“In the pursuit of wellness, understanding the risks is as crucial as seeking the benefits.” - Charliejeane

At last! I've finally got an answer for my IBS, thought Tom. Colonic hydrotherapy for Irritable Bowel Syndrome (IBS).

Apart from perhaps wondering what that is, you might be thinking why would someone have this done in the first place?

Well in Tom's case, he was struggling with his IBS symptoms and felt he'd tried everything to improve them... Until one day, as he was driving home, a huge banner caught his eye, proudly displaying the benefits of colonic hydrotherapy... With 'digestive discomforts' capturing his attention.

So are these procedures HELPFUL?

Or are they HARMFUL?

Some claim that it:

"Cleanses the colon for optimal digestive health."

Before we move on, let me be clear from the get-go...

What I'm going to be talking about here isn't your run-of-the-mill medical bowels-emptying gig, where you take some "bowel prep" laxatives so your doctor can slide a long, (thankfully) thin, flexible tube with a tiny camera up your bum to have a peek at your insides.

That's what's known as a colonoscopy ("col-on-os-co-pee") (1). This is where they can check for things like any ulcers, growths, or *'pouches'.

*Image to demonstrate the pouches or bulges that occur in the wall of the large intestine (colon) when someone has diverticular disease. I know, pretty gross looking, but a picture paints a thousand words!

Depending on your symptoms, age and medical history, you might've had this procedure yourself.

If not, think of it like trying to inspect the inside of a cup for any cracks, marks, or scratches while it's still coated with hot chocolate clinging to the sides and bottom.

Just like the cup needs to be cleaned before it can be properly checked, the doctor wants to clean out your bowel so they can have a thorough look inside and, if necessary, take tissue samples for testing.

Other than this, the doctor might want to empty your bowel if you're severely constipated or preparing for bowel surgery.

So nope, we're not on about that.

Instead, we're talking about colonic hydrotherapy. Whaaaat?

You might have heard it being called by numerous other names: Colonic irrigation, colon cleanses, colonic lavage, colonic therapy, colon detox, or simply a "colonic".

But there's also the choice of having a jolt of java via an enema! ...And there was me thinking coffee was for drinking.

What Are Some Of The Advertised Benefits To Having Your Bum Basically Rinsed Out?

• Removes toxin build-up

• Improves health conditions

• Helps with weight loss

• Boosts immunity

• Enhances hydration

• Improves nutrient absorption

• Boosts energy

• Improves skin health

How good does a colonic sound? Whoop, whoop 🙌

... Especially when you've got celebrities like Gwyneth Paltrow recommending them (2) and other celebs like Ben Affleck and Leonardo DiCaprio being rumoured to have indulged in them... Even the late Princess Diana was said to have been a fan.

Celebrity Endorsement Means It's Safe And It's Beneficial?

But before you dash off to search for your local practitioner in some health spa or wellness centre, let's dive into what the procedure entails, whether any of these benefits are justified including for IBS, and what potential risks might be involved.

This way, you can make an informed decision.

What Does A Colonic Involve?​

There are 3 main ways:

1. Consuming a product to flush out your gut

2. Enema (- different types of enemas can be taken by mouth or put up your bum)

3. Irrigation (- flushing fluid up your bum 😳 ... as with colonic hydrotherapy/irrigation/cleanse/detox).

So, for the colonic hydrotherapy, the practitioner, often specialising in complementary or alternative medicine, will insert a tube into your bum, and up to about 60L of warm water (plain, herb-infused or coffee-based) will gently flow into your colon from a specialised machine. And the waste will be removed. The whole procedure typically lasts about 40-60 minutes.

Fact vs. Fiction: The Truth About The Benefits of Colonics

Removes Toxins

Colonic cleansing became popular in the early 1900s, and in recent years it's staged a come back because it was thought that our colon is "clogged with toxins" (in our poo) (3).

This sounds believable, right? Because poo is waste matter after all.

And it's these 'toxins' in our poo that can supposedly lead to a range of health conditions including arthritis, eczema, diabetes and cancer (4,5).

If you do a quick internet search, you'll find thousands of health, wellness, naturopathic and alternative therapy websites promoting the benefits (and selling these procedures, so of course they'll rave about them - they've got a service to sell).

