Gut Health

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Should You Try a Gut Detox?

Written by Dr. Michael Ruscio, DC on September 30, 2022

Written by Dr. Michael Ruscio, DC on September 30, 2022 — Reviewed by Heidi Turner

• What is a Gut Detox?|
• Does Gut Detox Work?|
• Colon Cleanse|
• Detox vs. Reset|
• Intermittent Fasting and Elimination Diets|
• Elemental Diets|
• Your Healthy Gut Plan|

If you struggle with recurring stomach pain, bloating, diarrhea, or other digestive symptoms, you may have looked at the many boxes of “gut detox” or “gut cleanse” protocols at the health food store and wondered if you should try one. They often claim to get rid of toxins, flush out impurities, and create a better gut microbiome, ultimately helping you feel better and get rid of all your recurring symptoms. 

While a gut detox protocol may work for some people, none of these protocols have undergone clinical trials yet and so we do not have supporting research that they work, or how they work in any one person. Additionally, many of these protocols have ingredients in them that can increase stomach distress in some people.

However, that does not mean that gut detox protocols have not helped some people on an individual basis. In fact, some detox protocols may have helped because, as you will see later, some of the individual ingredients in the gut detoxes have been shown on their own to improve gut health.

In this article we are going to look at what a “gut detox” really is, what’s in those store bought protocols, and how to support natural detoxification, so that you can make informed decisions about your health. 

Additionally, I will outline two other, research-backed ways to help the gut reset and improve symptoms, that you can still do on your own at home.

Let’s get started and look at what a gut detox actually is.

What is a Gut Detox?

Technically, a “gut detox” is not a medical term, but a common term many people and doctors use to refer to a protocol that is supposed to remove toxins and residual fecal matter from the intestines, colon, and gastrointestinal system. Many gut detox protocols also aim to improve the makeup of the gut microbiome. The end goal, of course, is to improve gastrointestinal (and sometimes other) symptoms.

Most often, these gut detox protocols are sold in a kit that often includes a high-fiber supplement, a “support” supplement containing probiotics, herbs or enzymes, and a laxative tea, each to be used on a daily basis 1. The purpose of these kits is to help remove toxins and parasites and get rid of fecal matter that allegedly accumulates and adheres to the intestinal walls 1.

While a “gut detox”  may not be a medical term, detoxification of the body is a real process. It is defined by The Agency for Toxic Substances and Disease Registry (ATSDR) as “the process of removing a poison or toxin or the effect of either from an area or individual” 2. 

Our body detoxifies through many means, every day, through sweat, urine, and the work of our kidneys and liver. There is also a natural cellular detoxification process known as autophagy that helps clean up damaged cells and encourages cell growth. Some health practitioners may recommend certain things to help the body detoxify, such as using a sauna, exercise, improving water intake, and for the gut, fasting or an elimination diet.  

What we want to look at first is whether any of these gut protocols actually detoxify the gut, and, if not, what does? Let’s take a look at that question.

Do Gut Detoxes Improve Gut Health?

Packaged gut detox products may make different kinds of claims about what they do. 

For example, one product we looked at claimed to “get rid of all the nasties and create a better environment for good bacteria and nutrient absorption.” Another product claimed to “reconstruct the gut” and “support healthy detoxification.” Yet another product claimed to “flush impurities and toxins from your gallbladder, liver, and colon.” However, none of these products specified what toxins were being removed or how the detox helps improve the gut microbiome.

Many of the gut detox protocols we looked at do contain individual herbal antimicrobials that have been shown to kill off unhelpful gut bacteria, prebiotics, and probiotics, which do have proven gut health benefits and help balance the microbes in the gut. Therefore, it is certainly possible that some of the ingredients in a protocol can improve symptoms in some people. 

But do these combinations of products provide a real “detox”? 

The best research we have is a randomized control trial that investigated the effects of a detoxification supplement containing several different herbs, some of which have been shown to improve gut health. However, the results of the study found that the detox supplement did not provide any benefits compared to placebo for gut symptoms, waist circumference (weight loss,) or body composition 3.

