colon therapy

What Is It?
How Does It Work?
What You Can Expect

Health Benefits

How To Choose a Practitioner


Evidence Based Rating Scale


What Is It?

Colon therapy is the process of cleansing and flushing out the colon, or large intestine. Also called colonic irrigation, colonic hydrotherapy, or high colonic, the treatment is similar to an enema but is more extensive. Whereas an enema (which you can do yourself) bathes only the lower portion of the colon, colonic irrigation (which must be done by a trained practitioner) attempts to clean the entire--roughly five-foot--length.

Those who espouse colon therapy say that the health of the colon can affect the health of the entire body. But this theory holds little credence with the majority of conventional physicians, who believe there is no reason to irrigate the colon, except in some cases of constipation and before certain surgical procedures, such as a Colonoscopy. They also contend that the best way to care for the colon is to let its own natural physiological actions keep it in good working order.

Nevertheless, therapies to cleanse the colon have been around for thousands of years. The earliest recorded versions have been traced to physicians of ancient Egypt, who used devices similar to those employed for modern-day enemas. To improve one's well-being in 17th-century France, it was fashionable to "enjoy" as many as three or four enemas a day.

Irrigation of the entire colon only came into prominence during the late 19th century, when Russian microbiologist Ilya Ilich Mechnikov first described the concept of "autointoxication." He argued that the body could actually poison itself as the toxins from fecal matter were absorbed through the lining of the large intestine and into the bloodstream.

In the United States, this theory was adopted by Dr. John Harvey Kellogg (founder of the breakfast cereal company), who frequently lectured about autointoxication at his huge natural medicine clinic in Battle Creek, Michigan. In the late 19th and early 20th centuries, thousands flocked to Kellogg's "sanitarium" to enjoy the guru's health and fitness regimes, which included not only colonic irrigation and dunks in electrified water pools, but also aerobic exercise and the adoption of a low-Fat, vegetarian diet.

In an article enticingly entitled "Should the Colon Be Sacrificed or May It Be Reformed?" which appeared in the 1917 issue of the Journal of the American Medical Association, Kellogg reported his success in using colon therapy (along with diet and exercise) to prevent surgery in all but 20 of the 40,000 gastrointestinal patients he had treated at his "sanitarium."

The article created a wave of enthusiasm among conventional physicians, and for the next three decades various devices for colon irrigation became a common sight in the offices of many M.D.s, as well as in hospitals and nursing homes. Among the ailments for which doctors typically recommended colon therapy were high blood pressure, heart disease, arthritis, and depression.

Colon therapy flourished until the 1940s, when scientific articles began to argue that there was little evidence to support the idea of autointoxication and to suggest laxatives as a far easier option. Conventional physicians began to worry that unlicensed, non-medical practitioners, or “quacks,” had exaggerated the benefit of colon therapy. It didn't take long for the irrigation devices to disappear from doctors' offices, but the therapy was far from forgotten. It continued to be popular with chiropractors and naturopaths, who firmly believed in the benefits of what they now preferred to call "detoxification."

Today, some alternative practitioners continue to use colonic irrigation as part of a basic detoxification program, though many prefer to recommend herbal laxatives in supplement form. And there is still enough interest in colon therapy for several U.S. companies to manufacture irrigating devices, and for the number of colon therapists to increase annually.

In 1989, the International Association for Colon Hydrotherapy was founded to provide training and certification for colon therapists worldwide. Today, thousands of people continue to seek out colon therapy for detoxification and health maintenance.

How Does It Work?

As the lowest portion of the digestive tract, the colon aids in digestion and the elimination of waste products while resorbing fluid from the stool. When the colon is packed with accumulated, hardened feces due to a poor diet, inadequate fluid intake, constipation, or some other gastrointestinal problem, waste can build up. According to proponents of colon therapy, this buildup can result in stagnation and decay of the fecal material in the colon. This decay, in turn, produces a whole host of bacteria and other "toxins" that can be absorbed into the bloodstream, resulting in myriad illnesses--from a simple cold to life-threatening Coronary artery disease. Colon therapists suggest that the typical American diet, which is low in fiber and high in red meat and other fatty foods, is a major contributor to this problem.

Contemporary mainstream physicians typically take a different view, pointing out that food and waste products cannot "toxify" the body by remaining in the colon. In addition, they disapprove of colon therapy because they say it can interfere with the natural balance of helpful bacteria that keep the intestines functioning normally. Most conventional doctors do agree, however, that avoiding red meat and other fatty foods, and eating a healthy, high-fiber diet is the best way to keep the colon healthy.

What You Can Expect

During colonic irrigation, the therapist inserts a soft, disposable plastic tube into the rectum, which remains in place during the entire session. First, the therapist gently pumps a measured amount of body-temperature, filtered water into the colon; this may contain herbs, enzymes, or other "purifying" substances. The flow of water causes the muscles of the colon to contract, a process called peristalsis, which moves the built up feces through the colon. The therapist may also gently massage the abdomen to help release the impacted fecal material from the intestinal walls.  Finally, the pump is reversed, and the water is gently vacuumed back through the same tube and into a closed waste system without mess or foul odor.

