Colon cleansing

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Colon cleansing
Soapsuds Enemas.jpg
Large enema equipment for colon cleansing
Alternative therapy
ClaimsRemoval of unspecified toxins

Colon cleansing, also known as colon therapy, colon hydrotherapy, a colonic, or colonic irrigation, encompasses a number of alternative medical therapies claimed to remove unspecified toxins from the colon and intestinal tract by removing supposed accumulations of feces. Colon cleansing in this context should not be confused with an enema which introduces fluid into the colon, often under mainstream medical supervision, for a limited number of purposes including severe constipation [1] and medical imaging. [2]

Contents

Some forms of colon hydrotherapy use tubes to inject water, sometimes mixed with herbs or with other liquids, into the colon via the rectum using special equipment. Oral cleaning regimes use dietary fiber, herbs, dietary supplements, or laxatives. Those who practice colon cleansing believe in autointoxication, that accumulations of putrefied feces line the walls of the large intestine and that these accumulations harbor parasites or pathogenic gut flora, causing nonspecific symptoms and general ill-health.

Autointoxication, a term coined in 1884 by the French physician Charles Jacques Bouchard, [3] is a hypothesis based on medical beliefs of the ancient Egyptians and Greeks and was discredited in the early 20th century. [4] Nonetheless, during the 2000s Internet marketing and infomercials of oral supplements supposedly for colon cleansing increased. [5]

There is no scientific evidence for the alleged benefits of colon cleansing. [4] Certain enema preparations have been associated with heart attacks and electrolyte imbalances, and improperly prepared or used equipment can cause infection or damage to the bowel. Frequent colon cleansing can lead to dependence on enemas to defecate and some herbs may reduce the effectiveness of, or increase the risks associated with the use of prescription medications. [6]

Effectiveness and risks

The symptoms that are attributed to autointoxication—headache, fatigue, loss of appetite and irritability—may be caused by mechanical distention within the bowel, such as irritable bowel syndrome, rather than toxins from putrefying food. [7] [8] [9] The benefits anecdotally attributed to colon cleansing are vague and the claims made by manufacturers and practitioners are based on a flawed understanding of the body. [3] [10] There is little evidence of actual benefit to the procedure, and no evidence that it can alleviate the symptoms that are attributed to the theories of colon cleansing. [11]

As the colon normally expels waste, colon cleansing is generally unneeded. [12] [13] Colonic irrigation can disrupt the bowel's normal flora, and, if done frequently, can result in electrolyte depletion with dehydration. [13] Rare but severe adverse events have been rectal perforation, [14] as well as amoebic infection, from poorly sterilised equipment. [15] Others claim that colon cleansing may impede the colon's shedding of dead cells. [16]

Excessive use of enemas has also been associated with heart problems, such as heart failure, [13] as well as heart attacks related to electrolyte imbalances when performed as a coffee enema. [17] Frequent enemas or other colon-cleansing tools may lead to dependence and inability to defecate without assistance, as well as potential withdrawal symptoms. [6] [7] Herbs taken orally may modulate the absorption or the activity of prescription medications. [6]

Medical doctor Harriet Hall writes that "The colon cleanses itself... The idea that its walls are coated with years-old hamburger residue is preposterous". [18]

Supplement effectiveness

According to the American Cancer Society, "Available scientific evidence does not support claims that colon therapy is effective in treating cancer or any other disease". [4]

Colon hydrotherapy

Colonic irrigation, also known as colon hydrotherapy, colonic hydrotherapy, or a "colonic", is a treatment which is used "to wash out the contents of the large bowel by means of copious enemas using water or other medication." [19]

During a cleansing enema, liquid is introduced into the colon and retained for five to fifteen minutes. [20] During a colonic, liquid is introduced into the colon and then it is flushed out and this is repeated until the entire colon is cleared. [21]

Colonic irrigation has been described as an "unwise" procedure as it carries the risk of serious harm and has no proven benefit. [22]

Regulation

In the United States, the Food and Drug Administration (FDA) regulates the production of equipment used in colon hydrotherapy but does not regulate their use, or the supplements used in oral colon-cleansing regimens. Manufacturer claims do not require verification or supporting evidence. The contents of the products are also not verified or tested. [16] The FDA has issued several letters warning manufacturers and suppliers of colon hydrotherapy equipment about making false claims of effectiveness, safety issues, and quality control violations. [7]

History

The concept of autointoxication, the idea that food enters the intestine and rots, provides a rationale for colon cleansing. [7] [23] The ancient Egyptians believed that toxins formed as a result of decomposition within the intestines, [24] and moved from there into the circulatory system, causing fever and the development of pus. The Ancient Greeks adopted and expanded the idea, applying their belief in the four humours. In the 19th century, studies in biochemistry and microbiology seemed to support the autointoxication hypothesis, and mainstream physicians promoted the idea. [8] Daly notes that, historically, "purging was one of the few procedures that a physician could perform with visible, often impressive results and without immediate or obvious dangers". [25]

