Are Colonics Helpful or Harmful?

A colonic is a procedure that flushes the colon, the largest part of the large intestine, with water. Also known as colon cleansing, colonic hydrotherapy, and colonic irrigation, a colonic is an alternative therapy thought by some to offer health benefits, including the removal of toxins from the body ("detoxification"), improved immune health, and the avoidance of diseases.

A colonic is not the same thing as an enema used in standard medicine to clear the colon for medical imaging or treat severe constipation. Rather, it is regarded as a therapeutic procedure with health benefits that are largely unsupported by research. Some experts warn that colonics may do more harm than good.

History of Colonics and Colon Cleansing

A colonic is an alternative therapy whose roots extend as far back as the 19th century to a theory known as "autointoxication."

Following Louis Pasteur's groundbreaking work in bacteriology, physicians of the time theorized that many illnesses were due to feces and the "putrefaction" of fluids absorbed by the colon. The absorption of bacteria and putrefied fluids was thought to cause "blood poisoning" and a host of chronic illnesses.

John Harvey Kellogg (of Kellogg's Cereals fame) was among the leading proponents of the theory having published the best-selling book "Autointoxication or Intestinal Toxemia" in 1919. In it, Kellogg stressed the importance of routine colon cleansing as an essential part of disease avoidance.

While the theory of autointoxication fell out of favor by the 1930s, largely due to advances in the science of bacteriology, the general theory has remained intact, leading to a recent resurgence in the popularity of colonic cleansing.

Purpose of Colonics

While the term "autotoxication" is rarely used when describing the benefits of colonics, the theory of "detoxification" has driven modern interest in colon hydrotherapy.

According to proponents of the practice, feces (stool) contains wastes that are either toxic or become toxic as they "stagnate" in the large intestine. By flushing the colon with water, these toxins can be removed, while toxins in the body can be "drawn out" of intestinal tissues.

Colonics have been said to benefit people with a host of illnesses, including alcoholism, allergies, arthritis, asthma, backache, colitis, diabetes, fatigue, gout, headache, high cholesterol, high blood pressure, indigestion, insomnia, liver disease, mood disorders, sinus congestion, skin problems, and thyroid disease.

Some people use colonics simply as a means to promote general health and well-being, while others embrace the practice as part of a general skincare and beauty treatment regimen.

Benefits of Colonics: What the Research Says

As with many alternative therapies, there is limited evidence to support the health claims. The evidence, if any, is generally anecdotal and largely supported by testimonials rather than research.

Of the available research, much of the findings are contradictory. Here are two examples illustrating the uncertainty surrounding the use of colonic hydrotherapy:

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a functional digestive disorder that can cause bloating, gas, abdominal pain, cramping, and abnormal bowel movements. There are two main types: constipation-predominant IBS (IBS-C) and diarrhea-predominant IBS (IBS-D).

A 2016 study from Taiwan involving 18 participants,—12 with IBS-C and six with IBS-D—reported that twice-daily colonics performed six times weekly for one to four weeks improved symptoms in all groups. People with IBS-C reported bowel movements every 1.7 days rather than every 3.8 days, while people with IBS-D experienced more than a 50% reduction in loose or watery stool.

The findings are limited by the small study size and the lack of a control group (meaning participants without a disease against whom results are compared). Moreover, no information is available as to the potential harm of flushing the colon this frequently.

According to the National Collaborating Centre for Environmental Health (NCCEH) in Canada, colon cleansing is associated with some potentially serious complications, including perforations and electrolyte imbalances. Of 33 cases of perforation reported to the NCCEH, 13 caused death, while two out of five cases of electrolyte imbalances requiring hospitalization also resulted in death.

After 10 days of treatment, including the avoidance of colonics, the symptoms were alleviated and bowel movements were normalized.

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is an immune-mediated disorder that causes inflammation and tissue damage in the intestine. There are two main forms of IBD: ulcerative colitis (UC) limited to the large intestine and Crohn's disease (CD), which can span the length of the digestive tract.

A 2023 study from Hungary involving 41 participants (nine with CD, 13 with UC, and 19 controls with neither disease) reported that colon cleansing dramatically altered the composition of bacteria in stool—increasing Clostridiodes difficile that contributes to bowel inflammation while decreasing Bifidobacterium which is probiotic and contributes to normal digestion.

As such, colonics might actually increase the risk of IBD flare-ups rather than reduce them. More research is needed.

How a Colonic Is Done

A colonic is a procedure performed by a certified, non-medical professional called a hydrotherapist. Basic colonic certification can be obtained with a 100-hour course from a school approved by the National Board for Colon Hydro Therapy (NBCHT). Advanced certification may require 500 to 1,000 hours of coursework.