The process is repeated many times during the session, which lasts about an hour. Approximately 20 gallons of water will be used, but unlike an enema, the therapy does not require any "race to the toilet" afterward, since most of the water is removed by the end of the session.

Some people report feeling lighter and more energized after colonic irrigation. Others may experience nausea, headache, or flu-like symptoms. These symptoms generally pass within a few hours. Many colon therapists recommend the oral intake of a restorative electrolyte solution following a colon therapy session.

The number of suggested treatments depends on the reason for seeking colon therapy. For general health maintenance, once a year is usually enough. However, patients with a chronic condition (such as regular constipation, chronic fatigue, or persistent digestive complaints), may need several treatments within a few weeks.

Health Benefits

There are few scientific studies to support any therapeutic claims for colon therapy. On an individual basis, people do report that colon treatments relieve the distention and bloating associated with constipation and help to restore regular bowel movements. Anecdotal evidence suggests that colon therapy may be useful for a number of ailments including indigestion, gas, headaches, joint problems, allergies, asthma, skin problems, and even toxicity from drugs, alcohol, and smoking.

As far as general colon health is concerned, some reports in the conventional medical literature seem to echo what John Harvey Kellogg preached a century ago--that a high-fat, meat-heavy diet isn't good for the colon. These reports suggest that people who eat a lot of red meat have a higher incidence of colon cancer than the rest of the population. More research in this area still needs to be done, however.

Specifically, colon therapy may help to:

  • Relieve constipation. Early articles and experiments evaluating colon therapy debated the validity of autointoxication and the need for cleansing. In the 1920s, some of these experiments demonstrated systemic effects of minor manipulations of the colon. In a 1922 study attempting to refute the effects of autointoxication, one researcher (referred to as Donaldson) actually showed support of the clinical value of enemas. In the study, five subjects voluntarily induced constipation over four days. The researcher noted symptoms of so-called autointoxication, including coated tongue, markedly foul breath, canker sores, impaired appetite, mental sluggishness, depression, restlessness, irritability, drowsiness, and headache. The subjects’ nervous system, basal metabolism, blood sugar, and rate of muscle fatigue also showed impairment, according to the study. After these observations, the subjects underwent cleansing enemas (but not full colonic irrigations), and all subjects immediately showed improvement in depression, with mental alertness and feelings of physical fitness also rapidly improving. Reaction time, muscle fatigue and blood sugar also improved. The researcher concluded that symptoms improved after treatment with enemas because they relieved pressure in the lower bowels caused by constipation. Therefore, he concluded the subjects’ symptoms had been a result of constipation, not autointoxication of the colon; and that cleansing the colon by way of enema to relieve pressure is effective in treating constipation. (1) Other early researchers (in the 1920s and 1930s) demonstrated similar effects of colonic irrigation, but since then little research has followed up to further confirm their findings. In a 1995 review of anecdotal evidence evaluating medical treatment of constipation with enemas and colonic irrigations, the researcher noted that while little scientific evidence regarding the effectiveness of these treatments exists, the practices are widely used to treat constipation. (2) A 2000 article in the Townsend Letter for Doctors & Patients reports anecdotal evidence from several physicians who often use colonic irrigation to treat patients with constipation. Case studies from their patients indicate colonic irrigation can relieve chronic constipation and its symptoms, such as bloating, cramps, fatigue, lethargy, and headache. (3)

    However, the therapy is not recommended for chronic constipation. A 1996 review of therapeutic modalities for the mechanical cleansing of the colon indicates agents such as colonic irrigations are used to treat acute constipation but because the evacuation induced is extensive and harsh the method should not be used for long-term management of constipation. (4)

  • Ease digestion. Proponents of colonic irrigation believe the buildup of feces along the colon can prevent proper digestion and that cleansing the colon will improve the process. However, because colonic hydrotherapy has not been extensively studied, evidence in this area is lacking. A 2007 review of 1,051 articles examining treatments for functional bowel disorders found only nine articles regarding colonic irrigation as a treatment option. A review of these nine article found irrigation may be a successful treatment option for some patients, but the variations and methodological limitations of the studies do not provide high-quality results. (5)

  • High blood pressure. In his study on the effects of enemas to treat constipation, Donaldson also observed the effects of constipation on blood pressure in a dog. He found that a blockage in the colon of a dog caused a rise in blood pressure from 122 to 138 mm/Hg within four minutes, which he believed to be a result of autointoxication requiring cleansing. (1) Since then, naturopaths and other proponents of colon therapy promote the ability of colonic hydrotherapy to lower blood pressure. However, no further scientific studies have evaluated this claimed benefit.

