Colon hydrotherapy goes by many names: colonics, colon cleansing, and colonic irrigation are common stand-ins. But is colon hydrotherapy an effective method to “clean” your colon from waste and possible dysbiosis? 

Though they may sound like an effective way to promote detoxification and digestive health, we’ve taken a thorough look through the research, and found that the available evidence does not support these claims. Fortunately, there are many other therapies that can help you address the root cause of your gut health imbalances.

In this article, we’ll review the risks vs. benefits of colon hydrotherapy, why the research doesn’t support it as an effective alternative treatment method, and what you can do instead to investigate and address the root cause of your gut health issues. 

What Is Colon Hydrotherapy?

Colon hydrotherapy, or any of its other names mentioned above, refers to the practice of streaming water into the colon through a tube inserted into the rectum, filling the entire large intestine to stimulate peristalsis, and flushing waste out. The colonic is administered by a trained colon hydrotherapist, who may also administer enemas like coffee enemas or herbal infusions. Many people turn to colon hydrotherapy as a way to address severe constipation, dysbiosis, or parasites (1).

Colonics are much more invasive than a regular enema, where water is only inserted into the rectum and lower part of the large intestine to activate peristalsis. Enemas are generally recognized as safe and are even used before a colonoscopy to remove waste. However, some enemas, such as coffee enemas, can have side effects like abdominal pain and beyond (2). 

Health Benefits vs. Risks 

Proponents of colon cleansing suggest that the health benefits include (3):

• Reducing pathogenic bacteria and yeasts in the gastrointestinal tract
• Relieving constipation
• Regulating bowel movements
• Helping heal conditions like irritable bowel syndrome, colitis, and “autointoxication”
• Promoting weight loss
• Boosting your immune system

However, these reported benefits are based mostly on individual experience and not scientific research. This may be due in part to the placebo effect, which is quite common (4).

While it can take time for good quality evidence to emerge for alternative therapies, and we don’t necessarily want to be limited by the fact that a body of research is small, the available research at this time shows that colon hydrotherapy does not improve digestive or general health (3). 

While rare, there are also a number of adverse effects that have been associated with colon hydrotherapy, including (1):

• Inflammation in the colon
• Abdominal pain and cramping
• Electrolyte imbalance
• Rectal perforation
• Liver toxicity
• Kidney failure
• Acute water intoxication
• Amoeba infections 

Despite the popular narrative that we all need to detoxify, especially when it comes to the gut, colon cleansing may have a negative impact on your microbial balance. A randomized controlled trial found that when participants took purgatives (colon cleansing products taken orally), it decreased their total microbial load 31-fold, a drastic reduction in bacteria that could lead to dysbiosis (the growth of harmful bacteria) (5). Such a sudden change in your microbiome could open the door to hidden pathogens or cause other detrimental effects on the colon. 

The Research on Colon Hydrotherapy

Colon hydrotherapy is a widespread treatment for gut dysfunction, but the research unfortunately doesn’t back up its purported effectiveness. A systematic review found that the practice of colon cleansing is not supported by scientific literature. Furthermore, there are multiple reports of adverse effects occurring with the practice (3). 

You may feel better after a colon hydrotherapy session, but a better approach might be to  address the root cause of your symptoms with treatments that have been demonstrated to work (and are typically less expensive and less invasive). When you add in the expense, invasiveness, and potential harm that colon cleansing can cause, you’re probably better off seeking alternative solutions. 

There are two main issues with colon hydrotherapy not addressing root cause issues in the gut. 

1. Colon hydrotherapy doesn’t reach the small intestine, where something like SIBO may underlie symptoms of bloating, constipation, and maldigestion. So, while a colon cleanse might relieve your constipation temporarily, it will keep returning if an overgrowth of bacteria in the small intestine is responsible for your digestive symptoms. 
2. Colon health is an important piece of the puzzle, but it’s not the whole picture. Many people with gut health imbalances have root causes even higher up the digestive tract, like low stomach acid and digestive enzyme production from the pancreas (6, 7). For that matter, hormone imbalances, thyroid dysfunction, and nervous system dysregulation can all have a significant impact on gut health (8, 9, 10).  

Let’s turn now to investigating some of the potential root causes of digestive concerns. 

Investigating Your Gut Health

To solve your gut health challenges, look deeper at the potential root causes of issues in your gut in both the small and large intestine.

