Are colonics safe?

Source: Best Health Magazine, May 2011

Canadians are increasingly turning to colonics (despite a cost of about $100 per session). They do it to manage constipation and other digestive problems such as gas and bloating, and for a general sense of "cleansing," often believing that such a practice maintains a healthy colon. As well, a long list of celebrities, including Madonna and Jennifer Aniston, reportedly swear by it.

Yet there is no medical evidence that supports any health benefits of colonics (also called colon hydrotherapy or colonic irrigation). "The vast majority of standard healthcare professionals would not endorse colonic hydrotherapy for any reason," says Dr. David Armstrong, a gastroenterologist and associate professor at McMaster University’s department of medicine. It can be quite uncomfortable, he adds, and there is a risk of electrolyte depletion, which can result in seizures, fainting and, potentially, death for some people with a history of heart disease or kidney disease or who are on blood pressure medication. (Most colonic clinics screen new clients for these risks as well as for hemorrhoids and anal fissures. You must also sign a liability waiver.) Despite these potential drawbacks, many are willing to give colonics a try.

Why people choose colon irrigation

Lisa Keith, a certified colon hydrotherapist opened Inside-Out Wellness in Vancouver three years ago. "There’s a lot more awareness of colonics in recent years," she says. "I’m hearing people say they are ‘on a cleanse,’ instead of ‘on a diet,’ and colonics are part and parcel of a cleanse." At least half of her clientele are repeat customers. Most come to get treatment for constipation. While Keith concedes that colonics do not result in permanent weight loss, many of her clients expect to get rid of gas and bloating and to feel "lighter." She adds: "There’s a whole mind-body connection."

Since opening its doors in June 2010, Colon Hydro Care in Toronto has attracted 300 clients ’60 percent women, 40 percent men’ says part-owner and certified colon hydrotherapist Marlena Roe. "Constipation, fatigue and irritable bowel syndrome are the top three reasons why people come."

The concern some medical professionals have with this trend is that while training and certification are available, the industry is self-regulated ‘anyone can hang up a shingle and practise. Health Canada approves colonic equipment; however, no one is monitoring how closely therapists follow the manufacturer’s recommendations on, for instance, the proper cleaning and sterilization of reusable equipment. Says Armstrong: "Risk of infection [from colonics] is rare if appropriate cleaning and sterilization procedures are used, but the point is that this intervention has the potential for harm."

How colonics work

The colon is the largest part of the intestine (it’s about five feet long if straightened), and is the last place food goes before it leaves the body through the rectum. The colon’s role is to extract water, salt and potassium from solid waste before it is eliminated. (The small intestine, located in the central abdomen, is where food’s nutrients are absorbed.)

Dr. Gabor Kandel, a gastroenterologist and associate professor of medicine at the University of Toronto, explains that a colonic flushes out the lower portion of the colon. "While there’s no compelling scientific literature that shows retention of stool causes significant or life-threatening problems, it can make life very unpleasant," he says. He does not endorse colonics, but does recognize that many people who suffer with chronic constipation find relief from the procedure (along with making dietary changes). He recommends discussing colonics with your doctor before trying one.

The only preparation for a session is to not eat solid food immediately beforehand. A colonic is done through either a closed or an open system. In both, a nozzle with tubes attached is inserted about one inch into the rectum; filtered water fills the colon; normal peristalsis action (pushing material out the rectum) occurs; and the person releases the stool and water. A session typically takes about 40 to 60 minutes. Depending on the person’s issues, several sessions can be required within days of each other.

Closed system: In these older and less expensive models, a person lies on his or her side, and a therapist inserts a nozzle (about one inch wide) that is attached to two tubes. The therapist controls how much water flows into the colon from one tube (maximum two to three psi [pounds per square inch]), sometimes massaging the abdomen. When the release occurs, it goes into the second tube (which goes into a waste receptacle), or the person has to rush to a toilet.

Open system: In these newer models, a person sits on a unit that has a toilet. He or she inserts the nozzle (about the size of a pencil) and regulates how much water goes in (the pressure is regulated by the machine at one psi), and expels as needed by pushing in tune with the body’s peristalsis so the material passes through the nozzle.

Roe says nutritional education should be an important part of the experience. “We want clients to understand that their diets play a major role in their digestive issues. If you start a cleansing process, you can’t just put a lot of candy and pop and meat and cookies back into your system.”

The, ahem, "bottom" line

Doctors differ over whether relief of constipation outweighs the risks of colonics, namely electrolyte depletion, and infection when reusable instruments are used (punctures were once a concern, but the nozzles are much smaller today).

Talk to your doctor about the options. If you do plan to try a colonic, ensure the clinic uses disposable equipment to avoid the small risk of infection, and check whether your therapist is certified.

This article was originally titled "The truth about…Colonics" in the May 2011 issue of Best Health. Subscribe today to get the full Best Health experience’and never miss an issue!’and make sure to check out what’s new in the latest issue of Best Health