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{{short description|Psuedoscience procedure to cleanse human colon}}
{{short description|Pseudoscience procedure to cleanse human colon}}
{{About|the alternative medicine technique|the process to clean the colon before [[Colonoscopy|medical imaging]]|Enema}}
{{About|the alternative medicine technique|uses in [[medicine|standard medicine]]|Enema|and|Transanal irrigation|and|Bowel cleansing}}

{{infobox alternative medical intervention
{{infobox alternative medical intervention
| name = Colon cleansing
| name = Colon cleansing
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| image_size =
| image_size =
| alt =
| alt =
| caption = Colon cleansing bag
| caption = Large enema equipment for colon cleansing
| claims = Removal of unspecified toxins
| claims = Removal of unspecified toxins
| topics =
| topics =
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{{alternative medicine sidebar|fringe}}
{{alternative medicine sidebar|fringe}}


'''Colon cleansing''' (also known as '''colon therapy''') encompasses a number of [[alternative medicine|alternative medical therapies]] claimed to remove nonspecific [[Toxin#Misuse of the term|toxins]] from the [[colon (anatomy)|colon]] and intestinal tract by removing any accumulations of [[feces]]. Colon cleansing may be branded '''colon hydrotherapy''', a '''colonic''' or '''colonic irrigation'''. During the 2000s Internet marketing and [[infomercial]]s of oral supplements supposedly for colon cleansing increased.<ref name="Marketplace2009">{{cite web |url=http://www.cbc.ca/marketplace/2009/how_not_to_win_500000/busted.html |title=Do you really need to clean your colon? |publisher=[[CBC Television]] |work=[[Marketplace (Canadian TV program)|Marketplace]] |accessdate=2010-05-03 |year=2009 |archive-url=https://web.archive.org/web/20100315153906/http://www.cbc.ca/marketplace/2009/how_not_to_win_500000/busted.html |archive-date=2010-03-15 |url-status=dead }}</ref> Colon cleansing in this context should not be confused with an [[enema]] which introduces fluid into the colon under mainstream medical supervision for a limited number of purposes including severe constipation<ref name=Emmanuel2013>{{cite journal|last1=Emmanuel|first1=A V|last2=Krogh|first2=K|last3=Bazzocchi|first3=G|last4=Leroi|first4=A-M|last5=Bremers|first5=A|last6=Leder|first6=D|last7=van Kuppevelt|first7=D|last8=Mosiello|first8=G|last9=Vogel|first9=M|last10=Perrouin-Verbe|first10=B|last11=Coggrave|first11=M|last12=Christensen|first12=P|title=Consensus review of best practice of transanal irrigation in adults|journal=Spinal Cord|date=20 August 2013|volume=51|issue=10|pages=732–738|doi=10.1038/sc.2013.86|pmid=23958927}}</ref> or medical imaging.<ref name=NIH_barium>{{cite web |url = https://www.nlm.nih.gov/medlineplus/ency/article/003817.htm |title = Barium enema |website = MedlinePlus |publisher = U.S. Department of Health & Human Services – National Institutes of Health (NIH) |accessdate = 6 August 2014 }}</ref>
'''Colon cleansing''', also known as '''colon therapy''', '''colon hydrotherapy''', a '''colonic''', or '''colonic irrigation''', encompasses a number of [[alternative medicine|alternative medical therapies]] claimed to remove toxins from the [[colon (anatomy)|colon]] and intestinal tract by removing 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<ref name=Emmanuel2013>{{cite journal|last1=Emmanuel|first1=A V|last2=Krogh|first2=K|last3=Bazzocchi|first3=G|last4=Leroi|first4=A-M|last5=Bremers|first5=A|last6=Leder|first6=D|last7=van Kuppevelt|first7=D|last8=Mosiello|first8=G|last9=Vogel|first9=M|last10=Perrouin-Verbe|first10=B|last11=Coggrave|first11=M|last12=Christensen|first12=P|title=Consensus review of best practice of transanal irrigation in adults|journal=Spinal Cord|date=20 August 2013|volume=51|issue=10|pages=732–738|doi=10.1038/sc.2013.86|pmid=23958927|doi-access=free|url=https://www.openaccessrepository.it/record/26579/files/fulltext.pdf}}</ref> and medical imaging.<ref name=NIH_barium>{{cite web |url = https://www.nlm.nih.gov/medlineplus/ency/article/003817.htm |title = Barium enema |website = MedlinePlus |publisher = U.S. Department of Health & Human Services – National Institutes of Health (NIH) |access-date = 6 August 2014 }}</ref>


