Serious Flaws in Colonic Review

colonicAn investigation into the references of a recent article published by the Journal of Family Practice shows serious flaws among the evidence and context of the information presented, according to some health experts. Some research was taken out of context, and others appear to be misrepresented in the report.

In one statement made in the article, it says that there is no evidence of hydrotherapy efficacy, while referencing a review article (Richards et al. 2006) that actually states: “there is no clinical evidence that refutes the many clinical reports of efficacy among a myriad of health professionals.”

Furthermore, another study, also referenced in the article, showed that after colonic irrigation on ten patients with or without constipation:

“The number of leukocytes and their demarcation were then evaluated. The number and ratio of lymphocytes increased significantly after irrigation. This result suggested that colon irrigation might induce lymphocyte transmigration from gut-associated lymphatic tissues into the circulation, which may improve colon and immune system function.”

While the article accurately mentions rare adverse effects, the article amplifies the risk of these effects by stating: “Most reports in the literature note a variety of adverse effects of colon cleansing that range from mild (eg, cramping, abdominal pain, fullness, bloating, nausea, vomiting, perianal irritation, and soreness) to severe (eg, electrolyte imbalance and renal failure).” Yet the 2006 review of the scientific research states:

“Although there is little specific literature on colonic irrigations, a review of the literature on related procedures such as enemas and sigmoidoscopies suggests that the risk of serious adverse effects is very low when the irrigations are performed by trained personnel using appropriate equipment.” (Richards et al. 2006)

Out of the five references Dr. Mishori uses for the adverse effects statement, three relate to colonoscopy pretreatments – that use sodium phosphate and polyethylene glycol – rather than natural colon hydrotherapy; another is the reference above (Richards) and the last one is a report of one patient in Malaysia that apparently suffered confusion and memory loss from “acute water intoxicational hyponatremia” (too much water) following an enema (which is not the same as colon hydrotherapy administered by a trained professional).

In one of these references used to substantiate adverse effects from colon hydrotherapy (Abaskharoun et al. 2007), the administration of oral sodium phosphate or polyethylene glycol in preparation for colonoscopy was given to 767 patients by medical doctors in advance of a colonoscopy. Out of these 767 patients who received sodium phosphate or polyethylene glycol, 6.8% of those receiving sodium phosphate suffered from renal (kidney) failure and 8.7% of those receiving polyethylene glycol suffered renal (kidney) failure.

According to the literature, the administration of sodium phosphate and/or polyethylene glycol is not and has never been a practice of natural colon hydrotherapy for the purpose of removing putrefied waste from the colon.

The last of the five references used in the article is a monograph by the Natural Standard website, which states:

“Colon therapy, also called colonic irrigation and colonic hydrotherapy, has been popularized as a holistic health care practice on the basis of the unproven theory that it promotes health by removing toxins and pathogens from the colon. Colon therapy is practiced primarily in alternative health clinics.
Colon therapy involves flushing the colon with water in different quantities, temperatures and pressures.
There is limited clinical evidence validating colon therapy as a health promotion practice.”

Amongst these rare reports of adverse effects are tens if not hundreds of thousands of people who receive colon hydrotherapy every year. Just in the UK alone, an estimated 5600 people receive colon hydrotherapy every month. Many licensed health professionals report success using colon hydrotherapy with few if any side effects when performed by a professional.

Some health experts have spoken out against the findings of the article. “I don’t agree there are no benefits,” says Dr. Jamey Wallace, ND, and clinic medical director for Bastyr University’s Center for Natural Health, according to an interview with WebMD author Kathleen Doheny.

“If someone is constipated and they have no other medical diagnosis, it can be very helpful,” Dr. Wallace told WebMD. He added that colon hydrotherapy can improve bowel function, and cautioned that “Certain people should not consider hydrotherapy. Among them are people with colon cancer, ulcerative colitis, and other bowel problems.”

“If a patient is interested in a colonic irrigation they should first see a physician to make sure there are not health concerns that should be addressed medically,” said Dr. Wallace.