So all this together makes it seem reasonable, even essential, to have a colonic, or routine colonics...

Especially if you ignore how the body works and the science.

👉 It's important to know that there's NO scientific evidence supporting the idea that having a colonic reduces your risk of developing these conditions (3,6,7).

👉 And, your body is ALREADY equipped to rid itself of waste.

​Organs such as skin, the gut, liver and kidneys continually ‘detoxes’ the body by filtering out, breaking down and excreting toxins and waste products like alcohol, medications, products of digestion, dead cells, chemicals from pollution and bacteria (8,9).

There is no (quality) scientific evidence that these conditions are the result of having poo in your rectum...

... And to help you understand, here's a tiny bit about how our body works:

After your body has taken what it can from food, any waste passes into the large intestine. Here, water and electrolytes are absorbed, and turns the liquidy smoothie consistency into a solid. This forms a 'normal' poo as we know it.

This poo is then stored in the rectum (the lower end of the large intestine) (9) until it's ready to be evacuated - and you have a poo.

Poo isn't just undigested food. It's a mix of old red blood cells, dead and alive bacteria, and water (10). It's waste that needs to be removed.

Once you've had a colonic and flushed out the poo, your body continues going about its business and generating waste from normal bodily functions and the food you eat, so those 'toxins' will be right back in your bowel again.

So what do you do? Go have another? And another... And another...

Improves Health Conditions

Practitioners and fans of colonics believe they improve a range of health conditions such as constipation, bloating, IBS, and other gut issues.

Constipation:

If you suffer with constipation, it makes sense to have a good clear out, right?

Imagine your gut as a hose pipe, stretching from your mouth down to your bum. Just as the tap lets water into the hose, your mouth controls what enters your digestive system. And what goes in at the top, comes out at the other end, so the bottom of the hose represents your bum.

But what if mud was all clogged up in the bottom end of the hose?

If you sprayed water up there, the mud would soften and eventually clear out. This is similar to having a colon cleanse.

👉 The thing to consider here, apart from the potential risks and side effects of colonic hydrotherapy, is why are you constipated?

Because although having a clear out, whether that's from a laxative or a cleanse, if you don't fix the cause of the constipation, sooner or later after the clear out you'll get constipated again.

Then what happens? ... rinse and repeat? And how often is it safe, and how many times can you have one?

Orrrr... Do you do something about the underlying cause to try prevent you from getting constipated again?

So although having a colonic may help with occasional constipation, if you're severely or chronically constipated it's wise to speak with your medical doctor BEFORE you go ahead and have this invasive procedure❗️

Check this out by the Advertising Standards Authority from 2022👇

(11) https://www.asa.org.uk/advice-online/health-colon-hydrotherapy.html

What about other gut conditions?

Colon cleanses have been linked to several problems, which I'll cover shortly, including inflammation of the lining of the colon - known as colitis ("col-i-tis") (12,13).

Bloating:

Supposedly one of the conditions a cleanse will help improve is bloating, but bloating is known as one of the many potential side effects (14)!

IBS:

With no known cure for IBS (despite claims made by certain holistic or Naturopathic doctors and others), when people feel they've had no success with conventional treatments, they may turn to alternative therapies, including colon cleanses.

The UK's National Institute for Health and Care Excellence guidelines for IBS (15) recommends against using complementary and alternative medicine such as reflexology and acupuncture for IBS. And there is no mention of colonic hydrotherapy. Which shouldn't be interpreted as it being suitable.

If there was quality evidence to support its use, then NICE would've recommended it.

Also, there's NO mention or recommendation for it in the Canadian, US or Australian guidelines for IBS either (16,17,18).

👉 There is no quality scientific evidence that colonic cleansing improves or promotes general health (4,7,19).

Helps Weight Loss

Loads of people have given the colonic a try, including celebs and sports personalities like supposedly ex-England cricketer Freddy Flintoff, all in the hope of shedding those extra pounds (20).

People may find they lose a few pounds having had a colonic, but this will be from the loss of poo and water and will only be temporary. As gross as this may sound but to get my point across, I guess you could say it's like having a nice big poo and finding you weigh less than you did before using the toilet.