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 regimens use [[dietary fiber]], herbs, [[dietary supplement]]s, or [[laxative]]s. People who practice colon cleansing believe that accumulations of putrefied feces line the walls of the [[large intestine]] and that these accumulations harbor [[parasite]]s or pathogenic [[gut flora]], causing [[nonspecific symptom]]s and general ill-health. This "auto-intoxication" hypothesis is based on medical beliefs of the [[Ancient Egypt]]ians and [[Ancient Greece|Greeks]] and was discredited in the early 20th century.<ref name="ACS"/>
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 supplement]]s, or [[laxative]]s. 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 [[parasite]]s or pathogenic [[gut flora]], causing [[nonspecific symptom]]s and general ill-health.


'''Autointoxication''', a term coined in 1884 by the French physician [[Charles Jacques Bouchard]],<ref name = Ernst/> is a hypothesis based on medical beliefs of the [[ancient Egypt]]ians and [[Ancient Greece|Greeks]] and was discredited in the early 20th century.<ref name="ACS"/> Nonetheless, during the 2000s Internet marketing and [[infomercial]]s of oral supplements supposedly for colon cleansing increased.<ref name="Marketplace2009">{{cite web |url=http://www.cbc.ca/marketplace/2009/how_not_to_win_500000/busted.html |title=Do you really need to clean your colon? |publisher=[[CBC Television]] |work=[[Marketplace (Canadian TV program)|Marketplace]] |access-date=2010-05-03 |year=2009 |archive-url=https://web.archive.org/web/20100315153906/http://www.cbc.ca/marketplace/2009/how_not_to_win_500000/busted.html |archive-date=2010-03-15 |url-status=dead }}</ref>
There is no scientific evidence for the alleged benefits of colon cleansing.<ref name="ACS">{{cite web|title=Colon Therapy|url=http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/ManualHealingandPhysicalTouch/colon-therapy|publisher=American Cancer Society|archiveurl=https://web.archive.org/web/20150424180208/http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/ManualHealingandPhysicalTouch/colon-therapy|archivedate=24 April 2015|url-status=dead}}</ref> Certain enema preparations have been associated with [[Myocardial infarction|heart attack]]s and [[water-electrolyte imbalance|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 [[defecation|defecate]] and some herbs may reduce the effectiveness of, or increase the risks associated with the use of prescription medications.<ref name = Schneider>{{cite web | url = http://acsh.org/news/2003/02/27/how-clean-should-your-colon-be | publisher = [[American Council on Science and Health]] | last = Schneider | first= K | title = How Clean Should Your Colon Be? | date = 2003-02-27 | accessdate = 2014-07-19 }}</ref>

There is no scientific evidence for the alleged benefits of colon cleansing.<ref name="ACS">{{cite web|title=Colon Therapy|url=http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/ManualHealingandPhysicalTouch/colon-therapy|publisher=American Cancer Society|archive-url=https://web.archive.org/web/20150424180208/http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/ManualHealingandPhysicalTouch/colon-therapy|archive-date=24 April 2015|url-status=dead}}</ref> Certain enema preparations have been associated with [[Myocardial infarction|heart attack]]s and [[water-electrolyte imbalance|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 [[defecation|defecate]] and some herbs may reduce the effectiveness of, or increase the risks associated with the use of prescription medications.<ref name = Schneider>{{cite web | url = http://acsh.org/news/2003/02/27/how-clean-should-your-colon-be | publisher = [[American Council on Science and Health]] | last = Schneider | first= K | title = How Clean Should Your Colon Be? | date = 2003-02-27 | access-date = 2014-07-19 }}</ref>


