Can a Colonic Really Improve Your Gut Health?

If you’re having issues with gut health like pathogens, constipation, inflammation, even Crohn’s disease or ulcerative colitis, a colonic might be an appealing option. However, it may not be the most effective choice.

While colonics, also called colon hydrotherapy, have become trendy, we’ve gone through the research and found that there is little scientific evidence to back up their effectiveness for any health condition. They also come with some potential risks, from electrolyte imbalance to more serious side effects. And, because they don’t have an impact on the small intestine or address the root causes of gut health imbalances, any improvements in symptoms are likely to be short-lived.

But the good news is there are other options available that have been proven to be effective and safe.

In this article, we’ll define what a colonic is, how colonics differ from enemas, why a colon cleanse isn’t your best option to restore gut health, and better ways to build a healthy gut.

What Is a Colonic?

A colonic (also called a colon cleanse, colon hydrotherapy, colonic hydrotherapy, or colonic irrigation) is a procedure that claims to flush excess waste, toxins, and pathogens from your large intestine.

Colonics may be used for people with severe constipation, irritable bowel syndrome, or gut dysbiosis, or used as a detox treatment for conditions including Lyme disease or even cancer.

It can be self-administered but is often done by a colon hydrotherapist or another alternative practitioner. Typically, the only input used is warm filtered water, but herbal infusions may also be used during the course of the colon cleanse.

How It Works

During a colonic, a patient will lie on their left side, in a similar position as if receiving a colonoscopy. Then, the colon hydrotherapist will insert a speculum, a duck bill shaped device used to slightly open the rectum, attached to a hose through which filtered water is streamed into the entire colon and flushes back out, along with waste. It is a closed loop system, meaning that the waste is carried directly into the plumbing system, the same as a toilet.

The process may involve up to 16 gallons or 60 liters of water flushed through the bowel over a period of 45 minutes to 1.25 hours (1).

What Are the Potential Benefits of a Colonic?

According to proponents, possible benefits of a colonic include:

Relieves constipation and helps digestive health
Boosts the immune system and general well-being
Relieves allergies
Helps with weight loss
Reduces headaches
Helps with skin health and acne

However, there is very little scientific evidence to back up these claims (1, 2).

In addition, colon cleansing is sometimes promoted to help with “intestinal autointoxication,” the idea that the contents of your gut have built up and are poisoning you by sitting in your intestines, potentially for years. This theory has been discredited for decades and is likely causing unneeded stress (2).

You, or someone you know, may have had some benefit or felt better from a colonic. But keep in mind that anecdotal reports, and even your own experiences, can be misleading due to the placebo effect. The placebo effect is very normal — it produces positive results in IBS patients 40-72% of the time (3).

Given that colon hydrotherapy is a potentially costly, invasive, and even harmful therapy, the best option is to pursue safer and less expensive treatment options that have been scientifically validated.

Colonics vs. Enemas

Enemas also involve introducing water into the large intestine, but a much smaller amount that typically only fills the rectum up and possibly the last section of the bowel. There are two types of enemas (4–6 , 7):

Evacuative: only held in the rectum for a short period of time, used for relieving constipation
Retentive: held for a longer period of time, usually for delivering medication directly to the bowel

Enemas can be conducted by a medical professional or self-administered using an enema kit purchased from a pharmacy. They come with fewer risks than colon hydrotherapy and are generally more accepted by the scientific community. However, they still have potential side effects (8).

There is even more risk with certain types of enemas like coffee enemas, which are purported to rapidly detoxify the liver and colon and even help cure cancer (9). These claims are scientifically unsubstantiated.

Transanal Irrigation

One other type of colon irrigation is known as transanal irrigation. Transanal irrigation is very similar to an enema, but it uses an inflated balloon in the rectum to hold warm water in the lower colon, stimulating peristalsis (bowel contractions). Then the balloon is deflated, allowing the waste to evacuate.

This procedure is only used in medical cases where the person can not have a normal bowel movement due to nerve damage, for example, as a result of multiple sclerosis, spina bifida or stroke (10 , 11 , 12).

	Fluid Used	Claimed Benefits	Evidence Level
Colon Hydrotherapy	Up to 60 liters (16 gallons)	Detox, flush out bad bacteria, boost immune system, reduce colon cancer risk	Poor – benefits are anecdotal, and there are reports of potential harm.
Enema	150ml–1 liter (5 – 33 ounces)	Ease constipation, act as a colon cleanser, deliver medication	Moderate — some enemas may be medically useful, but they can harm if used inappropriately
Transanal Irrigation	500ml–1 liter (17–34 ounces)	Relieve constipation and anal leakage in people with nerve-related bowel dysfunction	Good (for the specific intended use of helping people with nerve-damage in the colon)

Why a Colon Cleanse Isn’t Your Best Option

A colon cleanse might seem like an attractive option to relieve constipation or target dysbiosis in the large intestine. However, it doesn’t solve the root cause of an issue, meaning that you’ll have to do it again and again to achieve temporary results, if anything at all.

Colon hydrotherapists and others who promote colon cleansing within the alternative health world are usually genuine in their desire to help people regain good gut health. However, the scientific evidence on common practices in the industry, from purgative herbs to apple cider vinegar enemas, is simply not there at this point (2).