Ilya Ilyich Mechnikov (1845–1916) became the strongest supporter of the idea of colon cleansing; he thought that toxins could shorten the lifespan. Over time, the concept broadened to autointoxication, which supposes that the body cannot fully dispose of its waste products and toxins, which then accumulate in the intestine. [23] In some cases, the concept led to radical surgeries to remove the colon for unrelated symptoms. [26]

Autointoxication enjoyed some favor in the medical community in the late 19th and early 20th centuries, but clinicians discarded it as advances in science failed to support its claims. [3] [11] [23] A 1919 paper entitled "Origin of the so-called auto-intoxication symptom" in the Journal of the American Medical Association marked the beginning of the rejection of the auto-intoxication hypothesis by the medical community. [8] [27]

Despite a lack of scientific support, autointoxication persists in the public imagination. In the 1990s the practice of colon cleansing experienced a resurgence [3] in the alternative-medical community, supported by testimonials and anecdotal evidence and promoted by manufacturers of colon-cleansing products. [3] [23]

See also

Related Research Articles

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<span class="mw-page-title-main">Enema</span> Injection of fluid into rectum, typically en route to the colon

An enema, also known as a clyster, is an injection of fluid into the lower bowel by way of the rectum. The word enema can also refer to the liquid injected, as well as to a device for administering such an injection.

<span class="mw-page-title-main">Constipation</span> Bowel dysfunction

Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement. Complications from constipation may include hemorrhoids, anal fissure or fecal impaction. The normal frequency of bowel movements in adults is between three per day and three per week. Babies often have three to four bowel movements per day while young children typically have two to three per day.

<span class="mw-page-title-main">Laxative</span> Agents that relax and loosen the bowels and stools

Laxatives, purgatives, or aperients are substances that loosen stools and increase bowel movements. They are used to treat and prevent constipation.

<span class="mw-page-title-main">Diverticulitis</span> Digestive disease of the large intestine

Diverticulitis, also called colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal pouches—diverticula—that can develop in the wall of the large intestine. Symptoms typically include lower abdominal pain of sudden onset, but the onset may also occur over a few days. There may also be nausea, diarrhea or constipation. Fever or blood in the stool suggests a complication. People may experience a single attack, repeated attacks, or ongoing "smouldering" diverticulitis.

<span class="mw-page-title-main">Diverticulosis</span> Condition of the wall of the intestine

Diverticulosis is the condition of having multiple pouches (diverticula) in the colon that are not inflamed. These are outpockets of the colonic mucosa and submucosa through weaknesses of muscle layers in the colon wall. Diverticula do not cause symptoms in most people. Diverticular disease occurs when diverticula become clinically inflamed, a condition known as diverticulitis.

<span class="mw-page-title-main">Malabsorption</span> Medical condition

Malabsorption is a state arising from abnormality in absorption of food nutrients across the gastrointestinal (GI) tract. Impairment can be of single or multiple nutrients depending on the abnormality. This may lead to malnutrition and a variety of anaemias.

<span class="mw-page-title-main">Ileus</span> Medical condition

Ileus is a disruption of the normal propulsive ability of the intestine. It can be caused by lack of peristalsis or by mechanical obstruction. The word 'ileus' is from Ancient Greek eileós. The term 'subileus' refers to a partial obstruction.

<span class="mw-page-title-main">Small intestinal bacterial overgrowth</span> Medical condition

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Mucoid plaque is a pseudoscientific term used by some alternative medicine advocates to describe what is claimed to be a combination of harmful mucus-like material and food residue that they say coats the gastrointestinal tract of most people. The term was coined by Richard Anderson, a naturopath and entrepreneur, who sells a range of products that claim to "cleanse" the body of such purported plaques.

<span class="mw-page-title-main">Intussusception (medical disorder)</span> Medical condition

Intussusception is a medical condition in which a part of the intestine folds into the section immediately ahead of it. It typically involves the small bowel and less commonly the large bowel. Symptoms include abdominal pain which may come and go, vomiting, abdominal bloating, and bloody stool. It often results in a small bowel obstruction. Other complications may include peritonitis or bowel perforation.

<span class="mw-page-title-main">Volvulus</span> Twisting of part of the intestine, causing a bowel obstruction

A volvulus is when a loop of intestine twists around itself and the mesentery that supports it, resulting in a bowel obstruction. Symptoms include abdominal pain, abdominal bloating, vomiting, constipation, and bloody stool. Onset of symptoms may be rapid or more gradual. The mesentery may become so tightly twisted that blood flow to part of the intestine is cut off, resulting in ischemic bowel. In this situation there may be fever or significant pain when the abdomen is touched.