== Effectiveness and risks ==
== Effectiveness and risks ==
The symptoms that are attributed to auto-intoxication—[[headache]], [[fatigue (medical)|fatigue]], [[Anorexia (symptom)|loss of appetite]] and [[Annoyance|irritability]]—may be caused by mechanical distention within the bowel, such as [[irritable bowel syndrome]], rather than toxins from putrefying food.<ref name = Quackwatch/><ref name = Wanjek/><ref>{{cite journal | last = Donaldson | first = AN | title = Relation of constipation to intestinal intoxication | journal = [[Journal of the American Medical Association|JAMA]] | volume = 78 |issue=12 | pages = 884–8 | year = 1922 |doi=10.1001/jama.1922.02640650028011 }}</ref> 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.<ref name = Ernst /><ref name = Beth>{{cite web | title = Colon Cleansing: Don't Be Misled By the Claims | url = http://redmondregional.com/your-health/condition_detail.dot?id=13996&lang=English&db=hlt&ebscoType=healthlibrary&widgetTitle=FOR%20ALL%20HOSTS%20***%20EBSCO%20-%20Condition%20Detail%20v2 | accessdate = 2013-11-13 | date = 2013-01-14 | publisher = Ebsco }}</ref> 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.<ref name = StraightDope/>
The symptoms that are attributed to autointoxication—[[headache]], [[fatigue (medical)|fatigue]], [[Anorexia (symptom)|loss of appetite]] and [[Annoyance|irritability]]—may be caused by mechanical distention within the bowel, such as [[irritable bowel syndrome]], rather than toxins from putrefying food.<ref name = Quackwatch/><ref name = Wanjek/><ref>{{cite journal | last = Donaldson | first = AN | title = Relation of constipation to intestinal intoxication | journal = [[Journal of the American Medical Association|JAMA]] | volume = 78 |issue=12 | pages = 884–8 | year = 1922 |doi=10.1001/jama.1922.02640650028011 }}</ref> 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.<ref name = Ernst /><ref name = Beth>{{cite web | title = Colon Cleansing: Don't Be Misled By the Claims | url = http://redmondregional.com/your-health/condition_detail.dot?id=13996&lang=English&db=hlt&ebscoType=healthlibrary&widgetTitle=FOR%20ALL%20HOSTS%20***%20EBSCO%20-%20Condition%20Detail%20v2 | access-date = 2013-11-13 | date = 2013-01-14 | publisher = Ebsco }}</ref> 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.<ref name = StraightDope/>


