the gut-brain connection. That support directly enabled my NIH-funded lab studying GI symptoms in neurodegenerative diseases.

I’m grateful to AGA for investing in me early, and I hope to mentor the next generation of neurogastroenterologists.

What’s a common misconception about GI health?

Dr. Pasricha: That you have to poop every day to be healthy. Normal ranges from three times a day to three times a week. What matters is what’s comfortable for you and whether changes affect your quality of life.

Looking ahead, what excites you most?

Dr. Pasricha: The evolving landscape of science communication both excites and concerns me. There’s enormous public appetite for health information, but also widespread oversimplification and misinformation.

The challenge is making nuance compelling. It’s easy to go viral with a hot take; it’s harder to say, “We don’t fully understand this yet.” But that’s what people need. I want to keep building something where nuance is the feature, not the liability.

Lightning round

Tell us about a mentor and what you learned from them.
My dad — he taught me how to think like a scientist.

Who inspires you?
My toddlers.

What are you excited about working on right now?
My book launches April 7.

Best piece of advice you’ve given or received?
“If not now, then when?”

Favorite quote or words to live by?
Do your best for the right reasons.

What’s your secret talent?
I’m devastatingly good at video games.

If you were not a GI, what would you be?
A Bollywood film director.

What’s your favorite GI organ?
The stomach.

Favorite way to spend a day off?
Cuddling my chow chow, Cannoli, and taking my kids to the beach.

Best way to unwind after work?
Going to the gym with my husband.