<span class="mw-page-title-main">Fecal impaction</span> Medical condition

A fecal impaction or an impacted bowel is a solid, immobile bulk of feces that can develop in the rectum as a result of chronic constipation. Fecal impaction is a common result of neurogenic bowel dysfunction and causes immense discomfort and pain. Its treatment includes laxatives, enemas, and pulsed irrigation evacuation (PIE) as well as digital removal. It is not a condition that resolves without direct treatment.

Detoxification is a type of alternative-medicine treatment which aims to rid the body of unspecified "toxins" – substances that proponents claim accumulate in the body over time and have undesirable short-term or long-term effects on individual health. Activities commonly associated with detoxification include dieting, fasting, consuming exclusively or avoiding specific foods, colon cleansing, chelation therapy, certain kinds of IV therapy and the removal of dental fillings containing amalgam.

<span class="mw-page-title-main">Bisacodyl</span> Laxative

Bisacodyl (INN) is an organic compound that is used as a stimulant laxative drug. It works directly on the colon to produce a bowel movement. It is typically prescribed for relief of episodic and chronic constipation and for the management of neurogenic bowel dysfunction, as well as part of bowel preparation before medical examinations, such as for a colonoscopy.

<span class="mw-page-title-main">Whole bowel irrigation</span> Medical process

Whole bowel irrigation (WBI) is a medical process involving the rapid administration of large volumes of an osmotically balanced macrogol solution, either orally or via a nasogastric tube, to flush out the entire gastrointestinal tract.

<span class="mw-page-title-main">Sir William Arbuthnot Lane, 1st Baronet</span> British surgeon

Sir William Arbuthnot Lane, 1st Baronet, CB, FRCS was a British surgeon and physician. He mastered orthopaedic, abdominal, and ear, nose and throat surgery, while designing new surgical instruments toward maximal asepsis. He thus introduced the "no-touch technique", and some of his designed instruments remain in use.

A coffee enema is the injection of coffee into the rectum and colon via the anus, i.e., as an enema. There is no scientific evidence to support any positive health claim for this practice, and medical authorities advise that the procedure may be dangerous.

<span class="mw-page-title-main">Amoebiasis</span> Human disease caused by amoeba protists

Amoebiasis, or amoebic dysentery, is an infection of the intestines caused by a parasitic amoeba Entamoeba histolytica. Amoebiasis can be present with no, mild, or severe symptoms. Symptoms may include lethargy, loss of weight, colonic ulcerations, abdominal pain, diarrhea, or bloody diarrhea. Complications can include inflammation and ulceration of the colon with tissue death or perforation, which may result in peritonitis. Anemia may develop due to prolonged gastric bleeding.

<span class="mw-page-title-main">Charles Alfred Tyrrell</span>

Charles Alfred Tyrrell was a promoter of medical devices, most notably an enema appliance. He was also author of tracts promoting the use of his device for colon cleansing as therapy for detoxification pursuant to a theory of auto-intoxication.

