Picture a colon 23 cm in diameter, so impacted with faecal material that there is only a 1 cm thick opening for fresh faecal material to pass through. This is what an American doctor, Dr Bernard Jensen, claimed he often saw in autopsies and this is what led him to believe that the colon is too often neglected and why colon hydrotherapy has merit. He is the author of the book Tissue Cleansing through Bowel Movement.

Colon hydrotherapy is an established complementary and alternative therapy and is increasingly practiced in South Africa. This article will explore the basics of colon hydrotherapy or colon irrigation. Although it may not appeal to all people, proponents of this therapy claim that they feel rejuvenated, detoxified and refreshed after a therapy session. One of the famous proponents of colon hydrotherapy was Diana, Princess of Wales.

Picture a colon 23 cm in diameter, so impacted with faecal material that there is only a 1 cm thick opening for fresh faecal material to pass through. This is what an American doctor, Dr Bernard Jensen, claimed he often saw in autopsies and this is what led him to believe that the colon is too often neglected and why colon hydrotherapy has merit. He is the author of the book Tissue Cleansing through Bowel Movement.

Colon hydrotherapy is an established complementary and alternative therapy and is increasingly practiced in South Africa. This article will explore the basics of colon hydrotherapy or colon irrigation. Although it may not appeal to all people, proponents of this therapy claim that they feel rejuvenated, detoxified and refreshed after a therapy session. One of the famous proponents of colon hydrotherapy was Diana, Princess of Wales.

Colon hydrotherapy is an internal body healing therapy and is described as the use of standard enemas for the rectosigmoid area of the colon or the use of apparatus for the prolonged irrigation of the higher colon.¹ It advocates a healthy colon for elimination of the buildup of toxins in the body.²

Colon hydrotherapy is also known as colon irrigation or colon therapy.¹ Water is introduced into the lower intestine to loosen impacted materials and to detoxify the colon.² The belief is that pieces of impacted faecal matter sometimes stick to the lining of the colon and that their constituents can then be reabsorbed by the bloodstream. Sometimes enzymes, herbs or coffee are added to the water.¹

Historical background

The exact date when colon hydrotherapy was first used is unknown but it can possibly be traced back to the ancient Egyptians.³ The occasion when the gods passed it down to the Egyptians have been described as follows: “Thoth himself had revealed the enema one day to a few priest-physicians who were standing on the banks of the Nile. The god of medicine and science had landed on the water in the form of a sacred ibis. Filling his beak with water, he had injected it into his anus. The doctors took the hint, and the result was a great boon to humanity, the Devine Clyster.”⁴ The ancient Egyptians appear to have made frequent use of the enema or clyster in their medical and surgical textbooks.

Enemas were, however, not limited to the Egyptians. Inscriptions on, for example, Babylonian and Assyrian tablets, Hindu medical texts, pre-Colombian Mayan art, as well as Hippocrates and Galen, made mention of enemas. The 17th century became known as the “age of the enema”. It was fashion in Parisian society to enjoy as many as three to four enemas per day, the popular belief being that an internal washing or lavement was essential to well being. The clyster reached the true height of its fashion in the early years of the reign of Louis XIV (1638-1715), who apparently had more than 2 000 enemas during his career! The introduction of rubber by the middle of the 18th century made it possible to use rubber for the making of enema apparatus. Pump systems were incorporated which allowed individuals to perform their own enemas. Improvements over time allowed a greater cleansing of larger parts of the colon. The technique was used in the spas of 19th century Europe, and became increasingly popular in the West. The therapy was brought to prominence in the USA in 1917 when Dr Kellogg reported in the Journal of American Medicine that he had successfully used diet, exercise and enema (colon hydrotherapy), for the treatment of gastrointestinal disease in more than 40 000 cases without surgery. Colon hydrotherapy continued to grow and was flourishing in the USA by the early 1950s. Towards the mid-1960s its use began to dwindle in hospitals and nursing homes, and in approximately 1972 the colostomy and prescription laxatives became favoured.4 Improvements in the equipment and procedure continued, however, and with modern technological advancements, safety procedures and more skilled therapists, colon hydrotherapy has become a recognised complementary and alternative medicine (CAM) therapy as an adjunct to mainstream medicine. Colon hydrotherapy is practised in the United States according to the scope of practice of the International Association for Colon Hydrotherapists (I-ACT) and the use of equipment registered with the FDA is strongly recommended. Conditions frequently treated Proponents of colon irrigation claim that it can provide relief for a wide range of symptoms. Colon irrigation is frequently used for constipation, diarrhoea, bloating, indigestion and other gastrointestinal disorders. Yet, although it is often advocated for constipation no clinical trial data exist to prove its effectiveness and the risk-benefit ratio is uncertain.¹