• SIBO (small intestinal bacterial overgrowth): As its name suggests, SIBO is a condition where excessive bacteria takes up residence in your small intestine, where there should actually be very little bacteria present. Common symptoms include constipation or diarrhea, brain fog, and fatigue (11, 12, 13). 
• Lack of digestive juices: Inadequate stomach acid and digestive enzymes can easily lead to digestive disturbances down the line (6, 7). These substances can decrease with age, but they may also be suppressed by pathogenic activity in the stomach and pancreas.
• Parasites/stealth infections: Roundworms, blastocystis hominis, trichomonas, H. Pylori, and Lyme are all examples of parasites or bacteria that can cause significant digestive symptoms from the stomach through the colon. Greatly reducing or eliminating the overgrowth of these microorganisms can help stabilize the gut and improve digestion (14).
• Motility issues or scarring: Structural damage to the gut can be a foundational issue. Scarring may be caused by abdominal surgery or severe inflammatory bowel disease (15, 16). There may also be dysregulation in the nervous system, especially the vagus nerve, causing digestion to speed up or slow down too much (17).

Foundations of Supporting Gut Health

Thankfully, there are many other methods besides colon hydrotherapy that you can use to regain excellent gut health. 

Diet

Addressing your diet is always the first step to fixing your gut and achieving optimal health. You can add supplements and antimicrobials all you like, but if the terrain in the gut isn’t prepared for a healthy microbiome, nothing will stick long-term. 

The food you eat sets the stage for a healthy gut or an inflamed one:

• The Paleo diet is our go-to recommendation because it emphasizes whole, unprocessed foods and eliminates symptom-causing foods to balance blood sugar and lower inflammation in the gut (18, 19, 20). 
• When the Paleo diet isn’t enough, the low-FODMAP diet can help further identify trigger foods and has been shown to improve symptoms related to IBS, IBD and SIBO, like constipation, gas, and bloating (21, 22, 23, 24). 
• Identifying your individual food sensitivities is also key. For example, simply avoiding gluten may be a key dietary change for some people. This one sensitivity may cause bloating, constipation, diarrhea, and other digestive symptoms (25). 

Finding the right diet for you may take some experimenting, but there is a step-by-step process you can follow. Begin with the Paleo diet, eliminating processed foods and common allergens and inflammatory foods like gluten, dairy, soy, and processed sugar. After a few weeks, reevaluate your symptoms and begin reintroducing trigger foods slowly. If your symptoms haven’t improved, you can move on to a more specialized dietary plan. 

Probiotics, HCl, and Digestive Enzymes

Once you’ve begun working on your diet, you can determine whether you might need some extra support. Supplements like probiotics, betaine HCl, and digestive enzymes can give your digestive system an extra boost to break down the nutrients your cells need. 

Plenty of research shows probiotics can help support a healthy microbiome and even reduce pathogenic activity in the gut. Probiotics are particularly known for: 

• Improving stool consistency (26) 
• Helping with stool frequency (27, 26, 28)
• Increasing intestinal transit time (27, 26, 28)
• Reducing bloating (26)

Saccharomyces boulardii, a beneficial yeast, can even help combat parasites, if that is at the root of your issues (29, 30). 

The production of stomach acid can easily be disrupted by inflammation, autoimmune disease, H. Pylori, or certain medications like acid blockers (31). Betaine HCl supplements taken with meals can help raise your stomach acid levels and improve digestion (6, 32). Just watch out for a burning sensation or other side effects, and discontinue if needed.

Lastly, supplementing digestive enzymes can help with the breakdown of fats, protein and carbohydrates. Research has shown that it can help improve IBS symptoms like constipation and diarrhea (33). 

Antimicrobial Agents

When dealing with a stubborn case of bacteria, fungal or parasitic imbalance, antimicrobial agents come in handy. Antimicrobial herbs help reduce the pathogenic load and allow beneficial bacteria to take up residence in their place. 

It’s important to address the foundation of diet and lifestyle before starting antimicrobials — without that base, pathogens are likely to resurface over time. You may even experience more side effects like fatigue when the pathogens die off. But with a healthy foundation in place, antimicrobials can restore your gut environment, rebalance, and return your digestion to working order (34, 35) (35, 36). 

The Bottom Line on Colon Hydrotherapy

Colon hydrotherapy may offer short-term relief of your gut-related symptoms, but it won’t address the root cause behind the systemic imbalances that caused the issues in the first place. 

Furthermore, colon cleansing may come with unpleasant side effects. Combined with the high cost of repeated treatments and the invasiveness of the procedure, this therapy is not the ideal solution for restoring your gut health. 

If you need help understanding your gut health, supporting your body’s natural detoxification pathways, and establishing a plan to regain your digestive function, reach out to us today at the Ruscio Institute for Functional Medicine.