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Who should avoid colonics?

While most people should avoid hydrotherapy, it's especially important that irrigation be avoided by: Anyone with diverticulitis, Crohn's disease, ulcerative colitis or ischemic colitis. Anyone who has had prior colon surgery. Anyone with kidney disease.

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This popular treatment may come with risks

Colon cleansing, also called colonic hydrotherapy and colonic irrigation, is promoted for digestive issues such as bloating, colitis, constipation and indigestion. It is also touted for completely unrelated problems that include arthritis, alcoholism, allergies, lethargy, asthma and skin conditions. Advertising Policy Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy “While this popular complementary treatment offers a great option for some patients with specific problems, I caution people about its use for routine problems and outside of a colonic hydrotherapist supervision,” says colorectal surgeon Eric Johnson, MD. Dr. Johnson explains the top four things you need to know about colon cleansing and what to expect.

1. What is colon cleansing?

Colon cleansing involves flushing the colon with large volumes of fluid. Patients who can benefit from colon cleansing have severe constipation resistant to laxative use. Irrigating and evacuating stool from the colon can bring these people immediate relief. A trained hydrotherapist performs the procedure in the medical facility under a physician’s direction. The use of disposable equipment and meticulous disinfection every time avoids bacterial contamination.

During a 45 minute colon cleansing, you can expect:

Step 1. A brief rectal exam.

Step 2. A speculum will be introduced 1.5 inches into the rectum. An inlet and outlet tube is then attached to the outside of the speculum. The procedure has a closed system so there is no odor. Step 3. Afterwards, the influx of carefully controlled amounts of filtered water — about 60 liters — is introduced. Step 4. Gentle abdominal massaging is started to help remove waste and gas pockets.

2. Unproven theories behind the practice

Hydrotherapy is based on the ancient autointoxication theory that the body poisons itself by retaining waste products. Removing fecal waste was believed to improve health. However, the idea that the average person’s colon needs to be cleansed or that this offers health benefits is not proven. “While this procedure is something I do offer to some patients, it’s for problems that have not been resolved after trying other, much gentler options,” says Dr. Johnson.

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Most of us can resolve our digestive issues with laxatives, probiotics, exercise and good bowel routines by allowing appropriate time. “Generally, I would argue that when our bodies are in good health, they are equipped to cleanse themselves,” notes Dr. Johnson.

3. Risks may be involved

The adverse side effects of colon hydrotherapy may include:

Mild cramping

Abdominal pain

Fullness

Bloating

Nausea

Vomiting

Perianal soreness

Some herbal preparations used in hydrotherapy have been associated with cases of aplastic anemia and liver toxicity. Rectal perforation and disseminated abscesses have also been reported. “Colonic cleaning via hydrotherapy can result in perforation of the colon in rare cases,” says Dr. Johnson. “This risk increases if the procedure is performed by an individual without proper training.”

4. Who should avoid hydrotherapy?

While most people should avoid hydrotherapy, it’s especially important that irrigation be avoided by:

Anyone with diverticulitis, Crohn’s disease, ulcerative colitis or ischemic colitis.

Anyone who has had prior colon surgery.

Anyone with kidney disease.

Anyone with heart disease.

These conditions increase the risks of dehydration, acute kidney failure, pancreatitis, bowel perforation, heart failure and infection. It’s important to make sure you ask your doctor whether colon hydrotherapy is right for you and that it’s recommended for your symptoms. A study noted that while there is adequate evidence to re-examine the method, rigorous studies must be performed on their short- and long-term effectiveness. Also, be sure the hydrotherapist is certified by the National Board for Colon Hydrotherapy (NBCH) or International Association for Colon Hydrotherapy (IACH).

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