Unfortunately, there's a tragic case report about a 30 year old lady who'd been taking a herbal colon cleanse for weight loss (21). Sadly this didn't end well. She had severe diarrhoea. Her whole large intestine was inflamed. Her heart and breathing rate were abnormal. And she had multi-organ failure.

Boosts Immunity

Currently, there is no scientific evidence that shows a colonic boosts immunity.

Enhances Hydration

As I've mentioned above the large intestine absorbs water, and during a colonic water is passed into the bowel. But it's then removed. Also, there's no evidence to support the claim that colonic hydrotherapy enhances hydration.

Improves Nutrient absorption

Improves nutrient absorption, eh? Lets check this out then...

Firstly, colonic hydrotherapy involves the large intestine.

Secondly, the large intestine is responsible for three key functions:

1. Absorbing water and some electrolytes (sodium and potassium) (22)

2. The trillions of bacteria that naturally live in the colon produce vitamins B and K (22,23,24)

3. Forms poo, and stores it until it's ready to be poo'd out

Ok, so where does the bulk of nutrient absorption take place then, because as I've shown it's not the large intestine?

It is in fact the small intestine (8,25).

... So how does colonic irrigation, that occurs in the large intestine, help improve nutrient absorption in the small intestine!

There is no evidence that a colonic improves nutrient absorption, yet despite this, many providers of these procedures make this claim.

Boosts Energy

I've literally spent days researching for this whole article, and I can't find any scientific evidence that proves a colonic boosts energy.

Improves Skin Health

The world of fashion and celebrities may believe “clean on the inside—beautiful on the outside” (26), but again there is no robust scientific evidence to support this claim. Although, perhaps it's more of a feeling - you feel empty, so you feel 'clean'.

The claim that it improves skin health may be based on the belief that colonics improve nutrient absorption and hydration, but as I've shown this isn't the case.

❗️So What's The Potential Risks And Side Effects?

Well, as you can imagine having a colonic is invasive and it can be a very embarrassing and uncomfortable experience. But what are the risks or side effects?

Remember Tom from earlier? He's just one of many guys who've approached me wondering if having a colonic would help their IBS.

He's seen all the bold claims, willing to put his embarrassment to one side to have the procedure but without knowing the associated risks:

1. Tears, punctures or holes in the bowel (- known as 'bowel perforation' in medical terms) - from poking the tube up your bum or high water pressure

2. Infections (including potential life-threatening sepsis) - from tearing the bowel and subsequently becoming infected, using unsterilised equipment or poor hygiene practices

3. Peritonitis (- infection of the inner lining of the abdomen) - left untreated, it can be life threatening

4. Kidney damage or failure

5. Inflammation of the bowel

6. Scalding inside the bowel, causing blisters, pain and possible infection

7. Bloating

8. Stomach cramps

9. Nausea, or vomiting

10. Diarrhoea

11. Pain in the bum, or stomach area

12. Dehydration

13. Electrolyte imbalance or depletion - which can have serious consequences

14. Bacterial imbalance or depletion - which can then cause bowel symptoms (amongst other consequences)

15. Allergic reactions

16. Potential interference with medication absorption

17. Death

(7,12,27-31)

​

💥 Some Key Points To Consider

1. DIY Risk:

Doing it yourself increases the risk of harm. Injuries have occurred even when performed by so-called "professionals", where experience, skill, and equipment influence the risk.

The safety also depends on your health, and if you've got any known or unknown health conditions which make the procedure unsuitable and unsafe.

Plus, safety is affected by where you've bought the DIY kit - different countries have different standards and regulations.

2. Regulation of Colonic Hydrotherapy:

Typically performed in private clinics and wellness centres, colonic hydrotherapy lacks the regulation and evidence-based practice seen in medical procedures.

3. Lack of Regulation for Practitioners:

Practitioners offering these services are not regulated by law but they can join a voluntary register for a fee. This lack of regulation poses potential and serious risk.

It's crucial to question whether the practitioner uses safe and hygienic practices and products.

4. Comparing Practitioners to Medical Doctors:

Unlike medical doctors, practitioners lack medical knowledge and experience. Even if they ask about your medical history, there's a risk if you have an undiagnosed gut condition like diverticular disease because this would make the procedure inappropriate. In contrast, a medical doctor can assess, diagnose, and act based on clinical evidence and your best interests.