References

  1. ↑ Emmanuel, A V; Krogh, K; Bazzocchi, G; Leroi, A-M; Bremers, A; Leder, D; van Kuppevelt, D; Mosiello, G; Vogel, M; Perrouin-Verbe, B; Coggrave, M; Christensen, P (20 August 2013). "Consensus review of best practice of transanal irrigation in adults" (PDF). Spinal Cord. 51 (10): 732–738. doi: 10.1038/sc.2013.86 . PMID   23958927.
  2. ↑ "Barium enema". MedlinePlus. U.S. Department of Health & Human Services – National Institutes of Health (NIH). Retrieved 6 August 2014.
  3. 1 2 3 4 5 Ernst E (June 1997). "Colonic Irrigation and the Theory of Autointoxication: A Triumph of Ignorance over Science". Journal of Clinical Gastroenterology. 24 (4): 196–8. doi: 10.1097/00004836-199706000-00002 . PMID   9252839.
  4. 1 2 3 "Colon Therapy". American Cancer Society. Archived from the original on 24 April 2015.
  5. ↑ "Do you really need to clean your colon?". Marketplace . CBC Television. 2009. Archived from the original on 2010-03-15. Retrieved 2010-05-03.
  6. 1 2 3 Schneider, K (2003-02-27). "How Clean Should Your Colon Be?". American Council on Science and Health . Retrieved 2014-07-19.
  7. 1 2 3 4 Barrett, S (2008-03-09). "Gastrointestinal Quackery: Colonics, Laxatives, and More". Quackwatch . Retrieved 2008-09-02.
  8. 1 2 3 Wanjek, C (2006-08-08). "Colon Cleansing: Money Down the Toilet". LiveScience . Retrieved 2008-11-10.
  9. ↑ Donaldson, AN (1922). "Relation of constipation to intestinal intoxication". JAMA . 78 (12): 884–8. doi:10.1001/jama.1922.02640650028011.
  10. ↑ "Colon Cleansing: Don't Be Misled By the Claims". Ebsco. 2013-01-14. Retrieved 2013-11-13.
  11. 1 2 Adams, C (1990-05-25). "Does colonic irrigation do you any good?". The Straight Dope . Retrieved 2008-09-02.
  12. ↑ Brody, J (2008-07-22). "Health 'Facts' You Only Thought You Knew". The New York Times . Retrieved 2012-10-06.
  13. 1 2 3 Picco, M (2007-03-21). "Colon cleansing: Is it helpful or harmful?". The Mayo Clinic . Retrieved 2008-11-09.
  14. ↑ Handley DV, Rieger NA, Rodda DJ (November 2004). "Rectal perforation from colonic irrigation administered by alternative practitioners". Med. J. Aust. 181 (10): 575–6. doi:10.5694/j.1326-5377.2004.tb06454.x. hdl: 2440/42823 . PMID   15540974. S2CID   6541837.
  15. ↑
    • Centers for Disease Control and Prevention (CDC) (March 1981). "Amebiasis associated with colonic irrigation—Colorado". MMWR Morb. Mortal. Wkly. Rep. 30 (9): 101–2. PMID   6789134.
    • Istre GR, Kreiss K, Hopkins RS, et al. (August 1982). "An outbreak of amebiasis spread by colonic irrigation at a chiropractic clinic". N. Engl. J. Med. 307 (6): 339–42. doi:10.1056/NEJM198208053070603. PMID   6283354.
  16. 1 2 Tennen M (June 2007). "The Dangers of Colon Cleansing". HealthAtoZ.com. Archived from the original on 2008-06-13. Retrieved 2008-09-01.
  17. ↑ Eisele JW, Reay DT (October 1980). "Deaths related to coffee enemas". JAMA. 244 (14): 1608–9. doi:10.1001/jama.1980.03310140066036. PMID   7420666.
  18. ↑ Hall, Harriet (2018). "The Care and Feeding of the Vagina". Skeptical Inquirer. 42 (5): 28–29.
  19. ↑ McFerran, Tanya (21 February 2008). Martin, Elizabeth A (ed.). Colonic irrigation. Oxford University Press. p. 103. ISBN   978-0-199-21177-7.{{cite book}}: |work= ignored (help)
  20. ↑ MarileeSchmelzer, Lawrence R.Schiller, Richard Meyer, Susan M.Rugari, PattiCase (November 2004). "Safety and effectiveness of large-volume enema solutions". Applied Nursing Research. 17 (4): 265–274. doi:10.1016/j.apnr.2004.09.010. PMID   15573335.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  21. ↑ Youngson M.D., Robert M.; et al. (2005). Encyclopedia of Family Health. Vol. 3. USA: Marshall Cavandish. p. 384. ISBN   978-0-7614-7489-0.
  22. ↑ Mishori, Ranit; Jones, Aminah Alleyne; Otubu, Aye (2011). "The dangers of colon cleansing: patients may look to colon cleansing as a way to 'enhance their well-being,' but in reality, they may be doing themselves harm". Journal of Family Practice. 60 (8): 454.
  23. 1 2 3 4 Chen TS, Chen PS (1989). "Intestinal autointoxication: a medical leitmotif". J. Clin. Gastroenterol. 11 (4): 434–41. doi:10.1097/00004836-198908000-00017. PMID   2668399.
  24. ↑ Ebbel, B. (1937). The Papyrus Ebers. Copenhagen: Levin and Munksgaard. pp. 30–32.
  25. ↑ Daly, Ann (1996). Fantasy Surgery 1880-1930. The Wellcome Institute Series in the History of Medicine. Vol. 38. Rodopi (published 1997). p. 67. ISBN   9789042000094 . Retrieved 2013-11-25. [...]purging was one of the few procedures that a physician could perform with visible, often impressive results and without immediate or obvious dangers.
  26. ↑ Smith JL (March 1982). "Sir William Arbuthnot-Lane, 1st Baronet, chronic intestinal stasis, and autointoxication". Annals of Internal Medicine . 96 (3): 365–9. doi:10.7326/0003-4819-96-3-365. PMID   7036818.
  27. ↑ Alvarez, WC (1919). "Origin of the so-called auto-intoxication symptom". JAMA . 72 (1): 8–13. doi:10.1001/jama.1919.02610010014002.
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