As the colon normally expels waste, colon cleansing is generally unneeded.<ref name = NYT>{{cite news | url = https://www.nytimes.com/2008/07/22/health/22brod.html | accessdate = 2012-10-06 | date = 2008-07-22 | last = Brody | first = J | work = [[The New York Times]] | title = Health 'Facts' You Only Thought You Knew }}</ref><ref name=MayoClinic>{{cite web |url=http://www.mayoclinic.com/health/colon-cleansing/AN00065 |title=Colon cleansing: Is it helpful or harmful? | publisher = The [[Mayo Clinic]] | last = Picco | first = M |date=2007-03-21 |accessdate=2008-11-09}}</ref> Colonic irrigation can disrupt the bowel's [[normal flora]], and, if done frequently, can result in electrolyte depletion with [[dehydration]].<ref name=MayoClinic/> Rare but severe adverse events have been [[rectal]] perforation,<ref>{{cite journal |vauthors=Handley DV, Rieger NA, Rodda DJ |title=Rectal perforation from colonic irrigation administered by alternative practitioners |journal=Med. J. Aust. |volume=181 |issue=10 |pages=575–6 |date=November 2004 |pmid=15540974 |url=http://www.mja.com.au/public/issues/181_10_151104/letters_151104-3.html}}</ref> as well as [[amoebiasis|amoebic infection]], from poorly sterilised equipment.<ref>
As the colon normally expels waste, colon cleansing is generally unneeded.<ref name = NYT>{{cite news | url = https://www.nytimes.com/2008/07/22/health/22brod.html | access-date = 2012-10-06 | date = 2008-07-22 | last = Brody | first = J | work = [[The New York Times]] | title = Health 'Facts' You Only Thought You Knew }}</ref><ref name=MayoClinic>{{cite web |url=http://www.mayoclinic.com/health/colon-cleansing/AN00065 |title=Colon cleansing: Is it helpful or harmful? | publisher = The [[Mayo Clinic]] | last = Picco | first = M |date=2007-03-21 |access-date=2008-11-09}}</ref> Colonic irrigation can disrupt the bowel's [[normal flora]], and, if done frequently, can result in electrolyte depletion with [[dehydration]].<ref name=MayoClinic/> Rare but severe adverse events have been [[rectal]] perforation,<ref>{{cite journal |vauthors=Handley DV, Rieger NA, Rodda DJ |title=Rectal perforation from colonic irrigation administered by alternative practitioners |journal=Med. J. Aust. |volume=181 |issue=10 |pages=575–6 |date=November 2004 |pmid=15540974 |url=http://www.mja.com.au/public/issues/181_10_151104/letters_151104-3.html|doi=10.5694/j.1326-5377.2004.tb06454.x |hdl=2440/42823 |s2cid=6541837 |hdl-access=free }}</ref> as well as [[amoebiasis|amoebic infection]], from poorly sterilised equipment.<ref>
*{{cite journal |title=Amebiasis associated with colonic irrigation—Colorado |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=30 |issue=9 |pages=101–2 |date=March 1981 |pmid=6789134 |author1= Centers for Disease Control and Prevention (CDC)}}
*{{cite journal |title=Amebiasis associated with colonic irrigation—Colorado |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=30 |issue=9 |pages=101–2 |date=March 1981 |pmid=6789134 |author1= Centers for Disease Control and Prevention (CDC)}}
*{{cite journal |author1=Istre GR |title=An outbreak of amebiasis spread by colonic irrigation at a chiropractic clinic |journal=N. Engl. J. Med. |volume=307 |issue=6 |pages=339–42 |date=August 1982 |pmid=6283354 |doi= 10.1056/NEJM198208053070603 |name-list-format=vanc|author2=Kreiss K |author3=Hopkins RS |display-authors=3 |last4=Healy |first4=George R. |last5=Benziger |first5=Michael |last6=Canfield |first6=Thomas M. |last7=Dickinson |first7=Patricia |last8=Englert |first8=Timothy R. |last9=Compton |first9=Roy C. |last10=Mathews |first10=Henry M. |last11=Simmons |first11=Robert A.}}</ref> Others claim that colon cleansing may impede the colon's shedding of dead cells.<ref name="Tennen">{{cite web |url=http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/dc/caz/canc/colc/alert08162005.jsp |title=The Dangers of Colon Cleansing |author=Tennen M |date=June 2007 |work=HealthAtoZ.com |accessdate=2008-09-01 |archiveurl=https://web.archive.org/web/20080613223754/http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=%2Fhealthatoz%2FAtoz%2Fdc%2Fcaz%2Fcanc%2Fcolc%2Falert08162005.jsp |archivedate=2008-06-13 |url-status=dead }}</ref>
*{{cite journal |author1=Istre GR |title=An outbreak of amebiasis spread by colonic irrigation at a chiropractic clinic |journal=N. Engl. J. Med. |volume=307 |issue=6 |pages=339–42 |date=August 1982 |pmid=6283354 |doi= 10.1056/NEJM198208053070603 |name-list-style=vanc|author2=Kreiss K |author3=Hopkins RS |display-authors=3 |last4=Healy |first4=George R. |last5=Benziger |first5=Michael |last6=Canfield |first6=Thomas M. |last7=Dickinson |first7=Patricia |last8=Englert |first8=Timothy R. |last9=Compton |first9=Roy C. |last10=Mathews |first10=Henry M. |last11=Simmons |first11=Robert A.}}</ref> Others claim that colon cleansing may impede the colon's shedding of dead cells.<ref name="Tennen">{{cite web |url=http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/dc/caz/canc/colc/alert08162005.jsp |title=The Dangers of Colon Cleansing |author=Tennen M |date=June 2007 |work=HealthAtoZ.com |access-date=2008-09-01 |archive-url=https://web.archive.org/web/20080613223754/http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=%2Fhealthatoz%2FAtoz%2Fdc%2Fcaz%2Fcanc%2Fcolc%2Falert08162005.jsp |archive-date=2008-06-13 |url-status=dead }}</ref>