5. Microorganism Balance Disruption:

The procedure can disrupt the balance of trillions of microorganisms within the bowel, which have a role in immunity, producing vitamin K and B vitamins, drug metabolism, and communication with the brain.

6. Increased Risk for Certain Conditions:

People with kidney disease, heart disease, or bowel conditions such as haemorrhoids, diverticular disease, or Inflammatory Bowel Disease (IBD) face an increased risk. And what if unbeknownst to you (and the practitioner), you have a health condition, like any of these.

7. If You Suffer Complications:

If complications arise, like an allergic reaction to the herbs, coffee or other substances, or you suffer excruciating pain, or bleeding - can the practitioner or centre provide the necessary emergency treatment?

Another important point to note is that if someone experiences complications during or after the procedure, it's essential to report them.

This reporting allows for the data to be monitored and analysed as an ongoing effort to enhance safety standards and inform potential improvements in the procedure and aftercare.

👉 Based on everything we've discussed here, regardless of what you call it, there's a clear lack of scientific evidence supporting the benefit of a colonic, with significant evidence of harm.

The dangers outweigh any potential benefit.

❗️But if you still fancy trying a colon cleanse, speak with your conventional (not alternative or complementary) medical doctor first BEFORE you go ahead with it 👍

Thankfully for Tom, he didn't go ahead with having a 'professional' colon cleanse or a DIY coffee enema. Instead, he took the simple, safe and effective route by working with me using a strategy based on scientific evidence and tailored to his specific needs.

And now he's no longer plagued by IBS flare-ups or risking his health and wasting money on 'cleansing' his bowel.

So please, think carefully before trying extreme measures to control your IBS symptoms. There is always a SAFE and BETTER way...

Click here to find out how.

Take care,

Charliejeane

P.S. If you're a guy with IBS - here's an invite just for you. Click here to join our exclusive men only Facebook Group, where you'll get support, valuable insights, and be surrounded by a community of men who get it.

References And Further Reading:

1. NHS. (2022). What is a colonoscopy? Available [online] from: https://www.nhs.uk/conditions/colonoscopy/

2. Guardian. (2017). Gwyneth Paltrow thinks you should try colonic irrigation. Is she right? Available [online] from: https://www.theguardian.com/lifeandstyle/2017/sep/18/gwyneth-paltrow-thinks-you-should-try-colonic-irrigation-is-she-right

3. Dore, M., & Gleeson, T. (2015). Escherichia coli septic shock following colonic hydrotherapy. The American journal of medicine, 128(10), e31.

4. Acosta, R. D., & Cash, B. D. (2009). Clinical effects of colonic cleansing for general health promotion: A systematic review. Official journal of the American College of Gastroenterology| ACG, 104(11), 2830-2836.

5. Seow‐Choen, F. (2009). The physiology of colonic hydrotherapy. Colorectal Disease, 11(7), 686-688.

6. Eykelbosh, A. & Wiens, M. (2018). Adverse effects after medical, commercial, or self-administered colon cleansing procedures. Vancouver, BC: National Collaborating Centre for Environmental Health.

7. Son, H., Song, H. J., Seo, H. J., Lee, H., Choi, S. M., & Lee, S. (2020). The safety and effectiveness of self-administered coffee enema: A systematic review of case reports. Medicine, 99(36).

8. Gandy, J. (Ed). (2019). Manual of dietetic practice. Wiley-Blackwell.

9. Feather, A., Randall, D., & Waterhouse, M. (Eds.). (2020). Kumar and Clark's clinical medicine. 10th Edition. Elsevier Health Sciences.

10. Britannica. (2023). Feces. Encyclopedia Britannica. https://www.britannica.com/science/feces

11. ASA. (Advertising Standards Authority) (2022). Health: Colonic hydrotherapy. Available [online] from: https://www.asa.org.uk/advice-online/health-colon-hydrotherapy.html

12. Hsu, T. C. (2020). Synchronous colitis induced by hot water enema: An easily missed etiology for colitis in modern days. Japanese Journal of Gastroenterology and Hepatology, 5(7), 1-5.

