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Complementary Medicine

General Detoxification and Colon Cleansing

03/06/2006

Question:

I have seen/ heard a great deal of info. lately about detoxifying the body, colon cleansing, etc. On the surface these types of therapies make sense. But have our bodies accumulated toxins,etc., over the years and can they be cleansed from the body? Are over the counter therapies effective? Are there any comprehensive studies on colon toxicity or cleansing?

Answer:

As you will note from the attached thorough science review from NaturalStandards.com, this therapy is useful only as a bowel prep. While many products are sold with vivid photos of the results none have any scientific studies to support their results. Many people are magnesium oxide deficient with resulting constipation and sluggish bowels and benefit from that if approved by their doctor.

See www.naturalstandard.com for more details on this and other complementary and alternative medicine therapies.

Colon therapy/colonic irrigation

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards.

In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms:

Bowel cleansing, colonic hydrotherapy, colonic irrigation, enema, high colonic.

History:

Irrigation of the colon for therapeutic purposes may have been used as early as ancient Egypt, China, India, and Greece. This practice gained popularity in 19th century European spas, and has been used in modern times to promote general well being and to treat multiple health conditions.

Definition:

Modern day colonic irrigation, or colonic hydrotherapy, is a variant of enema treatment. The technique involves flushing the bowel with water using different quantities, temperatures and pressures. A tube is inserted into the rectum and water is introduced either alone, or with the addition of enzymes, coffee, probiotics, or herbs. During a "high colonic," water goes in though one tube and is removed along with debris from the colon through another tube called an obturator. Treatment sessions may last up to one hour.

Proposed benefits of this therapy include improved mental outlook, enhancement of the immune system, and elimination of toxic substances. It has been suggested that intestinal bacteria or waste products can affect the entire body's immune system, and therefore may be involved with diseases outside of the gastrointestinal tract. By washing these away, it is theorized that beneficial effects may occur in overall health, although this has not been proven in scientific studies.

Uses These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. Grade*
Ostomy care

Colonic irrigation may be used in patients with ostomies (post-surgical connections of the intestines to the side of the body). This procedure should be performed by or under strict supervision of a qualified ostomy healthcare provider.


B
Surgical uses

Surgeons or other healthcare practitioners may use colon irrigation before or during some bowel surgeries for purposes such as cleansing or towards improved healing.


B
Fecal (stool) incontinence

Preliminary study shows possible benefits of regular irrigation of the lower part of the colon in the treatment of fecal incontinence. Further study is needed before a recommendation can be made.


C

*Key to grades:

A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use (it may not work);
F: Strong scientific evidence against this use (it likely does not work).

Safety

Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Colonic irrigation must be carefully administered to prevent potentially serious adverse effects. Excessive treatments may lead to absorption of too much water leading to electrolyte imbalances, nausea, vomiting, heart failure/fluid in the lungs, abnormal heart rhythms, or coma. Infections have been reported with the use of colonic irrigation, possibly due to contaminated equipment or as a result of clearing out normal colon bacteria allowing infectious bacteria to overgrow. There is a risk of bowel perforation (breakage of the bowel wall), which is a serious complication that can lead to septic shock and death.

People with diverticulitis, ulcerative colitis, Crohn's disease, severe or internal hemorrhoids, rectal/colon tumors, or recovering from bowel surgery should avoid colon irrigation, unless specifically directed by a doctor. Frequent treatments should be avoided in people with heart disease or kidney disease. Be sure that colonic equipment is sterile, and that the practitioner is a well-qualified healthcare provider before accepting treatment. Colonic irrigation should not be used as the sole treatment for serious conditions instead of more proven therapies, and should not delay the time before a qualified healthcare provider is consulted for potentially serious symptoms or illnesses.

  1. Anonymous. Amebiasis associated with colonic irrigation--Colorado. MMWR Morb.Mortal.Wkly.Rep. 3-13-1981;30(9):101-102.
  2. Briel, J. W., Schouten, W. R., Vlot, E. A., Smits, S., and van, Kessel, I. Clinical value of colonic irrigation in patients with continence disturbances. Dis.Colon Rectum 1997;40(7):802-805.
  3. Ernst, E. Colonic irrigation and the theory of autointoxication: a triumph of ignorance over science. J Clin.Gastroenterol. 1997;24(4):196-198.
  4. Istre, G. R., Kreiss, K., Hopkins, R. S., Healy, G. R., Benziger, M., Canfield, T. M., Dickinson, P., Englert, T. R., Compton, R. C., Mathews, H. M., and Simmons, R. A. An outbreak of amebiasis spread by colonic irrigation at a chiropractic clinic. N.Engl.J Med 8-5-1982;307(6):339-342.
  5. Lim, J. F., Tang, C. L., Seow-Choen, F., and Heah, S. M. Prospective, randomized trial comparing intraoperative colonic irrigation with manual decompression only for obstructed left-sided colorectal cancer. Dis.Colon Rectum 2005;48(2):205-209.
  6. Sha, L. J., Zhang, Z. X., and Cheng, L. X. [Colonic dialysis therapy of Chinese herbal medicine in abstinance of heroin addicts--report of 75 cases]. Zhongguo Zhong.Xi.Yi.Jie.He.Za Zhi. 1997;17(2):76-78.
  7. Sisco, V., Brennan, P. C., and Kuehner, C. C. Potential impact of colonic irrigation on the indigenous intestinal microflora. J Manipulative Physiol Ther 1988;11(1):10-16.
  8. van der Berg, M. M., Geerdes, B. P., Heij, H. A., and et al. Defecation disorders in children: treatment with colonic irrigation through an appendicostomy. Ned Tijdschr Geneeskd 2005;149(8):418-422.

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Response by:

Glen F Aukerman, MD, DABFP Glen F Aukerman, MD, DABFP
Formerly:
Professor of Family Medicine
College of Medicine
The Ohio State University