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It’s not an enema or bowel prep, and can harm proper colon function
You might have seen ads for wellness centers or spas promoting colon cleansing.
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Sometimes referred to as a colonic, colonic irrigation or colonic hydrotherapy, this procedure is often promoted as a good solution to maintain colon health.
At other times, it’s touted as a way to address issues such as bloating, colitis, constipation and indigestion.
But colon cleansings aren’t the solution for your digestive issues.
In fact, colorectal surgeon Anuradha Bhama, MD, stresses that colon cleansing shouldn’t be done regularly or recreationally.
“It’s not something that we recommend that you do,” she states. “It’s not something that you need to do to maintain the health of your colon. For some people, colonic hydrotherapy can actually be dangerous.”
Colon cleansing involves flushing out your colon from the bottom with large volumes of fluid. It’s based on the concept of hydrotherapy, in which water is used to treat various health systems.
While you might have heard of hydrotherapy associated with things like aquatic therapy (doing exercises in a pool), the type of hydrotherapy involved with a colon cleanse is slightly different.
It evolved from an ancient theory that the body poisons itself by retaining waste products. Removing fecal waste was believed to improve health.
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But there’s no scientific evidence to back up this theory. And at wellness centers, the hydrotherapists conducting colon cleanses also aren’t medical doctors.
While most people can prep for a colonoscopy at home, prior to a procedure, this step is done under the guidance of a doctor. Otherwise, no, you shouldn’t attempt to do colon cleansing at home.
Dr. Bhama says there are several major reasons why you should avoid colon cleansing.
Your colon absorbs water and stores stool (poop). If you start to mess with your colon’s ability to do either of those things, it can impact your health.
“Maintaining your water balance is really important,” Dr. Bhama explains. “And so if you interfere with your colon’s water absorption, that could throw off your fluid balance.”
If you’re on dialysis or living with heart failure, your fluid balance is really important, she adds. “Having this be off could exacerbate your condition.”
If you’ve had colon surgery before, or if you have any existing anatomic issues with your colon, a colon cleanse could cause further problems.
“In rare cases, colonic cleaning via hydrotherapy can result in perforation of the colon,” says Dr. Bhama. “This risk increases if the procedure is performed by someone without proper training.”
Some herbal preparations used in hydrotherapy have also been associated with cases of aplastic anemia and liver toxicity. Rectal perforation and disseminated abscesses have been reported as well.
If you fall into one of the below categories, it’s especially important that you avoid colonic irrigation.
That’s because these conditions already increase the risks of dehydration, acute kidney failure, pancreatitis, bowel perforation, heart failure and infection.
A colon cleanse is not the same thing as an enema. With an enema, you use liquid to clean out your rectum and the lower part of your colon. The goal of an enema is to help stimulate your digestive system so you poop.
The aim of colonic hydrotherapy is to clean out your whole colon. “It’s more like a super-aggressive enema,” Dr. Bhama states.
A colon cleanse is also not the same thing as bowel prep, which is used to clean out your colon prior to a colonoscopy or surgery.
“Bowel prep is when you take something orally (by mouth) to induce diarrhea,” explains Dr. Bhama. “This helps clean out the entire colon from beginning to end.”
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An example of bowel prep is drinking a laxative solution as part of colonoscopy preparation or before you have colon surgery.
In short — you shouldn’t need to have your colon cleansed. The idea that the average person’s colon needs to be cleansed — or that having colonic hydrotherapy offers health benefits — isn’t proven.
“Our bodies are equipped to cleanse themselves,” stresses Dr. Bhama.
If you’re having digestive issues, especially constipation, you can start by getting enough exercise, hydrating and making sure you’re getting enough fiber.
One easy way to do this is to make sure you’re eating foods high in fiber.
But if you’re experiencing severe, persistent constipation, Dr. Bhama says it’s important to schedule a visit with a primary care doctor.
“Constipation can be caused by multiple things, including underlying medical illness,” she explains. “Your doctor may run some bloodwork and find out that your constipation could be caused by hypothyroidism, for example. In this case, you wouldn’t want to go get a colonic to help relieve your constipation, when really what you need is treatment for hypothyroidism.”
Crohn’s disease, or ischemic colitis, can also lead to colon concerns. “You can have a stricture in your colon that could be causing blockage of stool. You’d want to make sure that you see your doctor for that.”
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After being evaluated for constipation, the next step would actually be seeing a gastroenterologist to determine what else might be going on with your bowels.
If your constipation is caused by your colon not functioning properly, your doctor might recommend over-the-counter stool softeners or laxatives. Prescription medications might also be warranted in certain cases, as can pelvic floor exercises.
“Your run-of-the-mill constipation can be treated with over-the-counter meds,” Dr. Bhama states. “But sometimes, it can get complicated. And so you would want to see those specialists. Surgery for constipation is extremely rare.”
If you’re worried you have an unhealthy colon, Dr. Bhama advises not to explore potential solutions for colon health by yourself. “Colon cleanses shouldn’t be used for routine problems,” she reiterates. “Any treatment you have done should be approved and supervised by a doctor.
“You want to make sure there’s no obstruction like a tumor,” she continues. “If you’re not up to date on your colonoscopy screenings, you need to make sure that there’s no underlying cancer.”
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