While anecdotally, colonics may ease constipation and other chronic symptoms, there are several downsides to consider.
Colon hydrotherapy doesn’t get to the root of gut health issues. There’s very little scientific evidence to support this and other types of colon cleanse.
You can support your gut health much better with the right diet and probiotics, which have been proven to help keep the microbiome (gut bacteria) balanced and healthy.
Colon hydrotherapy or having a “colonic” has become a wellness trend in recent years.
During this fairly extreme type of colon cleanse, a large amount of water is flushed through the colon via a tube inserted into the rectum. Colon hydrotherapy is billed as an ultimate detoxification regimen — you may have considered this therapy if you’re struggling with chronic constipation, dysbiosis, or related symptoms such as stomach pain, bloating, fatigue, or brain fog.
However, you might want to take a pause before having a colonic.
In this article, we’ll look at what colon hydrotherapy is, whether it works, and the scientifically-tested alternatives that can improve your gut and overall health instead.
What is a Colonic?
A colonic (also known as colon hydrotherapy, colonic hydrotherapy, colonic irrigation or a colon cleanse) is offered by some alternative practitioners to remove waste material, toxins and bacteria from your system.
During a colonic, large amounts of filtered water — up to 16 gallons, or about 60 liters — are flushed through the bowel (colon/large intestine). The whole process can take about 1-1.25 hours [1 Trusted SourcePubMedGo to source].
To administer a colonic, a colon hydrotherapist has the person lie on their side in much the same position as might be adopted for a colonoscopy. A hose then delivers a pressurized stream of water into the rectum. The water and waste material drain back out of the hose and into a plumbing unit.
Proponents of colonic hydrotherapy say that the process offers these health benefits :
Improves the immune system and general well-being
Relieves constipation and helps digestive health
Helps weight loss
Helps with acne
Unfortunately, after digging into the research on colonics, we found the scientific backing for these assertions to be weak to non-existent. One systematic review of 17 studies concluded that “the practice of colonic cleansing to improve or promote general health is not supported in the published literature and cannot be recommended at this time” [1 Trusted SourcePubMedGo to source, 3 Trusted SourcePubMedGo to source].
This can be hard to handle if you’ve been struggling with symptoms and hear glowing anecdotal reports. You may have met someone who swears by colonics and of course it is always great that someone feels better. However, it’s highly likely that the effect is a placebo one.
It’s always worth remembering that the placebo effect can be a really powerful one. In IBS, for example, research has shown that a placebo medication produces positive results on average 40-72% of the time [4 Trusted SourcePubMedGo to source].
If you feel better, that’s a good thing, but with colon hydrotherapy you risk becoming dependent on a placebo that can be expensive, invasive, and potentially harmful. The bottom line is that you’re better off exploring treatment options that have more thorough evidence and fewer risks behind them.
What About Enemas?
An enema also involves introducing a liquid into the bowel via the rectum, but a smaller quantity that generally only reaches the bottom half of the bowel. Enemas can be [5 Trusted SourcePubMedGo to source]:
Evacuative: Typically for constipation, in place of laxatives.
Retentive: When the enema is held in. Often used as a way to deliver medication to the bowel.
Enemas may be administered by a doctor or self-administered with kits bought from the pharmacy. They are scientifically more accepted than colon hydrotherapy, but they can still have risks [6 Trusted SourcePubMedGo to source].
This is especially the case with enemas used without good medical reason, such as coffee enemas that involve injecting brewed coffee and water into the rectum. These have been claimed (incorrectly) to detoxify the body and even help cure cancer [7 Trusted SourcePubMedGo to source].
Another form of irrigating the colon — called transanal irrigation — has specific, medically advised uses, for people who cannot have normal bowel movements due to nerve damage, (ex., as a result of multiple sclerosis, spina bifida or stroke) [8, 9, 10].
In this method, a device pumps warm water into the bowel which is temporarily held in with an inflated balloon until the water stimulates bowel contractions. The balloon is then deflated and the contents of the bowel comes out into the toilet.
Up to 60 liters (16 gallons)
Detox, flush out bad bacteria, boost immune system, reduce colon cancer risk
Poor – benefits are anecdotal and there are reports of potential harm.
