HeraSphere #34: SH#T Matters, so Listen to What Your Gut is Telling You

Hi friends,

It felt super uncomfortable and took guts to write this issue. Literally.

I brought it up at my Passover Seder table on Thursday — "I'm working on my next issue on poop" — and there was an awkward silence. My husband was nervous that he had just told his coworkers to sign up for HeraSphere and this would be their first issue. I reminded him: Everybody poops, so we’re going there.

Whether you're celebrating Easter, Eid, or Passover, this time of year has one thing in common: big meals, family tables, and a gut that's working overtime.

Everyone has had a bad experience. I have a very vivid memory of being unable to go in a Starbucks bathroom on vacation in my 20s while my best friend waited outside, undoubtedly wondering what had happened to me. I know people who plan their entire days around bathroom access. I know others who've never connected their anxiety, bloating, and exhaustion to what's happening in their gut, because nobody told them to.

So we're going there. Your gut is a command center. Understanding it might be one of the most useful things you do for your health.

The TL;DR

• Forty percent of Americans say bowel issues disrupt their daily lives — yet most have no idea what "normal" even looks like. The knowledge gap has real consequences: symptoms that warrant a doctor's visit get dismissed, and changes that signal something serious go unnoticed for months.

• Your gut houses 70% of your immune system, produces the same neurotransmitters as your brain, and sends 80% of its signals up to the brain. Gut dysfunction may be driving your anxiety and mood.

• Normal frequency is anywhere from three times a day to three times a week. Shape and color are your real signals — and there's a clinical chart for this.

• Your phone is giving you hemorrhoids. Sitting longer than five minutes increases pressure on rectal veins. Five minutes, then get up.

• A tight pelvic floor may be why fiber isn't helping. This is underdiagnosed in perimenopausal women and highly treatable with PT.

• Colorectal cancer screening starts at 45. Four symptoms warrant a call to your doctor sooner — don't wait.

We Have a Gut Problem That Nobody's Talking About

• 40% of Americans say their bowel habits disrupt their daily lives. Three out of four can't use a public restroom; one in three can't go normally on vacation. The shame and avoidance around this topic delay care and make symptoms worse.

• Colorectal cancer rates are rising in adults under 50, and women are disproportionately affected. This is one of the most underreported health trends of the last decade. Most people find out only after symptoms are advanced — often because they assumed something minor was to blame.

• We were never taught what normal looks like. Frequency, color, consistency, transit time — none of this comes up in routine wellness conversations. That knowledge gap has real consequences: symptoms that warrant a doctor's visit get dismissed, and changes that signal something serious go unnoticed.

Your Gut Is Actually a Brain

• Your gut has its own nervous system — the enteric nervous system — with more nerve cells than your entire spinal cord. It produces dopamine and serotonin — the neurotransmitters that regulate mood, motivation, and sleep. In fact, roughly 90% of the body's serotonin is made in the gut, not the brain. When researchers call it "the second brain," they mean it structurally and functionally.

• 80% of signals on the vagus nerve travel from the gut to the brain. The vagus nerve is a long, wandering nerve that connects your brain to nearly every organ in your body, including your entire GI tract. For decades, medicine assumed the brain was directing the gut. What we now know is that gut dysfunction may be driving anxiety and depression — opening an entirely different toolkit for treatment beyond antidepressants and therapy alone.

• 70% of your immune system lives in the gut. The microbiome — the trillions of bacteria, fungi, and microbes living in your GI tract — processes food, coordinates your immune response, produces hormones that regulate blood sugar and mood, and communicates upstream to your brain continuously.

• Gut dysfunction has been linked to neurodegenerative disease. Emerging research suggests conditions like Parkinson's may originate in the gut. The gut-brain connection is an active area of medical research with clinical implications for how we treat depression, cognitive decline, and more.

What "Normal" Actually Looks Like

• Normal bowel movement frequency is anywhere from three times a day to three times a week. What matters most is your personal baseline. A change from your normal pattern is more significant than the number itself.

• Shape and consistency are the real signal — and there's actually a chart for this. Gastroenterologists use the Bristol Stool Scale to categorize stool into seven types: from Type 1 (separate hard pellets — constipation) to Type 7 (entirely liquid — diarrhea). Type 3 looks like a sausage with surface cracks. Type 4 is smooth, soft, snake-shaped — that's the target. Types 1 and 2 mean things are moving too slowly; 6 and 7 mean too fast. Bookmark this chart!

