Do you really need a colon cleanse?

Sometimes, cleaning the colon is necessary before any medical procedure such as a colonoscopy. Some people believe that cleaning out their colon will remove toxins from their body that have built up over time due to the food they eat, the water they drink, and the lifestyles that they lead.
According to medical professionals, the body is well-equipped with its own mechanisms to eliminate harmful substances. These include the liver and kidneys. Colon cleansing to remove toxins is a dangerous and unnecessary practice, particularly colon hydrotherapy.

"Every week someone asks me if colon cleansing is safe" said Dr. Jacqueline Wolf. She is a gastroenterologist at Beth Israel Deaconess Medical Center, Boston, and author of "A Woman's Guide to a Healthier Stomach" (Harlequin), 2011.

Wolf informs her patients that there is very little research on colon-cleansing techniques and that many doctors don't believe or recommend them to their use.

Related: Colon cleansing is dangerous and useless according to a study

Preparing for a colonoscopy

According to the American College of Surgeons, one situation in which doctors recommend cleaning the colon is before a coloscopy. This is a procedure where a small camera attached to a lighted tube is inserted through anus, through rectum, and into large intestine. It allows the doctor to check for precancerous polyps, cancer, or other diseases. This is a simple case of cleaning the colon. "If you don’t clean out your stool, you won’t be able to see anything." Wolf stated that it is necessary to see the colon's [intestinal] wall.

Patients are advised to eat a low-fiber diet three days before their colonoscopy. This will ensure that their stool is not too difficult. Patients are advised to eat liquids the day before their colonoscopy. Patients drink a colonoscopy prep mixture the night before. This is a laxative that causes diarrhea to empty the bowel. Wolf explained that although different colonoscopy preps work differently, they all stimulate bowel movement. Diarrhea in this instance is not an issue, but it is the goal. It is essential to ensure that the colon doesn't become empty. The doctor may not be capable of seeing what they need.

There are some side effects that can be caused by colonoscopy preparations. Wolf stated that electrolytes are ions of chemical compounds like potassium and sodium that conduct electricity when they dissolve in water. Drinking a lot of water prior to a colonoscopy can dilute electrolytes such as sodium and magnesium. Wolf stated that diarrhea could have an opposite effect and cause higher concentrations of these chemicals. She said that lightheadedness could be caused by shifting sodium levels, while low potassium levels can cause leg cramps and abnormal heart rhythms.

Wolf stated that any laxative that draws in water to the colon can lead to dehydration if there is not enough fluid intake. When preparing for a colonoscopy, Wolf recommends that patients drink extra electrolytes in addition to water.

According to the American Society for Gastrointestinal Endoscopy, side effects can also include nausea, vomiting, and bloating.

Because it is a means to an ending, people will go through the discomfort of the prep and procedure. According to the Centers for Disease Control and Prevention, colonoscopies allow doctors to spot and treat colorectal cancer earlier, and prevent it from spreading. Wolf stated that the colon cleansing performed before a colonoscopy has no other health-related purpose.

Colon cleansing is claimed to have many benefits

According to colon-cleansing advocates, the colon should be cleaned from the inside out. The accumulation of waste can also lead to toxins in the blood that may eventually poison people. According to wellness companies, colon cleansing can relieve symptoms such as fatigue, weight gain, bloating, skin irritation, and weight gain. It also helps with a wide range of health issues, including depression, allergies, arthritis, and cancer.

Proponents of colon cleansing advocate two or three methods to clean the colon. There are three methods to clean the colon: one is using bowel-clearing powders, supplements or laxatives; another is using enemas. Another method involves drinking herbal teas that purportedly eliminate colon waste and release toxins. This method may feel more like frequent trips to the toilet with diarrhea.

A second method is called colonic irrigation or colon hydrotherapy--sometimes just referred to as 'colonics'--in which a practitioner flushes out the colon by sending gallons of water into the body through a tube inserted into a person's rectum. According to The Colon Therapists Network, this procedure can cost between $55 and $95 per session.

The third option is diet-related colon cleansing, such as juice cleanses or high-fiber diets.

Wolf suggested that people's curiosity about cleansing may be rooted in the belief that the bowel can be dirty and that it is important to get rid of any waste. Although she doesn't usually recommend colon hydrotherapy, she has recommended it to a few patients for colonoscopy preparation after traditional methods have failed. It was also recommended for severe constipation patients, even though there weren't strong drugs to treat it.

Similar: Have a nice colonoscopy. New test eliminates laxative and probing

However, does colon cleansing actually flush out toxins as its advocates suggest? Or does it flush out money down the drain?

Wolf stated to Live Science that "we don't have enough knowledge about colon cleansing" in order to discover the truth. It's something we need to learn more about.

In 2009, a review was published in American Journal of Gastroenterology. It concluded that there are no solid studies supporting colon cleansing as a method of improving or promoting general wellbeing.