It is also used for the removal of “toxins” in a wide range of conditions including addictions and allergies. According to its proponents, it can also provide relief for headache, backache, halitosis, lethargy and skin problems. A typical treatment session Colon hydrotherapy is an extended and more complete form of an enema. Both colon hydrotherapy and the standard enema involve the infusion of aqueous substances into the rectum. Whereas a standard enema involves the injection of water (one way) into the colon that is then retained and evacuated by the patient, colon hydrotherapy consists of an instrument-controlled continual bathing of the colon for cleansing and therapeutic purposes. Different to the use of enemas, there is no offensive odour or health risk to the patient or practitioner, and the dignity of the patient is maintained. Furthermore, it is claimed that whereas an enema’s cleansing ability is limited to the rectosigmoid area for a short period of time, colon hydrotherapy extends beyond the natural expulsion area to offer greater cleansing and therapeutic benefits.

During a session, most clothing may be kept on, or a gown may be used. The procedure essentially involves inserting a small rectal tube or speculum approximately 2.5 cm to 7.5 cm into the rectum. The speculum or rectal tube allows for temperature and pressurecontrolled, warm filtered water to flow into the rectum and through the colon with the objective of cleansing and balancing the colon. The duration of a session, the temperature of the water and the pressure of the water can be varied. The treatment allows for the softening of faecal material, which assists in the removal of the faecal material from the large intestine. The colon hydrotherapist may also gently manipulate the abdomen during the procedure to enhance the removal of waste material. The therapist may furthermore vary his or her techniques of abdominal manipulation, and lymphatic drainage, reflexology or energy work may also be used on a patient.

The process of filling and releasing is repeated several times during a session. The oral intake of an electrolyte solution is often recommended following a colon hydrotherapy session and the therapist may also recommend the use of products containing bifidus, acidophilus, cell salts or other similar products. The patient may also be referred to a general practitioner for further treatment. It is said that colon hydrotherapy best benefits the body when used in combination with adequate nutrient and fluid intake, as well as exercise.

The therapeutic effect of colon hydrotherapy is claimed to be improved muscle tone, which facilitates peristaltic action and enhances the absorption of nutrients from the caecum and ascending colon while minimising the absorption of toxic waste material. The cleansing effects of colon hydrotherapy further claim to reduce stagnation and subsequent bacterial proliferation in the colon and assist in maintaining harmony of the intestinal flora. Contraindications, adverse effects and risks

Although proponents of colon hydrotherapy claim that it is safe, the following is a list of known contraindications³:

• Uncontrolled hypertension
• Congestive heart failure
• Aneurysm
• Severe anaemia
• Gastrointestinal haemorrhage or perforation
• Severe haemorrhoids, or fissures and fistulas
• Renal insufficiency
• Cirrhosis
• Carcinoma of the colon, or recent (less than 3 months) colon surgery
• Pregnancy (especially during the first and third trimester, since colon hydrotherapy may induce labour)
• Abdominal hernia.

Colon irrigation removes the essential “healthy” and protective bacteria that occur naturally in the intestines together with the faeces and toxins. Potentially hazardous electrolyte imbalances can also easily occur due to the infusion of large amounts of fluids (primarily, or only water) into the colon.⁴ It is believed that a regular, balanced diet, high in fibre, can achieve the same effect against constipation and the possible build-up of toxins.

The putting of tubes into the rectum and colon could lead to perforation and unless the equipment is properly sterilised, there is a risk of crossinfection. Other risks therefore include infections and perforations, and deaths have even been reported.

Conclusion

Colon hydrotherapy is offered at various health resorts and clinics and many people claim to benefit from it. Home colon irrigation kits are also available. Most health care professionals, however, do not endorse the therapy unless it is conducted under strict medical supervision and for a specific medical indication (such as impacted faeces leading to chronic constipation). Generally it can therefore be stated that colon hydrotherapy is considered to be a therapy without sufficient evidence for its effectiveness.

REFERENCES

1. The Desktop Guide to Complementary and Alternative Medicine: An Evidence-Based Approach. 2001. Ed. by Ernst E, Pittler MH, Stevinson C & White A. London: Mosby.
2. Gordon RJ, Nienstedt BC & Gesler WM. 1998. Alternative Therapies: Expanding Options in Health Care. New York: Springer Publishing Company, Inc.
3. Novey DW. 2000. Clinician’s Complete Reference to Complementary & Alternative Medicine. St Louis: Mosby, Inc.
4. Shealy CN. 1999. The Complete Illustrated Encyclopedia of Alternative Healing Therapies. Dorset: Element Books Limited.