• Color is information your doctor actually wants. Chocolate brown is the goal — that's a well-functioning colon doing its job. Green can mean food moved through too quickly. Yellow or pale clay-colored stool can signal a liver or gallbladder issue. Black stool can come from iron supplements, but can also indicate bleeding higher up in the digestive tract. Bright red warrants an immediate call to your doctor.

• Transit time is longer than most people think. Food exits your stomach within about four hours, but the full journey from mouth to exit can take one to three days. The colon is absorbing water the entire time — which is why hydration matters as much as fiber.

The Habits Making Everything Worse

• Your phone is giving you hemorrhoids. Research shows that bringing a smartphone into the bathroom was associated with a 46% increased risk of hemorrhoids. Sitting longer than five minutes increases pressure on rectal veins. Five minutes, then get up and come back.

• Posture on the toilet changes everything. The puborectalis muscle wraps around the rectum like a sling and only fully relaxes when your knees are above your hips. A squatty potty (I use a small IKEA step stool) repositions the anorectal angle and reduces straining significantly.

• Repeatedly ignoring the urge to go teaches your rectum to stop signaling. Over time, this contributes to chronic constipation that becomes genuinely hard to reverse without intervention.

• The stress-gut loop is measurable. In studies from the 1950s, researchers used early colonoscopes to watch participants' colons in real time as they described stressful situations. The colon visibly spasmed. Anxiety causes gut symptoms; gut symptoms fuel anxiety.

How to Actually Fix It — And What to Watch For

• Start with water before fiber. Most people reach for more fiber when they're backed up — but without enough water, fiber makes things worse. Doctors recommend: hydration, movement, fiber in that sequence.

• Movement is a GI intervention. Even a short walk after a meal activates peristalsis — the muscular contractions that move waste through the colon. Sitting all day is a legitimate contributor to constipation, and the fix is genuinely simple.

• For bloating and gas, look at plant diversity before anything else. The American Gut Project — a study across 10,000 people in 40 countries — found that 30 different plant foods per week was the single most important factor for a healthy microbiome. That includes fruits, vegetables, nuts, seeds, beans, whole grains, and herbs.

• On probiotics: the food is more important than the supplement. Fermented foods — kimchi, sauerkraut, kefir — deliver live bacteria alongside the fiber that feeds them. A tablespoon of sauerkraut a day has more meaningful data behind it than most probiotic supplements. Save your money; spend it at the farmers market instead.

• Breathwork and stress management work on the gut-brain loop directly. If you've addressed diet and still struggle, stress physiology may be the missing variable. Vagus nerve stimulation, consistent sleep, and slow breathing have measurable effects on gut motility.

• If you've tried everything and still struggle, ask about your pelvic floor. A hypertonic — overly tight — pelvic floor is an underdiagnosed cause of chronic constipation in women, particularly in perimenopause. As estrogen drops, pelvic floor muscle elasticity changes. When those muscles can't properly relax during a bowel movement, stool doesn't pass easily regardless of how much fiber you're eating. Pelvic floor PT treats this directly and effectively — and it's covered by most insurance.

• Colon cancer screening starts at 45, and four symptoms warrant a call sooner. Blood in your stool (get it checked before assuming hemorrhoids), unexplained weight loss, a persistent change in stool caliber or consistency, or new GI symptoms that don't resolve within four weeks. Early detection changes outcomes dramatically.

What I'm Taking Away

The gut-as-brain reframe was the critical takeaway. Eighty percent of the messages traveling on the vagus nerve originate in the gut — meaning my gut is narrating my emotional state upstream to my brain before I've consciously registered it. That reframes a lot: the anxiety that arrives before a hard conversation, the way stress lands in the body before the mind has caught up.

TMI, but I'm also taking a peek after doing my business and seeing where I land on the Bristol stool scale. The step stool is staying by the toilet. The phone is staying out of the bathroom.

Now go look at your poop,

Lilly

P.S. Know someone who plans her day around bathroom access or has been brushing off GI symptoms as stress? Send her this. It might be the nudge she needs to find a solution.

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Note: While I love diving deep into research and sharing what I've learned about women's health and wellness, I want to be crystal clear: I'm a passionate health advocate and researcher, not a medical professional. Think of me as your well-informed friend who does extensive homework – but not your doctor.

Everything I share in HeraSphere comes from careful research and personal experience, but it's meant to inform and inspire, not to diagnose or treat any medical conditions. Your body is uniquely yours, and what works for one person might not work for another. Always consult your healthcare provider before making significant changes to your diet, exercise routine, or wellness practices, especially if you have underlying health conditions or take medications.

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