|Alternative medicine / fringe therapies|
|Claims||Removal of (unspecified) toxins|
|Subsequent proponents||e.g. Dr. Oz, Gillian McKeith|
|See also||enema, detoxification, mucoid plaque|
Colon cleansing (also known as colon therapy) encompasses a number of alternative medical therapies claimed to remove nonspecific "toxins" from the colon and intestinal tract. Colon cleansing may be branded colon hydrotherapy, a colonic or colonic irrigation. During the 2000s internet marketing and infomercials of oral supplements supposedly for colon cleansing increased.
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. People who practice colon cleansing believe 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. This "auto-intoxication" hypothesis is based on medical beliefs of the Ancient Egyptians and Greeks and was discredited in the early 20th century.
No scientific evidence supports the alleged benefits of colon cleansing, and it "has no known medical value and risks damage to the rectum or bowel." The bowel itself is "not dirty” and, unless disease or medication interfere, "nature does a fine job of clearing out wastes." 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 prescription drugs.
Effectiveness and risks
The symptoms that are attributed to auto-intoxication—headache, fatigue, loss of appetite and irritability—are actually caused by mechanical distention within the bowel, such as irritable bowel syndrome, rather than toxins from putrefying food. 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. 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.
As the colon normally expels waste, colon cleansing is generally unneeded. Colonic irrigation can disrupt the bowel's normal flora and if done frequently can result in electrolyte depletion with dehydration. Rare but severe adverse events have been rectal perforation and amoebic infection from poorly sterilised equipment. Another claim is that it may impede the colon's shedding of dead cells.
Excessive use of enemas has also been associated with cardiac problems, such as heart failure, and heart attacks related to electrolyte imbalances when performed as coffee enema. Frequent enemas or other colon-cleansing tools may lead to dependence and inability to defecate without assistance or withdrawal symptoms. Herbs taken orally may interfere with drug absorption or activity of prescription drugs.
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."
During an enema, the water is retained in the colon for approximately 15 minutes. During a colonic, water is introduced into the colon and then it is flushed out and this is repeated until the entire colon is cleared. 
Colonic irrigation has been described as an "unwise" procedure as it carries the risk of serious harm and has no proven benefit.
The consumer advocacy news program Marketplace conducted a consumer trial with three women on the effectiveness of two colon supplements versus fiber. The results showed the supplements did not assist in weight loss and provided no additional benefit over a basic fiber supplement. 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".
The concept of "auto-intoxication", the idea that food enters the intestine and rots, provides a rationale for colon cleansing. The ancient Egyptians believed that toxins formed as a result of decomposition within the intestines, 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. 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".
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 "auto-intoxication", which supposes that the body cannot fully dispose of its waste products and toxins, which then accumulate in the intestine. In some cases, the concept led to radical surgeries to remove the colon for unrelated symptoms.
Auto-intoxication 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. 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.
Despite a lack of scientific support, "auto-intoxication" persists in the public imagination. The practice of colon cleansing has undergone a resurgence[when?] in the alternative-medical community, supported by testimonials and anecdotal evidence and promoted by manufacturers of colon-cleansing products.
In the United States the Food and Drug Administration (FDA) regulates the production of equipment used in colon hydrotherapy in the USA but does not regulate their use, or the supplements used in oral colon-cleansing regimens and manufacturer claims do not require verification or supporting evidence. The contents of the products are also not verified or tested. 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.
- "Do you really need to clean your colon?". Marketplace. CBC Television. 2009. Retrieved 2010-05-03.
- "Colon Therapy". American Cancer Society. 2008-01-11. Retrieved 2010-05-04.
- Brody, J (2008-07-22). "Health 'Facts' You Only Thought You Knew". The New York Times. Retrieved 2012-10-06.
- Schneider, K (2003-02-27). "How Clean Should Your Colon Be?". American Council on Science and Health. Retrieved 2014-07-19.
- Barrett, S (2008-03-09). "Gastrointestinal Quackery: Colonics, Laxatives, and More". Quackwatch. Retrieved 2008-09-02.
- Wanjek, C (2006-08-08). "Colon Cleansing: Money Down the Toilet". LiveScience. Retrieved 2008-11-10.
- Donaldson, AN (1922). "Relation of constipation to intestinal intoxication". JAMA 78 (12): 884–8. doi:10.1001/jama.1922.02640650028011.
- Ernst E (June 1997). "Colonic irrigation and the theory of auto-intoxication: a triumph of ignorance over science". Journal of Clinical Gastroenterology 24 (4): 196–8. doi:10.1097/00004836-199706000-00002. PMID 9252839.
- "Colon Cleansing: Don't Be Misled By the Claims". Ebsco. 2013-01-14. Retrieved 2013-11-13.
- Adams, C. "Does colonic irrigation do you any good?". The Straight Dope. Retrieved 2008-09-02.
- Picco, M (2007-03-21). "Colon cleansing: Is it helpful or harmful?". The Mayo Clinic. Retrieved 2008-11-09.
- Handley DV, Rieger NA, Rodda DJ (November 2004). "Rectal perforation from colonic irrigation administered by alternative practitioners". Med. J. Aust. 181 (10): 575–6. PMID 15540974.
- Centers for Disease Control (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.
- Tennen M (June 2007). "The Dangers of Colon Cleansing". HealthAtoZ.com. Archived from the original on 2008-06-13. Retrieved 2008-09-01.
- Eisele JW, Reay DT (October 1980). "Deaths related to coffee enemas". JAMA 244 (14): 1608–9. doi:10.1001/jama.1980.03310140066036. PMID 7420666.
- McFerran, Tanya (21 February 2008). "Colonic irrigation". In Martin, Elizabeth A. A Dictionary Of Nursing (Oxford University Press). p. 103. ISBN 0-199-21177-9.
- Youngson M.D. et all, Robert M. (2005). Encyclopedia of Family Health 3. USA: Marshall Cavandish. p. 384. ISBN 0-7614-7489-7.
- 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" (pdf). Journal of Family Practice 60 (8): 454.
- 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.
- Daly, Ann (1997). Fantasy Surgery 1880-1930. The Wellcome Institute Series in the History of Medicine 38. Rodopi. 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."
- 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.
- Alvarez, WC (1919). "Origin of the so-called auto-intoxication symptom". JAMA 72 (1): 8–13. doi:10.1001/jama.1919.02610010014002.