13. Mehershahi, S., Ghazanfar, H., Ashraf, S., Shaikh, D. H., & Patel, H. (2021). Colitis induced by colon-cleansing agent. Case Reports in Gastroenterology, 15(2), 621-625.

14. Hsu, H. H., Leung, W. H., & Hu, G. C. (2016). Treatment of irritable bowel syndrome with a novel colonic irrigation system: A pilot study. Techniques in Coloproctology, 20, 551-557.

15. NICE. (2017). Irritable bowel syndrome in adults: Diagnosis and management. NICE Clinical guideline [CG61].

16. Lacy, B. E., Pimentel, M., Brenner, D. M., Chey, W. D., Keefer, L. A., Long, M. D., Moshiree, B., (2021). ACG Clinical Guideline: Management of Irritable Bowel Syndrome. The American Journal of Gastroenterology 116(1):p 17-44.

17. Linedale, E. C., & Andrews, J. M. (2017). Diagnosis and management of irritable bowel syndrome: a guide for the generalist. Medical Journal of Australia, 207(7), 309-315.

18. Moayyedi, P., Andrews, C. N., MacQueen, G., Korownyk, C., Marsiglio, M., Graff, L., ... & Vanner, S. (2019). Canadian Association of Gastroenterology clinical practice guideline for the management of irritable bowel syndrome (IBS). Journal of the Canadian Association of Gastroenterology, 2(1), 6-29.

19. Reddy, A., Barbara, M., Lopez, F., Patel, R., & Van, M. (2021). A rare presentation of peritonitis after colonic hydrotherapy. Official journal of the American College of Gastroenterology| ACG, 116, S794.

20. BBC. (2017). Flintoff, Savage and the ping pong guy. Available [online] from: https://www.bbc.co.uk/programmes/p0551tpg

21. Force, M., Robbins, J., Mahoro, G., Moleski, S., & Shivashankar, R. (2021). Colon cleansing for weight loss: A Case of severe pancolitis. Official journal of the American College of Gastroenterology, ACG, 116, S829-S830.

22. Azzouz, L. L. & Sharma, S. (2023). Physiology: Large intestine. In: StatPearls [Internet]. Available [online] from: https://www.ncbi.nlm.nih.gov/books/NBK507857/

23. Britannica. (2023b). Large intestine. Encyclopedia Britannica. https://www.britannica.com/science/large-intestine

24. Ellis, J. L., Karl, J. P., Oliverio, A. M., Fu, X., Soares, J. W., Wolfe, B. E., ... & Booth, S. L. (2021). Dietary vitamin K is remodeled by gut microbiota and influences community composition. Gut Microbes, 13(1), 1887721.

25. Fish, E. M., & Burns B. (2022). Physiology: Small bowel. In: StatPearls [Internet]. Available [onbline] from: https://www.ncbi.nlm.nih.gov/books/NBK532263/

26. Bazzocchi, G., & Giuberti, R. (2017). Irrigation, lavage, colonic hydrotherapy: From beauty center to clinic? Techniques in ColoProctology, 21, 1-4.

27. Lee, A. H., Kabashneh, S., Tsouvalas, C. P., Rahim, U., Khan, M. Y., Anees, M., & Levine, D. (2020). Proctocolitis from coffee enema. ACG Case Reports Journal, 7(1).

28. Flanigan, S. A., Cains, T. J., McIndoe, L. N., & Ferson, M. J. (2023). An audit assessing regulatory compliance of businesses that perform colonic lavage. Public Health Research & Practice. 2023;33(2):e32232210.

29. Zhu, X., Jiang, S., Wang, C., Gong, H., & Zhang, W. (2022). Severe rectal burn induced by hot normal saline enema: A case report. Gastroenterology Report, 10, goac027.

30. Lee, A., Kabashneh, S., Rahim, U., Khan, M., Anees, M., & Levine, D. (2019). A case of proctocolitis secondary to the use of coffee enema. Official Journal of the American College of Gastroenterology| ACG, 114, S919.

31. Mishori, R., Otubu, A., & Alleyne Jones, A. (2011). The dangers of colon cleansing. Journal of Family Practice, 60(8), 454.