There are two main problems with colon cleansing that make it an unreliable treatment method:

A colonic only reaches the large bowel: It may help to temporarily remove some waste and even pathogens, but many gut issues such as SIBO start in the small intestine or even earlier in digestion with low stomach acid or H. Pylori overgrowth. If these are part of your gut issues, colon cleansing won’t address the root cause.
A colonic can be harsh on the large intestine: It can cause discomfort such as cramping, bloating, and abdominal pain, not to mention disrupt the beneficial flora in the colon (1).In some cases, colonics have been linked to side effects such as colorectal perforation, inflammation of the lining of the rectum, lower abdominal pain, and bloody stools. The potential risk is not worth the short-term benefits of colon cleansing or self-administered enemas (13, 14) (13, 15).

What’s the Root Issue With Your Gut?

If you’re looking into colonic hydrotherapy, then you probably have some gut-related symptoms.

Common health issues related to gut health imbalances include:

Fatigue: Research shows that fatigue is a common symptom in patients with IBS (16 , 17), leaky gut (18), non-celiac gluten sensitivity (19), and people with other gastrointestinal issues (20).
Thyroid issues: Intestinal inflammation also damages your body’s ability to use thyroid hormone, potentially leading to symptoms of hypothyroidism (21).
Depression and anxiety: Research connects poor mental health (anger, irritability, tension, depression, and anxiety) to both IBS (20 , 22 , 23) and inflammatory bowel disease (24).
Skin problems: Acne (25), eczema (26 , 27, 28), psoriasis (29, 30) and other autoimmune skin conditions are all related to disruptions in the gut environment.
Brain fog: Inflammation can travel from the gut to the brain, causing brain fog, characterized by inability to focus, slowed thinking, forgetfulness, and low mental energy (31)

If you’re experiencing any of the above, you’re better off investigating the root cause of those issues and pursuing treatment from there to heal your gut in a more thorough and holistic way.

Common underlying issues that impact gut health usually come down to these four disruptions:

Dysbiosis, or imbalances in the gut bacteria (microbiome) (32)
Inflammation (33, 34)
Increased gut permeability (leaky gut) (35, 36)
Abnormal immune function (37)

If you suspect one or more of these issues is behind your symptoms, reach out to us to schedule a consultation with one of our providers.

These issues tend to be the pillars underlying chronic gut health symptoms. They are associated with different names and diagnoses, like SIBO, irritable bowel syndrome, and ulcerative colitis. However, a treatment has to address the whole person to heal the root cause.

Diet for Restoring Gut Health

A healthy diet is the foundation for gut health. Once that foundation is in place, other therapies can be added if necessary.

There are many foods that can irritate and cause inflammation in the gut, so a healthy gut diet should focus on these key components:

Reducing foods that cause dysbiosis or inflammation in the gut lining
Sealing the tight junctions of the gut lining and healing leaky gut
Promoting good bacteria in the colon
Identifying which foods trigger your symptoms and avoiding them until you have created a more resilient gut environment.

At our clinic, we most often recommend a Paleo diet to achieve these goals. This type of diet prioritizes fresh fruits and vegetables and lean animal protein while eliminating processed foods, gluten-containing grains, and dairy products. Some non-gluten grains like rice may be okay for some individuals, but not always. Following this diet allows the gut to heal and inflammation to calm down so that you can rebuild a healthy microbiome (38, 39). Once your gut has healed, you may gradually reintroduce healthy foods that were previously causing symptoms.

Once you have your healthy diet in place, a good next step is adding probiotics to the mix.

Supporting Colon Health with Probiotics

There is now a significant body of research proving the effectiveness of probiotic supplementation — adding beneficial bacteria to the colon to balance the microbiome and create a gut environment that is less hospitable to pathogenic bacteria. Unlike colon hydrotherapy, probiotics have been shown to produce meaningful and lasting gut health benefits.

Probiotics help to:

Relieve constipation, improve stool composition and frequency (40, 41 , 42)
Improve irritable bowel syndrome/IBS symptoms (43, 44, 45, 46, 47)
Reduce bloating (41)
Restore a healthy microbiome by increasing bacterial diversity (48)
Reduce gut inflammation and improve immune system response (48, 49, 50)
Reduce and repair damage done to the gut lining (51, 52, 53)

We have found that the best results occur with probiotics when you take multiple strains, usually:

A Lactobacillus and Bifidobacteria blend, including species of probiotics such as Lactobacillus acidophilus and Bifidobacterium infantis
Saccharomyces boulardii (a beneficial yeast)
Soil-based probiotics, usually Bacillus species.

The effectiveness of combining multiple probiotic strains is supported by research. For example, a systematic review and meta-analysis found that multiple strain probiotics were more effective than single strain probiotics in the treatment of IBS (47).

The Verdict on Colonic Hydrotherapy

Colonics, colon cleanses, or colonic hydrotherapy are scientifically unproven and can even have some dangerous consequences and side effects. You are much better off addressing the root cause of your gut health issues, changing your diet, incorporating probiotic therapy, and addressing pathogens where necessary with targeted antimicrobials.

Still, figuring out what the root cause of your gut imbalance is can certainly be a challenge. If you need guidance on the next steps in your healing journey, please reach out to us to schedule a consultation with one of our integrative health practitioners.

The Ruscio Institute for Functional Medicine