Licensure is not currently required in the United States, although some states are considering it given that the procedure is more invasive than massage therapy or even physical therapy.

What to Expect

A typical session lasts 45 minutes to one hour. Prior to the procedure, you will be given a short medical assessment and asked to sign a document stating that you understand the risks associated with colon hydrotherapy.

You will then be asked to undress completely, change into a gown, and lie on a treatment table. A colonic is often performed while lying on your side, but some treatment tables allow you to remain on your back.

Here's a step-by-step overview of how a colic is performed:

1. Once you are in the correct position, the therapist inserts a disposable nozzle into your anus. The nozzle is attached to a long disposable plastic hose that is connected to a machine called the hydrotherapy unit.
2. The hydrotherapy unit pushes a large amount of water into the colon. The water is then released back into the tube where it is disposed of in a concealed unit. Around 16 gallons of water are used.
3. The therapist may observe the contents as they are released back into the clear tubing and comment on the color or consistency of your stools.
4. After the session, you will be directed to a toilet to pass any residual water and stool.

The therapist may lightly massage your belly to encourage water into parts of the colon. The procedure may cause some pressure or discomfort but usually no pain. You do not smell anything while undergoing a colonic.

After the Colonic

Because a colonic can cause dehydration, avoid caffeine and alcohol for several days until your normal fluid balance is restored. Both of these a diuretics that promote urination.

A low-residue diet is also recommended to give your digestive system a chance to rest. This includes eating softer foods like applesauce, mashed potatoes, white rice, and chicken and avoiding harder-to-digest foods like raw vegetables, red meat, nuts, and whole grains.

Side Effects and Dangers of Colonics

When you undergo a colonic, the flushing of tissues with water alters the natural balance of fluids between tissues (referred to as osmosis). The change in osmotic pressure not only draws water out of intestinal tissues, promoting dehydration, but also essential minerals called electrolytes that regulate bodily functions, including muscle contractions and blood pressure.

This can lead to common, short-term side effects like:

• Nausea
• Lightheadedness
• Cramping
• Bloating
• Diarrhea
• Vomiting

More concerning are the potential harms that can occur with the excessive or long-term uses of colon hydrotherapy. This is because the procedure involves a larger volume of fluid than is used in medical practice, often as much as 60 liters (15 gallons) over 60 minutes.

This can lead to potentially serious and even life-threatening complications like:

• Electrolyte imbalances: This includes hyponatremia (low blood sodium) contributing to seizures, hypokalemia (low blood potassium) leading to abnormal heart rhythms, and hypocalcemia (low blood calcium) contributing to abnormally slowed heartbeats.
• Infections: Rinsing the colon disrupts the normal intestinal flora, allowing certain bacteria to overgrow. This includes Clostridiodes difficile (C. diff), a bacteria that can cause severe, watery diarrhea and dehydration when it overgrows.
• Rectal stricture: This is the potentially irreversible narrowing of the rectum, typically caused by inflammation induced by repeated colonic rinsing. A stricture can also be caused when the water temperature is excessively high, leading to burns and scarring.
• Rectal and bowel injury: This includes anal fissures (tears) and bowel perforation caused when water pressure is too high or the colon is overfilled with fluid. Bowel perforation is especially dangerous; it can lead to peritonitis and sepsis, both of which require emergency treatment.
  

To better avoid such risk, check the qualifications and certification of any hydrotherapist you plan to use. Also, ask if the facility has records showing how often the machines are cleaned and serviced.

Who Should Avoid Colonics?

Colonic hydrotherapy is discouraged in people with certain health conditions. Chief among these are conditions that cause intestinal bleeding or inflammation.

Avoid colonics if you have:

• Ulcerative colitis
• Diverticular disease
• Crohn's disease
• Severe hemorrhoids
• Rectal fissure
• Vascular disease
• Heart diseases, including heart failure and atrial fibrillation
• Severe anemia
• Abdominal hernia
• Gastrointestinal cancers
• Recent colon surgery

People who are pregnant should not have a colonic as it may stimulate uterine contractions.

Summary

A colon cleanse is a popular health trend that offers no confirmed benefits for detoxifying your body or supporting overall wellness. Using colonics involves flushing the colon with liquid. This process can actually put you at risk for dehydration and electrolyte imbalances. For some people, colonics can be especially dangerous.

If you're interested in improving your health, talk to your healthcare provider about lifestyle and dietary changes that are proven to be effective.