Toilet habits might feel straightforward, but many people are unknowingly doing themselves no favors when it comes to having a healthy bowel movement.
Acronyms can be handy, from minding your Ps and Qs (please and thank you) to dropping an easy LOL (laugh out loud).
But there’s another set of three Ps that’s far less playful—and a lot more useful for your health.
One gastroenterologist says most people will look at their bathroom routine differently once they understand what these Ps stand for.
Dr Trisha Pasricha says she regularly meets patients who hesitate to talk about bowel habits, even though she’s a physician-scientist at Beth Israel Deaconess Medical Center and an assistant professor of medicine at Harvard Medical School.
In other words, people would rather avoid discussing anything related to poop.
Yet being able to describe digestive symptoms matters, and so does learning how to go without unnecessary struggle—because ignoring problems can lead to complications.
To give patients a practical way to think about bowel movements, Dr Pasricha created what she calls the “three Ps of pooing,” aimed at helping with common issues such as constipation and diarrhea.
In her book, You’ve Been Pooping All Wrong: How to Make Your Bowel Movements a Joy, she lays out the approach step by step.
Her first point is about propulsion. Like any system that has to move something forward (think boats or jets), things sometimes need the right conditions to get going—whether the movement is voluntary or automatic.
Your colon generates its own muscular motion to move stool through the body, but there are moments when you can support that process—particularly at times when the gut is naturally more active, such as after coffee, within an hour of waking up, after eating, or after exercising.
During those windows, sitting on the toilet with your knees lifted toward your chest can help mimic the body’s natural mechanics, especially if you’re constipated.
Holding stool in instead can raise the risk of hemorrhoids and added strain, according to guidance from the Cleveland Clinic.
The second P is pliability, which refers to stool texture and how easily it passes.
If you’ve ever looked at the Bristol Stool Chart, you’ll know stool consistency can offer clues about what’s going on in your body.
The Cleveland Clinic outlines the scale, ranging from very hard, dry stools that are difficult to pass to fully liquid stools that pass too easily.
The sweet spot sits in the middle: stools that are neither too hard nor too soft—the “just right” zone.
In practical terms, getting enough fluids and fiber tends to produce that ideal type three or four consistency.
The Clinic notes that drinking more water and adding soluble-fiber-rich foods can help move stool toward that healthier middle range.
The third P focuses on the pelvic floor—an essential piece of the puzzle if you want to go comfortably and protect your long-term health.
In her book, Dr Pasricha compares the process to a toothpaste tube: squeezing hard when the cap is still on doesn’t work well and can create problems.
In her analogy, the “cap” is the pelvic floor muscles (running from the pubic bone to the tailbone), and they need to relax and coordinate properly for stool to pass without excessive force.
She warns that poor pelvic floor function can contribute to issues such as incontinence, pain during sex, or prolapse—making it especially important to stop straining during bowel movements, since repeated pressure can weaken these muscles.
This is another reason adjusting posture on the toilet (including lifting your knees) can be helpful, since it supports easier passage without forcing.
For people dealing with chronic constipation tied to pelvic floor dysfunction, she writes that biofeedback can be used to retrain the muscles and rebuild coordination and strength.
Biofeedback gives ‘real-time physiological feedback that trains them to shift behaviors,” Dr Pasricha wrote, adding: “A therapist may use electrodes on the skin outside the anal sphincters to measure muscle contractions. As you watch the recordings, you can see exactly how what you’re doing — such as where you direct force while bearing down — is helping or hurting.”
Finally, she notes that pain or bleeding with bowel movements should always be checked with a doctor for proper medical advice.