Further, many of the protocols contain large amounts of fiber which may help some people, but in many people with long-term gastrointestinal problems (Irritable Bowel Syndrome and Irritable Bowel Disease,) fiber can worsen symptoms 4 5 6 7 8. This is largely because certain kinds of fiber ferment in the gut which can cause gas, bloating, and diarrhea. 

In summary, it’s not that none of these protocols may help any one person, we just do not have any research supporting the claims that these protocols work in a larger population, or even why and how they would work and what they do.

And while the individual ingredients are often helpful, it may be more beneficial to work through a protocol that introduces them methodically, one at a time. 

What About a Colon Cleanse?

Colon cleanses (also called colon hydrotherapy, colonic hydrotherapy, and colonic irrigation) are another common suggestion for improving intestinal symptoms such as bloating, diarrhea, abdominal pain, and in particular constipation.

I recently wrote an in-depth article about the efficacy of colon cleanses, Why Colonics Aren’t Helpful and What Works Better Than a Colon Cleanse, but here is a quick summary.

Overall, there is insufficient evidence to support the use of colon cleanse therapies to improve overall or gut health. There have been a few small studies about colon irrigation, and one small study (not a clinical trial) even found that it did help improve bowel movements in people with poor bowel control. However, most of the participants in the study had side effects from colon irrigation 9.

Furthermore, one argument for a colon cleanse, as well as a gut cleanse, is that both of these things clean the gut of residual feces, which is claimed to cause toxicity to the body. This is called autointoxication, and the theory that residual stool in the gut causes disease has been disproven 10 11. 

There are inherent and serious risks from colon cleanses and because the research does not show significant improvements with these methods, but does show a good amount of risk, I do not recommend colon cleanses 11 12. 

We do have good supporting evidence for other ways to support the gut microbiome and help heal the gut though, which we will talk about next. 

Gut Reset vs. Gut Detox

According to an article published by the National Center for Complementary and Integrative Health (NCCIH), “detoxes” and “cleanses” may include anything from a colon cleanse to herbal teas, sauna, and fasting 13. 

What we do know is that while the idea of a gut detox that clears all toxins may not be supported by evidence, some forms of what is defined as a “detox,” such as fasting and elimination diets, actually do help improve the health of the gut and improve gastrointestinal symptoms. These interventions can be especially helpful for people who have tried many different interventions but are still struggling with symptoms.

I prefer to call this a gut reset because what we are really doing is giving the gut a rest and allowing it to heal. A gut reset provides your system with a rest from the work of digestion, a very low inflammatory diet in order to help calm gut inflammation, and decreases feeding some of the unhelpful bacteria that proliferates off of eating sugars or other fermentable carbohydrates. 

Lower inflammation and an improved gut microbiome may help the gastrointestinal system clear toxins as well as keep toxins from crossing from the gut into the bloodstream by improving leaky gut (when the lining of the digestive tract weakens and allows toxins to go into the bloodstream triggering the immune system to mistakenly attack our own GI system.) 

There are two forms of gut reset that I find work well for my patients at our clinic; intermittent fasting with an elimination diet, or a short-term elemental diet followed by an elimination diet. 

Let’s take a look at both of those options so you can see if one might be right for you.

Option 1: Fasting Plus Elimination Diet 

If you have intermittent gastrointestinal symptoms and have made some changes to your diet, but you still can’t resolve your symptoms, then a combination of intermittent fasting with an elimination diet for a month might be a good fit for you. 

Both short-term extended fasts (such as a 5-10 day fast) and intermittent fasting (fasting 14-18 hours in a day,) have been shown to result in better digestive health 14 15 16 17 18 19

Intermittent fasting is probably the most accessible form of fasting for most people. If you stop eating a few hours before bed and delay eating a few hours after you wake up, you can easily reach a 14-hour fast 20.  

Intermittent fasting increases a natural cellular detoxification process known as autophagy that helps clean up damaged cells and encourages cell growth 20 21. One study even found that intermittent fasting improved gut bacterial diversity and levels of butyrate-producing bacteria which is an energy source for the cells of the intestine 18. 

For these reasons, adding in intermittent fasting can be a great way to give your gut a rest and help it start to heal. However, what you do not want to do is fast and then eat foods that are highly inflammatory during your eating window and may undo all of the progress fasting has created. 

