Detox danger: Trendy colon cleansing a risky ritual

You may be flushing more than your waste and your wallet down the toilet with a colon cleanse. Your health could be circling the drain, too, according to a new study released today in the Journal of Family Practice.

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Researchers from Georgetown University Medical School looked at 20 studies published in the last decade and found little evidence of benefit to colon cleansing. But they did find dozens of cases of problems: cramping, bloating, vomiting, electrolyte imbalance,  renal failure, and the biggest problem of all, death.

“This is not a manifesto against complementary and alternative medicine, since I’m a big proponent,” says Georgetown family medicine physician and lead author Dr. Ranit Mishori. “But there is absolutely no evidence that it [colon cleansing] helps. Instead, we found that it can be harmful.” 

The theory behind the need to cleanse your colon is called “autointoxication.” Food gets trapped in the colon, rots, and causes the release of toxins. The theory was largely discounted in the early 20th century.

But everything that’s old is new again, and detoxing is hot, stemming largely from people’s fears of the copious amounts chemicals and pesticides found in food and the environment. With claims that a cloggy, toxin-filled colon can lead to a litany of ills including skin problems, sexual dysfunction, asthma, obesity, memory loss and even cancer, detox devotees are making colon cleansing trendy again.

You can get your colon clean a few ways. Herbal concoctions, some of which are mixed with coffee or laxatives, can be taken orally or in the form of a suppository. Although they promise rejuvenation and well being, herbal preparations, none of which are FDA regulated, can cause serious side effects like dehydration and liver toxicity. Other DIY cleanses, such as the lemon-juice based Master Cleanse, are reportedly used by celebrities such as Gwyneth Paltrow.

Some people prefer a more up-close-and-personal approach with a colonic, also called colon hydrotherapy. A “colon hydrotherapist,” or “colon hygienist” inserts a rubber tube into the rectum, and fluid (often as much as 60 liters) is pumped in and out through the tube. The procedure is like an "enema on steroids," says Mishori, citing rectal perforations, acute water intoxication and even an outbreak of amebibiasis, a parasitic infection caused by contaminated equipment, among study findings.

But colon cleansing has its advocates. “Almost to a one, people will say they feel better after a colonic,” says Russell Kolbo, a chiropractor and naturopathic doctor in Gig Harbor, Wash. Although Kolbo, who says about 50 colonics a week are done in his clinic, is a believer in the autointoxication theory, he also believes that more rigorous studies need to be done, and that therapists should not diagnose, treat or prescribe unless they are professionals licensed by the state to do so.

But it’s also the “cure-all claims” that do some real damage. “It [a colonic] is just one tool in a tool box,” says Kolbo, past president of the International Association for Colon Hydrotherapy. “When people start throwing around the word ‘cure’ that’s a real problem.”

Until there’s more scientific evidence, Mishori is telling her patients to steer clear of colon cleansing. “I never used to know what to say when patients would ask,” she says. “Now I know the answer, and it’s ‘no.’”