05/08/2013 03:56 pm ET Updated Jul 08, 2013

Constipation 101, Part I: You, From the Inside Out

A few weeks ago, we discussed the liver, and how it sends most toxins to be excreted through your gastrointestinal tract (your gut).

OK, I freely admit it: I am poop obsessed. By now I am used to those puzzled looks on your face when I ask: "How many times a day do you have a bowel movement?" Without a doubt, you are wondering: "Why on earth is my gynecologist asking me about THAT? She's wondering about the wrong orifice, right?"

Bear with me.

Extra and undigested food is processed through the intestines. Interestingly though, you don't seem to get rid of nearly half as much as you take in! Did you know that there are bacteria in your intestine whose job it is to break YOU down when you die? They love rotting substances in your gastrointestinal tract. It gets more sinister, especially for women, since your liver is a key detoxification organ and has two steps in taking toxic substances from toxic to non-toxic.

In the first step, known as phase one, your liver takes a substance, such as estrogen, and alters its chemical form, often making it more toxic than when it started. In phase two of the detoxification process, your liver binds the old/extra estrogen and dumps it into your intestines to be transported out of your body. Your intestines hold a wonderful enzyme called Beta-glucuronidase. Its sole job is to break up certain molecular pairs, such as complex carbohydrates, and is also found in breast milk.

Now imagine a scenario in which you are chronically constipated. Before I go any further, let me clarify that my definition of constipated is failing to have a large, fully-formed bowel movement every day. When you are constipated, the enzyme Beta-glucuronidase has more time to circulate through the waste sitting in your colon and cleaves the estrogen from its binding molecule, leaving a free estrogen molecule. This free (and remember, very toxic) form of estrogen then gets recycled into your body, where it joins the rest of the circulating estrogen and alters the normal levels and balance of estrogens. This may lead to a whole host of potential issues that include premenstrual tension, acne, menstrual pain, hormonal imbalances, and increased risk of breast cancer.

Yes, increased risk of breast cancer too, and I promise that I will address the breast cancer risk in a very near posting. Next week we'll get to part two, which will look at ways to get your gut functioning better!

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