The International Association for Colon Hydrotherapy (IACT), which certifies colon hydrotherapists, also spoke out against the article. IACT Executive director A.R. Hoenninger told WebMD that, “Colon hydrotherapy when performed by a trained therapist using FDA registered equipment and disposable speculums or rectal nozzles is safe.”


Mishori R. The Journal of Family Practice, August 2011; vol 60: pp 454-457.

Richards DG, McMillin DL, Mein EA, Nelson CD. Colonic irrigations: a review of the historical controversy and the potential for adverse effects. J Altern Complement Med. 2006 May;12(4):389-93.

Abaskharoun R, Depew W, Vanner S. Changes in renal function following administration of oral sodium phosphate or polyethylene glycol for colon cleansing before colonoscopy. Can J Gastroenterol. 2007 Apr;21(4):227-31.

Colon therapy/colonic irrigation. Natural Standard Professional Monograph. 2011.

Rex D. Dosing considerations in the use of sodium phosphate bowel preparations for colonoscopy Ann Pharmacother. 2007;41:1466–1475.

Doheny K. Colon Cleansing May Be Risky, Study Finds. WebMD Health.

Norlela S, Izham C, Khalid BA. Colonic irrigation-induced hyponatremia. Malays J Pathol. 2004 Dec;26(2):117-8.

Comment: If we are to abandon a therapy based on the reports of a few adverse side effects, perhaps we might consider other forms of medical therapies, that have more damaging effects first. For example, Carolyn Dean, M.D., N.D., in her book “Death By Medicine” (2005), compiled the following statistics for 2005:

Hospital Adverse Reaction…. 106,000 deaths
Medical Error…. 98,000 deaths
Bedsores…. 115,000 deaths
Infection…. 88,000 deaths
Malnutrition…. 108,800 deaths
Outpatient Adverse Reaction…. 199,000 deaths
Unnecessary Procedures…. 37,136 deaths
Surgery-Related…. 32,000 deaths
Total Annual Deaths…. 783,936 deaths

Furthermore, the Journal of the American Medical Association (Lazarou et al. 1998) reported that in 1994, 2,216,000 Americans were either hospitalized, permanently disabled, or died as a result of pharmaceuticals. According to a nationwide poll conducted by Louis Harris and Associates released in 1997 by the National Patient Safety Foundation and the American Medical Association, an estimated 100 million Americans experienced a medical mistake: 42% of those randomly surveyed. Misdiagnosis and wrong treatments accounted for 40% of those mistakes. Medical medication errors accounted for 28% of these, and medical procedure errors accounted for 22% of these. In a study of four Boston adult primary care practices involving 1202 outpatients, 27% of responders experienced adverse drug events (Gandhi et al. 2003).

Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA. 1998 Apr.

Dean C. Death by Modern Medicine. Belleville, ON: Matrix Verite-Media, 2005.

Gandhi TK, Weingart SN, Borus J, Seger AC, Peterson J, Burdick E, Seger DL, Shu K, Federico F, Leape LL, Bates DW. Adverse drug events in ambulatory care. N Engl J Med. 2003 Apr 17;348(16):1556-64.

The Living Cleanse

Case Adams is a California Naturopath with a PhD in Natural Health Sciences, and Board Certified Alternative Medicine Practitioner. He has authored 26 books on natural healing strategies. “My journey into writing about alternative medicine began about 9:30 one evening after I finished with a patient at the clinic I practiced at over a decade ago. I had just spent the last two hours explaining how diet, sleep and other lifestyle choices create health problems and how changes in these, along with certain herbal medicines and other natural strategies can radically yet safely turn ones health around. As I drove home that night, I realized I needed to get this knowledge out to more people. So I began writing about health with a mission to reach those who desperately need this information. The strategies in my books and articles are backed by scientific evidence along with wisdom handed down through traditional medicines for thousands of years.” Case connects with the elements by surfing, hiking and being a beach bum.

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