  • Improve arthritis. In the 1930s, arthritis was thought to be an infectious disease, and researchers believed removing infection from the site (such as from the colon) was appropriate treatment. Researchers have since learned this degenerative joint disease is not caused by infection but by wear and tear, and in some cases through a genetic predisposition. Other research has linked arthritis to digestive system disorders, particularly inflammatory disorders such as inflammatory bowel disease. Therefore, proponents of colonic irrigation now believe autointoxication may contribute to toxins in arthritic tissue, and cleansing the colon may improve symptoms of arthritis by eliminating these. However, scientific evidence in this area is lacking. Research is needed to determine efficacy.

  • Improve mental state. Since its inception in Egypt, colon therapy has been touted for its therapeutic effects and providing a general sense of well-being. This may partially be explained by the connection between the colon and the nervous system. The colon is regulated by the enteric nervous system, which is sometimes called the second brain or “abdominal brain” because it can operate autonomously. This nervous system is embedded in the lining of the gastrointestinal system and has more neurons than the spinal cord. Therefore, reflexes from the colon can affect the entire nervous system and may influence our emotions and mental processes. In a 1917 article in the Journal of the American Medical Association, two researchers (Satterlee and Eldridge) found that colonic irrigation seemed to clear up or markedly improve symptoms such as mental sluggishness, memory problems, phobias, depression and hallucinations. (6) And in a 1932 writing in the same journal, another researcher noted, “when one sees the dirty gray, brown or blackish sheets, strings and rolled up wormlike masses of tough mucus with a rotten or dead-fish odor that are obtained by colon irrigations, one does not wonder that these patients feel ill and that they obtain relief and shop improvement as the result of the irrigation.” (7) Colonic irrigation was often recommended for treating mental illness in the 1930s, particularly because the process seemed to induce sedative effects. However, since then little research has focused on the therapeutic benefits of colon therapy in regard to mental function. Research is needed in this area.

How To Choose a Practitioner

Colon therapy should only be performed by a therapist certified by the International Association for Colon Hydrotherapy (I-ACT) in San Antonio, Texas. You can consult this organization to find a certified therapist in your area. Only the state of Florida requires colon therapists to be registered.

Be sure to visit the facility in advance to make sure that it is clean and neat. All equipment should be registered with the FDA. Make sure disposable tubing is used, or reusable equipment is properly cleaned and sterilized.


  •  If you have any questions about how colon therapy may affect your health, discuss them with a doctor first.

  • Because colon therapy can cause perforation of the colon or lead to toxic or allergic reactions, it is not recommended if you have blood in your stool, severe hemorrhoids, Crohn's disease, congestive heart failure, severe anemia, abdominal hernia, heart disease, high blood pressure, amoebic dysentery, gastrointestinal cancer, tumors of the large intestine or rectum, ulcerative colitis, diverticulitis, or recent colon surgery (less than three months).

  •  If you are in the first or third trimester of pregnancy, colon therapy is not recommended because it may induce labor.

  •  Make sure the clinic you choose is clean and that the therapist is reputable and well-trained. Infection can occur if equipment is not properly sterilized or disposable.

  •  Colon therapy is not known to react with any drugs or medications.

  •  Among the possible but remote complications of colon therapy are perforation of the intestinal wall, disturbance in the body's fluid balance, and heart failure caused by excess water in the blood


1. Donaldson AN. Relation of constipation to intestinal intoxication. JAMA. 1922;78:884-8.
2. Jensen JE. Medical treatment of constipation. In Wexner SD, Bartolo DCC, Eds. Constipation: Etiology, evaluation and management. Oxford: Butterworth Heineman, 1995.
3. Walker M. Value of colon hydrotherapy verified by medical professionals prescribing it. Townsend Letter for Doctors & Patients. 2000;Aug/Sept:205-6.
4. Messick CR, Danziger LH. Therapeutic modalities for mechanical cleansing of the colon. J Am Pharm Assoc (Wash). 1996 Jul;NS36(7):439-42.
5. Tod AM, Stringer E, Levery C, et al. Rectal irrigation in the management of functional bowel disorders: a review. Br J Nurs. 2007 Jul 26-Aug 8;16(14):858-64.
6. Satterlee GR, Eldridge WW. Symptomatology of the nervous system in chronic intestinal toxemia. JAMA. 1917 (Oct. 27);69:1414-18.
7. Bastedo WA. Colonic irrigations: their administration, therapeutic application and dangers. JAMA. 1932;98:734-36.

 Evidence Based Rating Scale 

The Evidence Based Rating Scale is a tool that helps consumers translate the findings of medical research studies with what our clinical advisors have found to be efficacious in their personal practice. This tool is meant to simplify which supplements and therapies demonstrate promise in the treatment of certain conditions. This scale does not take into account any possible interactions with any medication/ condition/ or therapy which you may be currently undertaking. It is therefore advisable to ask your doctor before starting any new treatment regimen.
















Date Published: 04/19/2005

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