Wolf stated that there is no evidence to show how effective certain cleansing methods are at eliminating toxins from the body.

A colon cleanse is not known to cause significant weight loss. Although a cleanse can help someone lose a few pounds, it is temporary. This is due to the loss of water weight and stool and not permanent fat loss. Wolf stated that while it can be motivating to see some weight loss for a few days after cleansing, it is not a long-term solution for a weight problem.

Related: 5 experts answer the question: Is it possible to cleanse your body with healthy juices?

The real dangers

Wolf stated that there is no data available on the health or harmful side effects of cleansing. The majority of side effects are reported in medical literature, not research studies.

Wolf stated that colon cleansing with herbal preparations, laxatives, or enemas, can increase the risk of dehydration and alter electrolyte levels.

Aplastic anemia, a rare blood condition, and liver failure have been linked to herbal cleanses.

According to Mayo Clinic, colon hydrotherapy can cause stomach cramping, nausea, vomiting, diarrhea, and stomach pain. Live Science previously reported that more severe complications could include electrolyte imbalances and kidney and liver failure as well as bowel perforation. One case study showed that a 55 year-old man suffering from chronic constipation made his bowels perforate using a garden hose to make an enema.

According to MDedge Family Medicine, a news site for family doctors, the Food and Drug Administration requires that colon hydrotherapy systems meet certain requirements. It has not approved any of them to be used for non-medical purposes such as colon cleaning. Premarket approval is required for all uses that go beyond the original indications. This includes preparation for radiologic and colonoscopies. MDedge Family Medicine has sent several warning letters to manufacturers who have not received premarket approval to use colon hydrotherapy systems for colon cleansing.

Wolf also stated that colon cleansing is particularly dangerous for those with heart disease or kidney disease. This is because they can cause electrolyte shifts and could make it difficult to maintain fluid balance. A colon cleanse can increase the risk of complications for people with gastrointestinal issues such as Crohn’s disease, ulcerative colitis, and recurrent diversilitis.

Wolf stated that colon hydrotherapy can be dangerous for those with Ehlers Danlos syndrome (a connective tissue disorder) and anyone who has had previous colon surgery or severe hemorhoids.

The colon is home to trillions of bacteria. It can be difficult to eliminate them or change the number of harmful and beneficial bacteria.

Wolf stated that while a colon cleanse will not eliminate all bacteria, research is showing that there is a lot of good bacteria in the colon. Bad bacteria can be controlled by some of the good colon bacteria.

Wolf stated that scientists don't know whether colon cleansing and colon hydrotherapy can disrupt the bacteria or cause an imbalance of the microbiome. She said, "It hasn’t been studied."

How about a "dietary" cleanse.

While laxatives, colon hydrotherapy, and colon enemas have their risks, what about colon-cleansing techniques that are purely dietary? Another method for colon cleansing is to consume certain foods and liquids. For several days, a juice cleanse might include drinking only juice, which is often unpasteurized and "raw." A fiber-based cleanse is one that focuses on whole grains, fruits, and vegetables.

Research on diet and colon cleansing is similar to other cleansing methods. According to the National Institutes of Health’s National Center for Complementary and Integrative Health, (NCCIH), the research on this topic is limited and of poor quality. According to the NCCIH, existing research shows that "juicing" and "detox" diets can lead to initial weight loss due to low calories. However, once a person returns to a normal diet, they tend to cause weight gain."

Wolf suggests that high-fiber foods and green leafy vegetables be included in a healthy diet. She said that there is no evidence to support the idea that these foods are good for cleansing the colon.

Drinking juice for a few days is not balanced. The NCCIH states that some juices have high levels of oxalate. This is a waste product excreted from the body through urine and can also be found in high amounts in certain foods like spinach and beets. According to the NCCIH, drinking a lot of high-oxalate juices can increase your risk of developing kidney problems. University of Michigan Health warns people that too much oxalate may cause kidney stones.

According to the NCCIH, juices that aren't pasteurized could contain bacteria that can make people sick.

Fiber "cleanses" can sometimes be equivalent to eating the daily recommended intake of fiber. According to the NIH, the recommended daily intake of dietary fibre is 38 grams (1.3 ounces) for men, and 25 grams (0.9 oz) for women. However, many people don’t consume this much fiber regularly. A fiber-based cleanse does not require you to eat a specific food. However, it can help with constipation and promote regular bowel movements. Some research also suggests that it may reduce the risk of type 2 diabetes and cardiovascular disease. People who consume more fiber, which is bulky without calories, are less likely to eat as many calories and to weigh less.

Experts recommend a dietary cleanse that focuses on fiber.

This article is intended to provide information only and does not constitute medical advice. Ashley P. Taylor, a Live Science contributor, updated this article on November 9, 2021.