Colon Cleansing: Is It Safe?

Popular complementary treatment

splash of water

Colon cleansing, also called colonic hydrotherapy and colonic irrigation, is promoted for digestive troubles such as bloating, colitis, constipation and indigestion. It is also touted for completely unrelated problems. These include arthritis, alcoholism, allergies, lethargy, asthma and skin conditions.

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While this popular complementary treatment offers a great option for some patients with specific problems, I caution people about its use for routine problems and  outside of a colonic hydrotherapist supervision.

What is colon cleansing?

Colon cleansing involves flushing the colon with large volumes of fluid. Patients who can benefit from colon cleansing have severe constipation resistant to laxative use. Irrigating and evacuating stool from the colon can bring these people immediate relief.

A trained hydrotherapist performs the procedure in our medical facility under a physician’s direction. The use of disposable equipment and meticulous disinfection every time avoids bacterial contamination.

During colon cleansing, you can expect:

  1. A brief rectal exam
  2. A speculum introduced 1.5 inches into the rectum
  3. An inlet and outlet tube attached to the outside of the speculum
  4. The influx of carefully controlled amounts of filtered water — about 60 liters
  5. Gentle abdominal massaging to help remove waste and gas pockets
  6. A closed system so that there is no odor
  7. About a 45-minute procedure

Unproven theories behind the practice

While this procedure is something I do offer to some of my patients, it is for problems that have not resolved after trying other, much gentler options.

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Most of us can resolve our digestive issues with:

  • Laxatives
  • Probiotics
  • Exercise
  • Good bowel routines (i.e. allowing appropriate time)

Hydrotherapy is based on the ancient “autointoxication” theory that the body poisons itself by retaining waste products. Removing fecal waste was believed to improve health.

The idea that the average person’s colon needs to be “cleansed” or that this offers health benefits is not proven. The Natural Standard Professional Database cites “limited clinical evidence validating colon therapy as a health promotion practice.” Generally, I would argue that when our bodies are in good health, they are equipped to cleanse themselves.

Risks may be involved

The adverse side effects of colon hydrotherapy may include:

  • Mild cramping
  • Abdominal pain
  • Fullness
  • Bloating
  • Nausea
  • Vomiting
  • Perianal soreness

Some herbal preparations used in hydrotherapy have been associated with cases of aplastic anemia and liver toxicity. Rectal perforation and disseminated abscesses have also been reported.

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Who should avoid hydrotherapy

While most people should avoid hydrotherapy, it’s especially important that irrigation be avoided by:

  • Anyone with diverticulitis, Crohn’s disease, ulcerative colitis or ischemic colitis
  • Anyone who has had prior colon surgery
  • Anyone with kidney disease
  • Anyone with heart disease

These conditions increase the risks of dehydration, acute kidney failure, pancreatitis, bowel perforation, heart failure and infection.

So make sure you ask your doctor whether colon hydrotherapy is right for you and that it’s recommended for your symptoms. Also, be sure the hydrotherapist is certified by the National or Board of Colon Hydrotherapy (NBCH) or International Association of Hydrotherapy (IACH).

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Brooke Gurland, MD

Brooke Gurland, MD, is a surgeon with the Department of Colorectal Surgery at Cleveland Clinic.