150ml–1 liter (5 – 33 ounces)
Ease constipation, act as a colon cleanser, deliver medication
Moderate — some enemas may be medically useful, but they can harm if used inappropriately
500ml–1 liter (17–34 ounces)
Relieve constipation and anal leakage in people with nerve-related bowel dysfunction
Good (for the specific intended use)
Why a Colon Cleanse Misses the Mark
The whole concept of colon cleansing has a long and chequered history, including many misconceptions around what the process may achieve. One of these misconceptions is a colon cleanse could fight “intestinal autointoxication”, or being poisoned by the contents of the gut, a theory which was discredited in the 1930s [3 Trusted SourcePubMedGo to source].
Today, the colon cleansing industry still promotes everything from purgative herbs and colon hydrotherapy to coffee and apple cider vinegar enemas as a way to improve health, despite no good evidence for benefit [3 Trusted SourcePubMedGo to source].
A colon cleanse might seem an attractive idea and might temporarily help digestive system symptoms. But when you compare science-backed methods to improve gut health with colon cleansing, you’ll find two main problems with the latter:
Colon cleansing only targets your bowel — not the whole gastrointestinal tract, including the small intestine where nutrients are absorbed and gut imbalances, such as SIBO (small intestinal overgrowth), can also occur.
A colon cleanse can be harsh — it can cause issues such as cramping. It also flushes good as well as bad bacteria from the bowel [11 Trusted SourcePubMedGo to source].
Without being alarmist, it’s important to mention some of the dangers associated with colon hydrotherapy and self-administered cleansing enemas in particular.
Thyroid issues: Inflammation originating in the gut also damages your body’s ability to use thyroid hormone — this can lead to hypothyroid symptoms [30 Trusted SourcePubMedGo to source].
Using Diet to Reset Gut Health
When addressing any of these chronic symptoms, changing your diet should be your first approach. With the groundwork established, you can add other therapies, should they be needed.
Because many common foods can inflame the gut, a gut healing diet should focus on:
Reducing or removing foods that may irritate your gut lining or feed imbalanced gut bacteria
Healing and sealing any intestinal permeability
Feeding your good gut bacteria
Helping you understand which foods are triggering your symptoms
For many people, a Paleo-style diet ticks most of these boxes. I generally recommend you try this healthy eating plan before other more restrictive diets. On a Paleo diet, you eat a lot of fruit and vegetables and lean protein, while avoiding gluten-containing grains, dairy, and processed foods. This helps to calm inflammation by minimizing your exposure to foods that provoke an immune response [31 Trusted SourcePubMedGo to source, 32 Trusted SourcePubMedGo to source].
If a Paleo diet doesn’t alleviate symptoms after a week or two, you can try progressively more restrictive diets such as the low FODMAP diet. The low FODMAP diet helps to reduce bacterial overgrowth by restricting foods that feed bacteria, and has many scientifically validated benefits, such as:
Many people don’t seem to achieve balance in their microbiota with just one probiotic formula. I have seen the best results with my patients when they include one probiotic from each of these three categories:
For many patients who have tried just one type of probiotic, this approach makes all the difference.
Research also supports combining different probiotic strains — for example, two systematic reviews and meta-analyses indicated that multi-strain probiotics were more effective than single-strain probiotics for treating IBS [48 Trusted SourcePubMedGo to source].
If you’re still not on top of your symptoms after making changes to your diet and taking probiotics, there are plenty more strategies to try. It still isn’t a good idea to resort to therapies science doesn’t support, such as colonic hydrotherapy.
Everybody’s recovery progress tends to be different, and healing is not linear — it’s a process that can go in stops and starts. But sticking with these tried and tested protocols can help support better health, helping you to enjoy life.
The Bottom Line
Colon hydrotherapy comes with some extravagant claims but no real evidence to support them. It therefore makes sense to try the trusted route of diet and probiotics instead.
Finding your way through troublesome ailments may not be easy on your own though. If you require more personalized help with gut-related or other symptoms, you can schedule a virtual or in-person consultation at our functional medicine center.
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