Colon cleansing, also known as colonic irrigation or colonic hydrotherapy, involves flushing the colon with fluids to remove waste. The practice dates back to ancient times, and proponents believe that digestive waste can be a toxin to the body. While some practitioners claim numerous health benefits, such as improved digestion and weight loss, colon cleansing also carries potential risks.
What is a Colon Cleanse?
A colon cleanse is the act of flushing out the large intestine (colon). It's a normal way to prepare for some medical procedures, such as a colonoscopy. Some people with fecal incontinence or chronic constipation may go to the doctor for a colon cleanse to help them have regular bowel movements. Generally, a professional called a colonic hygienist performs the colon cleanse while you rest on a table. It involves sending approximately 60 liters of fluid through a tube into the rectum. Toxins are then expelled through a different tube, and the process is repeated. You can find at-home colon irrigation products online or in your local drug store.
There are two main colon-cleansing methods. You can buy products to use at home, or you can see a colon hygienist or hydrotherapist to have a colon irrigation using a colon hydrotherapy machine. Colon cleanse with powdered or liquid supplements. You take some supplements used for colon cleansing by mouth. Others you take through the rectum. Either way, the idea is to help the colon expel its contents. You can find these products online or in health food stores, supermarkets, or pharmacies. They include:
- Enemas
- Laxatives -- both stimulant and nonstimulant types
- Herbal teas
- Enzymes
- Magnesium
The first modern colonic machine was invented about 100 years ago. Today, colonic hygienists or colon hydrotherapists perform colon irrigations. Colon irrigations work somewhat like an enema but involve much more water, sometimes up to 16 gallons. While you lie on a table, a low-pressure pump or a gravity-based reservoir flushes the water through a small tube inserted into your rectum.
After the water is in the colon, the therapist may massage your abdomen. Then you release the water like a regular bowel movement; the process flushes out the fluids and waste. The therapist may repeat the process, and the session may last up to an hour.
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The practitioner may use a variety of water pressures and temperatures and may or may not combine water with enzymes, herbs, coffee, or probiotics. Probiotics are supplements containing beneficial bacteria.
Purported Benefits of Colon Cleansing
Practitioners of colon cleansing say you can reap numerous benefits by removing the toxins from your digestive system. They say it can lead to weight loss, better digestion, increased energy, and clearer thinking. Practitioners of colon cleansing say the benefits include:
- Removal of toxins
- Boost in energy
- Improvement of immune system function
- Weight loss
- Fewer headaches
- Promotion of good health or overall well-being
- Lower risk of colon cancer
Some proponents also believe that toxins from the digestive tract can cause headaches, arthritis, and other conditions, and that colon cleansing removes these toxins and boosts energy or the immune system.
However, most of these claims are unproven and lack scientific support. One small pilot study done in 2016 noted improvement in gastrointestinal symptoms after colonic irrigation in patients with irritable bowel syndrome.
Risks Associated with Colon Cleansing
Despite the purported benefits, colon cleansing should be approached with caution, as it can potentially lead to colon damage. The list of potential risks associated with colon cleansing is much longer than the list of benefits.
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- Dehydration: While some of the weight loss associated with colon cleansing is due to the removal of waste, it also causes the removal of fluids. Dehydration can lead to kidney failure in extreme cases.
- Electrolyte imbalance: Colon cleanses can upset the balance of electrolytes like potassium and sodium in your body. These chemicals carry electrical signals across cells, and an imbalance can lead to a loss of consciousness as well as kidney damage.
- Bacterial imbalance and infection: Colon cleanses can potentially invite unhealthy bacteria into the lower digestive system with the instruments and fluids used. They also remove the healthy bacteria that can fight that infection. Your gut bacteria (microbiome) is important for your immune system to work the way it should. Bacteria in your gut help protect your body from infections with harmful bacteria. Your microbiome may also help protect you from colon cancer. A colon cleanse changes your microbiome by getting rid of the bacteria that keep you healthy.
- Bowel perforation: Bowel perforation happens when a tear occurs in the wall of the lower intestine. It’s considered a medical emergency. Though symptoms begin with fever, pain, chills, and nausea, it can progress and even be fatal.
- Other potential risks and side effects: Cramping, Bloating, Diarrhea, Vomiting and nausea, Irritation in the skin around the anus, Soreness, Potential interference with medication absorption on the day of colon cleansing, Infection, Kidney failure. Be aware, if the therapist adds a substance to the water during colon irrigation, you also run the risk of an allergic reaction.
Some herbal colon-cleansing products have also been linked with aplastic anemia (when your bone marrow stops making blood cells) and liver toxicity. In a few cases after colon hydrotherapy, doctors have also reported:
- Back and pelvic abscess (pockets of pus)
- Gas accumulation in the veins
- Rectal tears
- Gangrene in the perineum (patch of skin between your genitals and anus)
- Water intoxication
- Swelling of the colon and blood poisoning from coffee enemas
- Death from amebiasis (a disease caused by the parasite Entameoba histolytica)
Regulatory Status and Professional Standards
The FDA considers colon cleanse products you buy at the store to be dietary supplements, so it doesn't regulate them or approve them. However, the FDA and the Federal Trade Commission (FTC) took action against some companies selling detox and colon-cleansing products because they contained illegal and potentially harmful ingredients. The FDA also said that these products were marketed using false claims that they could treat serious diseases. Moreover, the machines used for colon irrigation are not approved for colon cleansing by the FDA. The FDA issued warning letters to manufacturers of these machines in the early 2000s for nonmedical use during colon cleansing.
