Ketan Kulkarni, M.D. Summer 2014 - Vol. 9, No. 2

Colon Cleansing: Medical Breakthrough or Myth?

Ketan Kulkarni, M.D.
Regional Gastroenterology Associates of Lancaster


Colon cleansing has been a popular topic recently; not a week goes by without seeing a television commercial, a magazine advertisement, or an infomercial that describes its purported benefits. Colon cleansing is a broad term that encompasses a variety of techniques that include fasting and juice fasts; oral regimens that contain laxatives, dietary supplements, or herbs; and enema preparations and colon hydrotherapy. Common colon cleanse preparations include ingredients such as senna, aloe vera, sodium phosphate, coffee, flaxseed, probiotics, fiber, or magnesium oxide.1

Colon hydrotherapy specifically refers to a process which utilizes tubes to irrigate the colon with water in an effort to clean out the colon of fecal matter. In some instances herbs or other supplements are also added to the irrigation process. A therapist might massage the abdomen to help remove waste which is expelled from the body by another tube. Colon cleansing is becoming more popular due to advertising that successfully attracts potential clients by promoting its natural quality that makes use of herbs, rather than traditional medicine, in order to detoxify the body.


The advocates of colon cleansing claim that it offers a variety of benefits including an ability to increase energy level and concentration, improve weight loss and well-being, prevent colon cancer, strengthen the immune system, and improve overall health. They suggest that cleansing one’s colon can help treat a variety of illnesses such as alcoholism, allergies, asthma, cardiovascular disease, infections, arthritis and even cancer. Given all of the supposed benefits, one would imagine that colon cleansing would be a widely accepted procedure indicated for many individuals. Unfortunately the claims made by advocates of colon cleansing do not match the reality.

The rationale behind colon cleansing is the theory that toxins and undigested material build up in one’s colon over a prolonged period of time and eventually are absorbed by the body, resulting in a variety of symptoms such as fatigue, headaches, depression and weight gain. This theory of autointoxication dates back to the ancient Egyptians and was further advanced by Hippocrates, the father of Western medicine.1,2 During the nineteenth century colonic cleansing became more widespread and was considered mainstream, but subsequent advances in science have led us to better understand the normal function of the colon. It soon became apparent that there was no scientific evidence to support the theory of autointoxication. Indeed, a recent literature search conducted by Mishori and colleagues demonstrated no scientific studies to support colon cleansing.1 We now understand that the liver is the primary organ in the body for detoxification. The lining of the colon is designed to prevent absorption of unwanted substances and the human body is able to naturally eliminate waste material.


While colon cleansing has never been proven to provide a benefit, it has been associated with deleterious side effects that many people may not be aware of. Even the least invasive, oral only, regimens can be associated with potentially adverse effects such as cramping, abdominal pain, and vomiting.1,3 Significant electrolyte abnormalities and renal failure have also been associated with colon cleansing. Case reports have documented serious complications of colonic hydrotherapy such as pelvic abscesses, air emboli, colitis, and rectal perforation.1,4 If equipment is not properly sterilized, infections can be passed from patient to patient. In fact, one outbreak of amebiasis spread by colonic irrigation resulted in the death of six people.5 Furthermore some treatments are quite expensive, while providing no medical benefit to the individual undergoing the cleansing.

The only proper medical indication for colon cleansing is preparation prior to a colonoscopy. The Food and Drug Administration has never approved any device for non-medical use of colon cleansing. Furthermore, though the FDA has written a number of warning letters for unapproved use of devices for colon cleansing,3 it classifies the additives used for colon cleansing as dietary supplements, and does not regulate them either.


While colon cleansing may not result in any actual benefits, there are simple things people can do to maintain a healthy colon. Epidemiologic and observational studies have suggested that a well-balanced diet high in fiber as well as regular physical activity may protect against the development of colon cancer.6,7 A diet low in red meat intake is likely beneficial as well.8 Tobacco use and alcohol consumption have both been linked to an increased risk of colon cancer.9 Finally, making sure one is being adequately screened by colonoscopies at regular intervals can help identify and remove precancerous polyps which may have led to the development of colon cancer.


Despite the growing popularity of colon cleansing, evidence supporting its benefit is lacking. Techniques for colon cleansing include oral regimens, enema preparations and colonic irrigation or hydrotherapy. The FDA does not regulate the preparations used for colon cleansing. Furthermore, many patients are unaware of the potential side effects associated with colon cleansing, some of which can be quite severe. While colon cleansing provides no proven benefit to patients, there are many ways individuals can improve colon health. Lifestyle changes, such as following a well-balanced diet high in fiber, participating in regular physical activity, and undergoing appropriate colon cancer screening will help reduce one’s risk for the development of colon cancer.


1. 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.

2. Ernst E (1997). "Colonic irrigation and the theory of auto-intoxication: a triumph of ignorance over science". Journal of Clinical Gastroenterology 24 (4): 196–8.

3. Barrett, S (2010). "Gastrointestinal Quackery: Colonics, Laxatives, and More". Quackwatch.

4. Picco, M (2012). "Colon cleansing: Is it helpful or harmful?". The Mayo Clinic.

5. Istre GR, Kreiss K, Hopkins RS et al. (1982). "An outbreak of amebiasis spread by colonic irrigation at a chiropractic clinic". N. Engl. J. Med. 307 (6): 339–42.

6. Physical activity and colon cancer prevention: a meta-analysis. Wolin KY, Yan Y, Colditz GA, Lee IM. Br J Cancer. 2009;100(4):611.

7. Dietary fiber and colorectal adenoma in a colorectal cancer early detection programme. Peters U, Sinha R, Chatterjee N, et al. Lancet. 2003;361(9368):1491.

8. Dietary fat, cholesterol and colorectal cancer in a prospective study. Järvinen R, Knekt P, Hakulinen T, et al. Br J Cancer. 2001;85(3):357.

9. Alcohol drinking and colorectal cancer risk: an overall and dose-response meta-analysis of published studies. Fedirko V, Tramacere I, Bagnardi V, et al. Ann Oncol. 2011 Sep;22(9):1958-72. Epub 2011 Feb 9.