Excessive use of enemas has also been associated with heart problems, such as [[heart failure]],<ref name = MayoClinic/> as well as [[myocardial infarction|heart attacks]] related to electrolyte imbalances when performed as a [[coffee enema]].<ref>{{cite journal |vauthors=Eisele JW, Reay DT |title=Deaths related to coffee enemas |journal=JAMA |volume=244 |issue=14 |pages=1608–9 |date=October 1980 |pmid=7420666 |doi= 10.1001/jama.1980.03310140066036}}</ref> Frequent [[enema]]s or other colon-cleansing tools may lead to dependence and inability to defecate without assistance, as well as potential withdrawal symptoms.<ref name= Schneider/><ref name = Quackwatch/> Herbs taken orally may modulate the [[absorption (pharmacokinetics)|absorption]] or the activity of [[prescription medication]]s.<ref name = Schneider/>
Excessive use of [[enema]]s has also been associated with heart problems, such as [[heart failure]],<ref name = MayoClinic/> as well as [[myocardial infarction|heart attacks]] related to electrolyte imbalances when performed as a [[coffee enema]].<ref>{{cite journal |vauthors=Eisele JW, Reay DT |title=Deaths related to coffee enemas |journal=JAMA |volume=244 |issue=14 |pages=1608–9 |date=October 1980 |pmid=7420666 |doi= 10.1001/jama.1980.03310140066036}}</ref> Frequent enemas or other colon-cleansing tools may lead to dependence and inability to defecate without assistance, as well as potential withdrawal symptoms.<ref name= Schneider/><ref name = Quackwatch/> Herbs taken orally may modulate the [[absorption (pharmacokinetics)|absorption]] or the activity of [[prescription medication]]s.<ref name = Schneider/>
Medical doctor [[Harriet Hall]] writes that "The colon cleanses itself"... The idea that its walls are coated with years-old hamburger residue is preposterous".<ref name="Care and Feeding">{{cite journal |last1=Hall |first1=Harriet|authorlink=Harriet Hall |title=The Care and Feeding of the Vagina |journal=Skeptical Inquirer |date=2018 |volume=42 |issue=5 |pages=28–29 }}</ref>
Medical doctor [[Harriet Hall]] writes that "The colon cleanses itself... The idea that its walls are coated with years-old hamburger residue is preposterous".<ref name="Care and Feeding">{{cite journal |last1=Hall |first1=Harriet|author-link=Harriet Hall |title=The Care and Feeding of the Vagina |journal=Skeptical Inquirer |date=2018 |volume=42 |issue=5 |pages=28–29 }}</ref>


According to the [[American Cancer Society]], "Available [[evidence-based medicine|scientific evidence]] does not support claims that colon therapy is effective in treating cancer or any other disease".<ref name=ACS/>
==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."<ref>{{cite book|editor-first=Elizabeth A|editor-last=Martin|title=Colonic irrigation|work=A Dictionary Of Nursing|publisher=Oxford University Press|isbn=978-0-199-21177-7|page=103|url=https://books.google.com/books?id=0WvugujhtMkC&pg=PA103|date=21 February 2008|first=Tanya|last=McFerran}}</ref>


== Colon hydrotherapy ==
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.<ref>{{cite book|last=Youngson M.D. et all|first=Robert M.|title=Encyclopedia of Family Health|year=2005|publisher=Marshall Cavandish|location=USA|isbn=978-0-7614-7489-0|volume=3|page=384}}</ref>
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 [[enema]]s using water or other medication."<ref>{{cite book|editor-first=Elizabeth A|editor-last=Martin|title=Colonic irrigation|work=A Dictionary Of Nursing|publisher=Oxford University Press|isbn=978-0-199-21177-7|page=103|url=https://books.google.com/books?id=0WvugujhtMkC&pg=PA103|date=21 February 2008|first=Tanya|last=McFerran}}</ref>