Colon cleanse practitioners aren't licensed by a scientific or medical authority. They usually go through a training program, but the certificate isn't from a medical board. So, there's no oversight by an independent group that makes sure the procedures are needed, safe, and the same across practitioners.
Precautions and Recommendations
If you know the risks and are still interested in colon cleansing, there are things you can do to reduce the likelihood that you’ll suffer any ill health effects.
- Talk to your doctor first. Some people may be at a greater risk for complications. Doctors recommend you be wary of colon cleansing, especially if you have:
- A history of gastrointestinal diseases, such as diverticulitis or inflammatory bowel conditions (Crohn's disease or ulcerative colitis)
- A history of colon surgery
- Severe hemorrhoids
- Kidney disease
- Heart disease
- These conditions make the risk of side effects more likely.
- Drink plenty of fluids. Drink plenty of water to prevent dehydration both before and after your cleanse.
- Choose your therapist wisely. There are no licensing requirements for colonic hygienists, but some belong to professional organizations that require some training in first aid and CPR. Talk to other people who have used specific therapists before you go through with your appointment.
- Ensure only new, disposable equipment and protective gear is used. Make sure your hygienist has a proper disinfection routine and uses disposable equipment whenever possible. Colon cleansing equipment can transmit bacteria if not properly sterilized.
Alternatives to Colon Cleansing for Improved Colon Health
Doctors recommend the following ways to improve your colon health:
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- Drink plenty of water. Among other benefits, adequate water intake is necessary to keep food moving through your digestive system. Depending on your weight and activity level, adequate water intake varies, but it's generally 12-16 cups per day. You know you're drinking the right amount if you rarely feel thirsty and your pee is colorless or light yellow.
- Get enough exercise. Department of Health and Human Service's Physical Activity Guidelines for Americans, most adults should get about 150-300 minutes of moderate-intensity or 75-150 minutes of vigorous-intensity aerobic exercise per week. Or you can combine moderate and vigorous intensity exercises. Moderate-intensity exercise is anything that gets your heart rate up (such as walking or raking leaves) and vigorous-intensity exercises involve activities such as jogging, running, or shoveling snow.
- Eat a plant-based diet with plenty of vegetables, whole grains, fruit, and beans. This should help make sure you get plenty of fiber. Up your intake of both soluble and insoluble fiber, which can help prevent a wide range of gastrointestinal problems, including constipation, diverticular disease, and colorectal cancer. The typical American consumes about 15 grams a day of fiber, but you need closer to 25-30 grams. If you aren't allergic to gluten, add sources of insoluble fiber, such as cereal and whole grains. You can get your soluble fiber from foods such as bran, some fruits and vegetables, and oatmeal.
- Also, consider adding more resistant starches to your diet. Resistant starches are carbohydrates that aren't digested in your small intestine but ferment in your large intestine. This fermentation process feeds the good bacteria in your gut. Foods that feed your good gut bacteria are called prebiotics. Resistant starches may help prevent constipation and lower your risk of colon cancer. Food sources rich in resistant starches are generally high in carbohydrates and include:
- Plantains and green bananas (the starch in a banana changes to regular starch as it ripens)
- Beans, peas, and lentils (especially white beans and lentils)
- Whole grains, including oats and barley
- Rice that has been cooked and then cooled (heat increases the amount of resistant starches in some foods)
- Eat more probiotic foods. Probiotics are foods that have helpful bacteria and yeasts in them. These foods can help keep your microbiome in a healthy balance. Foods with probiotics include:
- Yogurt and kefir
- Cottage cheese
- Miso soup
- Kombucha
- Sauerkraut and kimchi
- Pickles and pickle juice
- If you don't like probiotic foods, there are supplements available, too. One common probiotic is acidophilus, which is a bacteria found in your mouth, gut, stomach, lungs, vagina, and urinary tract.
- Avoid toxins. Avoid tobacco, alcohol, and processed meats, such as bacon, sausage, deli meats, and hot dogs. Also, limit the amount of beef, pork, and lamb you eat to no more than 18 oz per week to keep your chances of getting colon cancer low.
- Get screened. Start testing for colon cancer beginning at age 45, or earlier if your doctor advises.
- Maintain a healthy weight. What matters most about your weight is the amount of body fat you have. A higher body fat percentage puts you at higher risk for colon cancer.
Scientific Evidence and Expert Opinions
Scientific research on colon cleansing is limited. There’s no good evidence for most of the claims that its practitioners make. And the side effects can range from mild to serious.
One of the main theories behind a colon cleanse for detoxification (detox) is an ancient belief called autointoxication. This is the belief that undigested foods make toxins that enter your blood circulation and cause chronic health problems.
Some people claim these toxins cause a wide range of symptoms and health problems, such as:
- Fatigue
- Headache
- Weight gain
- Low energy
- Arthritis
- High blood pressure
- Skin problems
On the surface, the idea of toxins being reabsorbed by the body makes some sense. But the theory of autointoxication was disproved in the early 1900s.
Since then, researchers have only tested the detox effects of colon cleansing in a few trials. But other researchers have found problems with these researchers' methods. Their criticisms include that these studies:
- Have only been done on a few people
- Have not been reviewed by other experts
- Have poor designs
So, doctors don't consider colon cleansing for detox to have good scientific support.Doctors recommend you be wary of colon cleansing, especially if you have:
- A history of gastrointestinal diseases, such as diverticulitis or inflammatory bowel conditions (Crohn's disease or ulcerative colitis)
- A history of colon surgery
- Severe hemorrhoids
- Kidney disease
- Heart disease
These conditions make the risk of side effects more likely. It's always a good idea to talk with your doctor before starting a new practice such as colon cleansing.