Cleanses for a fresh start to 2018

Feb 01, 2018

Feeling a bit low on energy? A few more headaches than usual? Googling treatment options quickly leads you to websites suggesting you may be at risk from an accumulation of toxins and a good cleanse will literally turn things right around.

The idea of cleansing has been around since the time of the Egyptians in 1500 BC.  In 500 BC, Hippocrates, who is often referred to as the "Father of Medicine,” suggested using enemas for fever therapy.

The benefits of cleansing were based on the theory of autointoxication, a belief that food not absorbed in the upper intestinal tract passes into the colon, where bad bacteria ferment it to form poisons that were then absorbed into the bloodstream and were a major factor in the development of a variety of chronic disease states.

The procedure became increasingly popular in the early 1900’s until a paper in 1919 discounted the theory of autointoxication. When it became clear that the scientific rationale was wrong and colonic irrigation was not merely useless but potentially dangerous, its practice was condemned by the American Medical Association as quackery and it subsequently went into a decline.

We now know that the multiple bacteria inhabiting the colon, our microbiome, do indeed metabolize unabsorbed carbohydrates, but instead of being poisons, these short chain fatty acids are necessary for our health. They can reduce the inflammation that aggravates arthritis, lower cholesterol, and may prevent certain cancers. This knowledge would suggest that colon cleansers or laxatives would reduce the absorption of these beneficial nutrients.

In 2009, a systematic review of the worldwide medical literature found “no methodologically rigorous controlled trials of colonic cleansing to support the practice for general health promotion.” Yet this practice is touted by alternative medicine providers and its use increasing.

There are two approaches to cleansing the lower intestine - orally and per rectum (colonic irrigation or lavage).  Both may use large volumes of water, up to 16 gallons (about 60 liters) for a colonic. And they often contain other substances such as herbs or coffee.

These procedures are not risk free. The large volumes of fluid--even if just salt water--can lead to major shifts in the body’s water balance (especially risky if you have kidney or heart problems). Even herbal supplements are not without their side effects (imagine how you’d feel if you suddenly took in the caffeine equivalent of 3 or 4 Grande coffees at Starbucks).

Then there is the risk of physical injury from the enema paraphernalia, namely infections and possible bowel perforation.

The take away points are:

  1. Colon irrigation is unproven as far as benefits while it has a real risk of adverse effects.
  2. The devices that practitioners use for the procedure are not approved for colon cleansing by the US Food and Drug Administration. Inadequately disinfected or sterilized irrigation machines have been linked to bacterial contamination.
  3. Colon cleansing practitioners are not licensed by a scientifically based organization. Rather, practitioners have undergone a training process structured by an organization that is attempting to institute its own certification and licensing requirements.

If you feel you are carrying around a colon burdened by bad bacteria and toxins, a safer approach might be an increase in daily fiber (flax is easy) and perhaps a probiotic yogurt to shift the bacterial population.

Your comments and feedback are always welcome. Please direct any inquiries or requests for potential subjects for future columns to: adoctorsrx@gmail.com

You can revisit previous columns at: https://adoctorsrx.blogspot.com/.

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