While there are not many randomized clinical trials that have combined intermittent fasting with an elimination diet, there are many studies that show elimination diets can improve many gastrointestinal conditions 7 22 23 24 25 26 27 28, in particular, because they eliminate foods that are harmful to the lining of the gut.  

I recommend using intermittent fasting with an elimination diet because both interventions have been shown to be helpful in resolving gut problems. 

Choosing Your Elimination Diet

There are many types of elimination diets, but I generally start my patients on a Paleo diet-based framework which eliminates common inflammatory foods such as whole grains, legumes (beans,) dairy, and processed sugar. It also limits a few of the fermentable dairy foods, such as kefir, that can cause stomach distress in some people.

If you have already tried a Paleo diet and you still experience symptoms, you could try a low-FODMAP diet which eliminates fermentable carbs that often cause bloating and diarrhea. Often helpful also for people with IBS and IBD 7 24 25 26 29. There are quite a few options for elimination diet frameworks, which you can find in our article, Everything You Need to Know About Gut Healing Diets. 

Starting an elimination diet can be overwhelming, so if you need help following an elimination diet, take a look at this article: How to Build an Elimination Diet Meal Plan for Healing 

After a month on your elimination diet, you can start adding in one food at a time to see if you have any food sensitivities that cause gastrointestinal distress. 

It is good to note though, that one group that may want to be careful of longer intermittent fasts is older adults with ulcerative colitis, as one study found that intermittent fasting worsened symptoms in this population 19.

If you are in an acute bout of gastrointestinal distress for multiple days or experience daily symptoms such as bloating, diarrhea, constipation, and abdominal pain, then this next gut reset option might be right for you. 

Option 2: Elemental Diet Followed By Elimination Diet 

Sometimes even with intermittent fasting and an elimination diet, gut symptoms persist.  

If this is the case for you, you are having an acute flare of symptoms, or if you have been struggling with symptoms almost daily for a few weeks, 2-4 days of an elemental diet may be worth a try. After that, you can move on to a month of an elimination diet.

An elemental diet is a powdered meal replacement that is anti-inflammatory, anti-bacterial, and hypoallergenic. The proteins are pre-digested so the formula is very easily absorbed in the digestive tract and it provides all essential vitamins and macronutrients. 

An elemental diet is typically prescribed by a doctor, but there are semi-elemental diets available that you can purchase and use at home. Semi-elemental diets have been shown to be just as effective, and sometimes even better, than prescription elemental diets 30 31. 

I have developed my own semi-elemental diet formulas, as well as a whey-free formula which is the only fully elemental diet available on the market without a prescription. 

Elemental diets have been shown to help to heal and repair the gut:

• Elemental diets have consistently been shown to be very effective in improving symptoms in IBD, such as with Crohn’s and Colitis 32 33
• Studies have shown elemental diets to be as effective as prednisone (an anti-inflammatory drug) in remission of IBD 34.
• While data is still preliminary, elemental diets have been shown to improve irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), celiac disease, and rheumatoid arthritis 35 36 37

After you have completed your course with an elemental diet, you can choose one of the elimination diets we discussed earlier for a month as your next step. Generally, you don’t want to jump right back into a standard diet after taking the time to do an elemental diet. Instead, you’ll want to use an elimination diet to continue with the gut healing process.

Your Healthy Gut Plan

If you have been struggling with chronic issues with your digestive system such as bloating, diarrhea, and abdominal pain, doing a gut reset can be a great way to improve your digestive system and overall wellness. 

A gut reset is designed to give the digestive system a rest, repair the gut lining and decrease the permeability of the gut lining to stop toxins from entering the bloodstream, and improve the gut microbiome by reducing bad bacteria and increasing beneficial bacteria. 

Whichever gut reset you choose, intermittent fasting with an elimination diet or an elemental diet followed by an elimination diet, remember to stick with your elimination diet for a month in order to really allow the gut to reset. Remember, the diet is not forever and after four weeks you can start to reintroduce foods one at a time every three days or so to watch for any reactions. 

While a gut reset is not forever, it can be a bit overwhelming to plan and follow on your own. If you would like some help, we have a team of experienced practitioners at the Ruscio Institute for Functional Medicine who can support you on your healing journey.

The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.