This article originally appeared on VICE US
Reading a description of a colonic is enough to make most people squirm. Essentially, a tube is inserted into the rectum, and a large amount of water (up to 60 liters) is pumped in. Sometimes herbs, fiber, coffee, or other goodies are added to the mix.
“It’s like an enema on steroids,” says Ranit Mishori, a physician and professor of family medicine at Georgetown University School of Medicine. Meanwhile, Tonic’s human guinea pig, Grant Stoddard, memorably described the procedure as one where “water is fed into your butthole through a hose to sluice out crap,” performed by “Roto-Rooters of the rectum.” I haven’t been able to look at plumbing equipment the same way since.
So why on earth would anyone want to partake of this industrial-sized rectal cocktail? The alternative names for a colonic (intestinal lavage, colonic hydrotherapy, colonic irrigation, or colon cleansing) hint at the reason: harnessing the alleged cleansing powers of water. Proponents of colonics argue that many of us are carrying around blockages of poop and other gunk in our intestines, and our bodies need some help in flushing it all out. Supposedly this can not only reduce constipation, but also lead to weight loss, more energy, relief from allergies, and clearer skin.
This belief that the colon needs to be cleansed recurs throughout history, from ancient Egyptians to early Greeks to 20th-century Americans to our current celebrity wellness-obsessed moment. These fads often center on the idea of autointoxication, or self-poisoning, from feces accumulating in the colon.
“I think it largely has to do with a generalized lack of understanding of how the gastrointestinal tract works, and how the body works to clear out toxins and process indigestible food,” says Brooks D. Cash, director of Gastroenterology with McGovern Medical School at UTHealth and UT Physicians in Houston, Texas.
Cash emphasizes that there’s no reliable evidence that colonics have any health benefits, either for general health or for specific conditions. “Any benefit or improvement in feeling that people get with regard to general health likely is a placebo effect,” he explains.
Sure, some people may feel lighter after a colonic, but that’s mainly down to diarrhea. Most colonics, like most detox teas, are essentially laxatives by another name. And colonic-driven diarrhea can cause serious electrolyte imbalance—in this case the loss of important minerals like potassium, magnesium, and calcium that are flushed out along with other bodily fluids, Mishori says.
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And the purported cleansing/detox benefits simply don’t exist. Mishori explains, “There is no such thing as ‘detoxing’ through colon cleansing. The body detoxes naturally through the kidneys and the liver. It does so 24/7 and it does not need any external help.”
There’s misinformation and misleading advertising about colonics, which may be especially appealing to people who distrust conventional medicine. And as Cash says, “When you have movie stars and public personae who are attractive and who endorse certain practices, I think that makes it attractive to laypeople as well.” (Yes, Gwyneth Paltrow’s site Goop mentions the benefits of colonics.)
Not only are colonics useless, they also come with serious risks, one being the possible transmission of harmful bacteria. In 2015, doctors reported that a 78-year-old man developed E. coli septic shock following a colonic where herb-infused water was pumped into his rectum. In the late 1970s, colonic equipment heavily contaminated by fecal coliform bacteria caused an outbreak of amebiasis (an intestinal infection caused by the parasite E. histolytica) in one Colorado clinic, leading to at least six deaths.
And because they’re generally not performed by medical workers with scientifically recognized licenses, or with equipment that is FDA-approved for non-medical colonic hydrotherapy, there’s no guarantee of basic hygiene standards.
Aside from bacteria, the strong pressure of the water can also lead to colovesical fistula (an abnormal opening between the colon and the bladder) and perforation (rupture) of the rectum or bowel wall—definitely not places where you want holes. Even without perforation, colonics can lead to rectal pain and bleeding. One recent case report described a 34-year-old man who’d been experiencing such pain after his fifth colonic. The culprit was two hard plastic pieces of a catheter used to pump in water that had become lodged in his rectum.
Colonics have also been linked to abscesses, pancreatitis, and heart failure. “More commonly, we see nausea, vomiting, cramping, bloating, diarrhea, and dehydration,” Mishori says. And “the risks can be much higher for those who have any medical conditions—especially heart, kidney, liver, or gastroenterological disease.”
Cash says that while the FDA has issued warning letters to some companies offering colonics, it’s got bigger fish to fry. Or to use his more colorful metaphor, when it comes to regulating the marketing of colonics, “This is a fly on an elephant’s rear end.”
For people who do have severe constipation and want relief, much gentler enemas and prescription laxatives can be helpful. And people with defecation disorders, such as difficulty coordinating the pelvic floor muscles, can turn to pelvic floor training and biofeedback therapy where patients gain greater control of the defecation process.
But the only reason to have a colon cleansing is as preparation for a medically necessary procedure, like a colonoscopy or gastrointestinal surgery, and even then doctors usually recommend laxatives and over-the-counter enema kits for this purpose.
As for the purported benefits? “If the purpose of colonics is to enhance wellness….well, we already have alternatives with extensive scientific proof—namely, regular exercise, a healthy diet, drinking in moderation, and not smoking,” Mishori points out. A fiber-rich diet, drinking plenty of water, and physical activity are all linked to healthy bowel movements. The advice may seem boring, but it’s stood the test of time (and, unlike a colonic, doesn’t come with the prospect of watching your own liquidy poop shuttling through a tube).
Ultimately, Mishori comments, “it is a pointless procedure. You will be throwing money down the toilet, almost literally.”