During a cleansing enema, liquid is introduced into the colon and retained for five to fifteen minutes.<ref>{{cite journal|title=Safety and effectiveness of large-volume enema solutions| author= MarileeSchmelzer, Lawrence R.Schiller, Richard Meyer, Susan M.Rugari, PattiCase|date=November 2004| journal=Applied Nursing Research| doi=10.1016/j.apnr.2004.09.010| volume=17| issue=4| pages=265–274| pmid= 15573335}}</ref> 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.<ref>{{cite book|last=Youngson M.D.|first=Robert M.|display-authors=etal|title=Encyclopedia of Family Health|year=2005|publisher=Marshall Cavandish|location=USA|isbn=978-0-7614-7489-0|volume=3|page=384}}</ref>


Colonic irrigation has been described as an "unwise" procedure as it carries the risk of serious harm and has no proven benefit.<ref name=colonic>{{cite journal
Colonic irrigation has been described as an "unwise" procedure as it carries the risk of serious harm and has no proven benefit.<ref name=colonic>{{cite journal
|title=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
|title=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
|url=http://www.mdedge.com/jfponline/article/64413/gastroenterology/dangers-colon-cleansing
|url=http://www.mdedge.com/jfponline/article/64413/gastroenterology/dangers-colon-cleansing
|first1=Ranit
|first1=Ranit
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|year=2011}}</ref>
|year=2011}}</ref>


=== Regulation ===
== Supplement effectiveness ==
In the United States, the [[Food and Drug Administration (United States)|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.<ref name = Tennen/> 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.<ref name = Quackwatch/>
The consumer advocacy news program [[Marketplace (Canadian TV program)|Marketplace]] conducted a consumer trial with three women on the effectiveness of two colon supplements versus fiber.<ref name="Marketplace2009"/> 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".<ref name=ACS/>


== History ==
== History ==
The concept of "auto-intoxication", the idea that food enters the intestine and rots, provides a rationale for colon cleansing.<ref name = Quackwatch>
The concept of autointoxication, the idea that food enters the intestine and rots, provides a rationale for colon cleansing.<ref name = Quackwatch>
{{cite web | url = http://www.quackwatch.org/01QuackeryRelatedTopics/gastro.html | title = Gastrointestinal Quackery: Colonics, Laxatives, and More | last = Barrett | first = S | publisher = [[Quackwatch]] |authorlink = Stephen Barrett | date = 2008-03-09 | accessdate = 2008-09-02 }}
{{cite web | url = http://www.quackwatch.org/01QuackeryRelatedTopics/gastro.html | title = Gastrointestinal Quackery: Colonics, Laxatives, and More | last = Barrett | first = S | publisher = [[Quackwatch]] |author-link = Stephen Barrett | date = 2008-03-09 | access-date = 2008-09-02 }}
</ref><ref name = Chen/> The [[ancient Egypt]]ians believed that toxins formed as a result of decomposition within the intestines,<ref>{{Cite book|title = The Papyrus Ebers|last = Ebbel|first = B.|publisher = Levin and Munksgaard|year = 1937|isbn = |location = Copenhagen|pages = 30–32}}</ref> and moved from there into the [[circulatory system]], causing [[fever]] and the development of [[pus]]. The [[Ancient Greek]]s adopted and expanded the idea, applying their belief in the [[Humorism|four humours]]. In the 19th century, studies in [[biochemistry]] and [[microbiology]] seemed to support the autointoxication hypothesis, and mainstream physicians promoted the idea.<ref name = Wanjek>
</ref><ref name = Chen/> The [[ancient Egypt]]ians believed that toxins formed as a result of decomposition within the intestines,<ref>{{Cite book|title = The Papyrus Ebers|last = Ebbel|first = B.|publisher = Levin and Munksgaard|year = 1937|location = Copenhagen|pages = 30–32}}</ref> and moved from there into the [[circulatory system]], causing [[fever]] and the development of [[pus]]. The [[Ancient Greece|Ancient Greeks]] adopted and expanded the idea, applying their belief in the [[Humorism|four humours]]. In the 19th century, studies in [[biochemistry]] and [[microbiology]] seemed to support the autointoxication hypothesis, and mainstream physicians promoted the idea.<ref name = Wanjek>
{{cite web | url = http://www.livescience.com/health/060808_bad_colon.html | title = Colon Cleansing: Money Down the Toilet | last = Wanjek | first = C | authorlink = Christopher Wanjek | publisher = [[Imaginova|LiveScience]] | date = 2006-08-08 | accessdate = 2008-11-10 }}
{{cite web | url = http://www.livescience.com/health/060808_bad_colon.html | title = Colon Cleansing: Money Down the Toilet | last = Wanjek | first = C | author-link = Christopher Wanjek | publisher = [[Imaginova|LiveScience]] | date = 2006-08-08 | access-date = 2008-11-10 }}
</ref>
</ref>
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".<ref>
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".<ref>
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| last1 = Daly
| last1 = Daly
| first1 = Ann
| first1 = Ann
| title = Fantasy Surgery 1880-1930
| title = Fantasy Surgery 1880-1930
| series = The Wellcome Institute Series in the History of Medicine
| series = The Wellcome Institute Series in the History of Medicine
| volume = 38
| volume = 38
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| page = 67
| page = 67
| isbn = 9789042000094
| isbn = 9789042000094
| accessdate = 2013-11-25
| access-date = 2013-11-25
| quote = [...]purging was one of the few procedures that a physician could perform with visible, often impressive results and without immediate or obvious dangers.
| quote = [...]purging was one of the few procedures that a physician could perform with visible, often impressive results and without immediate or obvious dangers.
| year = 1996
| year = 1996
Line 81: Line 84:
</ref>
</ref>


