Colon Hydrotherapy for Irritable Bowel Syndrome
For those with irritable bowel syndrome, there is a safe and natural treatment option that has been overlooked: Colon hydrotherapy, also called colonic irrigation or more simply, a colonic.
Between 10 percent and 20 percent of people have irritable bowel syndrome or IBS. More women than men suffer from the disorder. IBS typically comes with intestinal cramping, constipation, abdominal pain and periodic diarrhea. So any treatment that helps relieve these symptoms is a welcome option for IBS sufferers.
In this article
What is colon hydrotherapy?
Note that colon hydrotherapy or a colonic is not the same as an enema. I cannot tell you how many patients have asked me this question over the years. An enema is using an enema bag to push water up into your colon, waiting a few minutes and then letting it flush out.
Colonic irrigation also pushes water into the colon. But it does this with a mechanical pump that inserts water in and then suctions the water back out. The suctioned water is then safely disposed of, while fresh water is pumped back into the colon. This slow and easy pumping and suction process will continue for 20 minutes to 45 minutes depending upon the situation and condition. Typical cycles of flushing range from five to ten times.
Colon hydrotherapists are certified and they must complete a course and examination to receive this certification. Many practitioners in other modalities will also include colon irrigation with their other treatments.
Colon hydrotherapy is not the same as an enema. An enema also inserts water through the rectum. But the water has a lack of pressure and will typically reach the top of the rectum.
A 2017 review of the research on colon hydrotherapy from University of Bologna doctors determined significant evidence for the conclusion that the technique had value for those with intestinal issues:
“In conclusion, there is adequate evidence based on convincing clinical data to re-examine the scientific community’s total rejection of this method …”
The review also identified clinical studies that showed a colonic can have significant benefits:
Moreover, some controlled studies have appeared comparing the effect of irrigation and lavage with conventional treatment approaches, in particular, for constipation and fecal incontinence which reap the greatest benefits both in terms of symptoms and quality of life.
A number of other studies have supported the irrigation technique for constipation patients. But we also find clinical research showing benefits to patients suffering from irritable bowel symptoms.
Colonics relieve IBS symptoms
A clinical study from the Mackay Memorial Hospital in Taipei City, Taiwan tested 18 patients with IBS. Twelve of them had IBS-C, which means IBS with constipation.And six of the patients had IBS-D which means they had
The researchers treated the patients with different ranges of colonic irrigation periods, ranging from one to four weeks. They tested them throughout the treatment period, and used patient diaries.
The researchers found that the colonics more than doubled the number of bowel movements the constipation IBS group. Among the IBS-D group, there was significantly less diarrhea – about a third of the diarrhea. Meanwhile, the IBS patients as a whole had significantly easier bowel movements.
“Colonic irrigation also improved the stool consistency in most participants, whether this was for hard, lumpy stool in IBS-C or loose, watery stool in IBS-D patients. The results demonstrate colonic irrigation is effective in improving IBS-related constipation and diarrhea.”
The patients also had significantly less abdominal pain after the colonic treatments. The average pain scores were 4.23 before the treatment period and 0.73 following the treatment period. This means an 87 percent reduction in pain.
Distress and discomfort scores improved by 200 percent (doubled) and bowel movement satisfaction increased from 3.10 to 6.52. Again, more than double.
Controversy in colonic research
Other research has shown similar results after colonic irritation. But this doesn’t mean the treatment has been controversial. There are some studies showing a lack of treatment success with colonics – not specifically for IBS, but for digestive issues in general.
An example of this is a study that reviewed research prior to 2010 on colon hydrotherapy efficacy. But there were serious flaws in this study, as we’ll discuss.
An investigation into the references of the article published by the Journal of Family Practice shows serious discrepancies among the evidence and context of the information presented. This is not my opinoin, but rather, according to other 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.”
Among 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. Colon hydrotherapy can improve bowel function. 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.”
Is colon hydrotherapy safe?
The International Association for Colon Hydrotherapy (IACT), which certifies colon hydrotherapists, also spoke out against the article. IACT Executive director A.R. Hoenninger clarified, “Colon hydrotherapy when performed by a trained therapist using FDA registered equipment and disposable speculums or rectal nozzles is safe.”
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).
Bazzocchi G, Giuberti R. Irrigation, lavage, colonic hydrotherapy: from beauty center to clinic? Tech Coloproctol. 2017 Jan;21(1):1-4. doi:10.1007/s10151-016-1576-6.
Hsu HH, Leung WH, Hu GC. Treatment of irritable bowel syndrome with colonic irrigation system: a pilot study. Tech Coloproctol. 2016 Aug;20(8):551-7. doi: 10.1007/s10151-016-1491-x.
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.
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.