[[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.<ref name="Chen">{{cite journal |vauthors=Chen TS, Chen PS |title=Intestinal autointoxication: a medical leitmotif|journal=[[J. Clin. Gastroenterol.]] |volume=11 |issue=4 |pages=434–41 |year=1989 | pmid=2668399 |doi=10.1097/00004836-198908000-00017 }}
[[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.<ref name="Chen">{{cite journal |vauthors=Chen TS, Chen PS |title=Intestinal autointoxication: a medical leitmotif|journal=[[J. Clin. Gastroenterol.]] |volume=11 |issue=4 |pages=434–41 |year=1989 | pmid=2668399 |doi=10.1097/00004836-198908000-00017 }}
</ref> In some cases, the concept led to radical surgeries to remove the colon for unrelated symptoms.<ref name="pmid7036818">
</ref> In some cases, the concept led to radical surgeries to remove the colon for unrelated symptoms.<ref name="pmid7036818">
{{cite journal |author=Smith JL |title=Sir William Arbuthnot-Lane, 1st Baronet, chronic intestinal stasis, and autointoxication |journal=[[Annals of Internal Medicine]] |volume=96 |issue=3 |pages=365–9|date=March 1982 |pmid=7036818 |doi=10.7326/0003-4819-96-3-365 |title-link=Sir William Arbuthnot-Lane, 1st Baronet }}</ref>
{{cite journal |author=Smith JL |title=Sir William Arbuthnot-Lane, 1st Baronet, chronic intestinal stasis, and autointoxication |journal=[[Annals of Internal Medicine]] |volume=96 |issue=3 |pages=365–9|date=March 1982 |pmid=7036818 |doi=10.7326/0003-4819-96-3-365 |title-link=Sir William Arbuthnot-Lane, 1st Baronet }}</ref>


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.<ref name = Ernst>
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.<ref name = Ernst>
{{cite journal|author=Ernst E |title=Colonic irrigation and the theory of auto-intoxication: a triumph of ignorance over science|journal=Journal of Clinical Gastroenterology |volume=24 |issue=4 |pages=196–8 |date=June 1997 |pmid=9252839 |doi= 10.1097/00004836-199706000-00002|url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0192-0790&volume=24&issue=4&spage=196}}</ref><ref name = StraightDope>
{{cite journal|author=Ernst E |title=Colonic Irrigation and the Theory of Autointoxication: A Triumph of Ignorance over Science|journal=Journal of Clinical Gastroenterology |volume=24 |issue=4 |pages=196–8 |date=June 1997 |pmid=9252839 |doi= 10.1097/00004836-199706000-00002|doi-access=free }}</ref><ref name = StraightDope>
{{cite web | url = http://www.straightdope.com/columns/read/852/does-colonic-irrigation-do-you-any-good | title = Does colonic irrigation do you any good? | last = Adams | first = C | authorlink = Cecil Adams | publisher = [[The Straight Dope]] |accessdate = 2008-09-02 | date = 1990-05-25 }}</ref><ref name = "Chen"/>
{{cite web | url = http://www.straightdope.com/columns/read/852/does-colonic-irrigation-do-you-any-good | title = Does colonic irrigation do you any good? | last = Adams | first = C | author-link = Cecil Adams | publisher = [[The Straight Dope]] |access-date = 2008-09-02 | date = 1990-05-25 }}</ref><ref name = "Chen"/>
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.<ref name = Wanjek /><ref>
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.<ref name = Wanjek /><ref>
{{cite journal | journal = [[Journal of the American Medical Association|JAMA]] |first = WC | last = Alvarez | year = 1919 | title = Origin of the so-called auto-intoxication symptom |volume=72 |issue=1|pages=8–13 |doi=10.1001/jama.1919.02610010014002|url = https://zenodo.org/record/1423417 }}
{{cite journal | journal = [[Journal of the American Medical Association|JAMA]] |first = WC | last = Alvarez | year = 1919 | title = Origin of the so-called auto-intoxication symptom |volume=72 |issue=1|pages=8–13 |doi=10.1001/jama.1919.02610010014002|url = https://zenodo.org/record/1423417 }}
</ref>
</ref>


Despite a lack of scientific support, "auto-intoxication" persists in the public imagination. The practice of colon cleansing has undergone a resurgence{{when|date=November 2013}} in the [[Alternative medicine|alternative-medical]] community, supported by [[testimonial]]s and [[anecdotal evidence|anecdotal]] evidence and promoted by manufacturers of colon-cleansing products.<ref name = Ernst /><ref name = "Chen" />
Despite a lack of scientific support, autointoxication persists in the public imagination. In the 1990s the practice of colon cleansing experienced a resurgence<ref name=Ernst/> in the [[Alternative medicine|alternative-medical]] community, supported by [[testimonial]]s and [[anecdotal evidence|anecdotal]] evidence and promoted by manufacturers of colon-cleansing products.<ref name = Ernst /><ref name = "Chen" />

== Regulation ==
In the United States the [[Food and Drug Administration (United States)|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.<ref name = Tennen/> 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.<ref name = Quackwatch/>


==See also==
==See also==
* [[Mucoid plaque]]
* [[Mucoid plaque]]
* [[Whole bowel irrigation]]


==References==
==References==
{{Reflist|33em}}
{{Reflist|33em}}


{{Naturopathy}}
{{pseudoscience}}
{{pseudoscience}}


Line 108: Line 110:
[[Category:Alternative detoxification]]
[[Category:Alternative detoxification]]
[[Category:Large intestine]]
[[Category:Large intestine]]
[[Category:Naturopathy]]
[[Category:Pseudoscience]]
[[Category:Pseudoscience]]

Latest revision as of 18:07, 25 October 2024

Colon cleansing
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 toxins from the colon and intestinal tract by removing 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]

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

[edit]

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]

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

[edit]

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

[edit]

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

[edit]

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

[edit]

References

[edit]
  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. ^ a b c d e 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. ^ a b c "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. ^ a b c Schneider, K (2003-02-27). "How Clean Should Your Colon Be?". American Council on Science and Health. Retrieved 2014-07-19.
  7. ^ a b c d Barrett, S (2008-03-09). "Gastrointestinal Quackery: Colonics, Laxatives, and More". Quackwatch. Retrieved 2008-09-02.
  8. ^ a b c 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. ^ a b 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. ^ a b c 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. ^ a b 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. ^ a b c d 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.