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‘Colonic hydrotherapy?’ What’s that?

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

By Marty Clear
9/10/2010 © Health News Florida

Who would want to have their insides flushed out if they didn’t have to --and pay for it, to boot?

Well, Ben Affleck, for one. Also Courtney Love, Andie MacDowell, Janet Jackson, Cindy Crawford, Alicia Silverstone, Paris Hilton and Liv Tyler.

The “colonic” of yesteryear is back in fashion, but now it’s called “hydrotherapy.” It’s being touted as a prevention or cure for a wide range of diseases, not to mention weight loss.
It's now in the news because of a suit over a perforated intestine filed by a 55-year-old man against a Pinellas County clinic. He says the water pressure was too high; the clinic denies responsibility.

Colonic hydrotherapy, a.k.a. colonic irrigation, is unfamiliar to many, even to health professionals. What, exactly, is it?

It's kind of like an enema, except that it uses more water and reaches higher into the colon. And you go to a clinic to have it done instead of doing it yourself in your bathroom.

Those who want more detail can find it at WebMD: “While you lie on a table, a machine or gravity-driven pump flushes up to 20 gallons of water through a tube inserted into your rectum.

"After the water is in the colon, the therapist may massage your abdomen," the article continues. "Then the therapist flushes out the fluids and waste through another tube. The therapist may repeat the process, and a session may last up to an hour.

Here is a videofrom a practitioner explaining what she does. 

Hydrotherapists may use a variety of water pressures and temperatures and may add enzymes, herbs, or even coffee to the water. Some add "probiotics," beneficial bacteria that aid digestion.

Practitioners use machines that are manufactured specifically to send the water in and empty it back out. Ideally, the practitioners are trained, but Florida is the only state that licenses hydrotherapists and requires them to pass a test.

Colonic hydrotherapy has many fans, including Donna Swain, a licensed massage therapist in Mount Dora. Both times she had colon hydrotherapy, she said, she felt “incredibly energized,” although she allowed that could have been a placebo effect.

However, virtually no peer-reviewed scientific research shows benefit from colonic hydrotherapy, while some speaks of potential dangers.

In 1985, a statement from the California Department of Health Services warned that the procedure could cause death from colon perforation, infection or electrolyte depletion. One study called it a triumph of ignorance over science.

Some opponents say hydrotherapy can be harmful because it eliminates the “good” bacteria in the colon, including acidopholus and bifidus, that fight parasites, viruses, fungi and disease-causing bacteria.

The Pinellas lawsuit isn't the first to claim the procedure led to a perforated intestine. In 2004, a paper in the Medical Journal of Australia
detailed three such cases; all three patients required surgery.

The authors wrote: “We feel that colonic irrigation is of dubious benefit. There is potential for serious harm.”

Predictably, people from the colon hydrotherapy industry have another view.

“The procedure is extremely safe,” said E.R. “Dick” Hoenninger, the executive director of the International Association of Colon Hydrotherapists.

The speculum that is inserted into the patient is only a few inches long, Hoenninger said. He said the water flows at a low pressure, no more than 2.5 pounds per square inch, making injury virtually impossible.

Injuries aside, mainstream doctors tend to regard it as simply a waste of money.

The idea behind colon cleansing is centuries old, the "auto-intoxication" theory that waste products build up in the intestine and poison the body. 

By 1920, papers in the Journal of the American Medical Association  argued forcefully against the theory, pointing out that surgeons who directly observed the colon saw no waste accumulation.

Yet alternative health advocates revived the idea of autointoxication in the 1980s. A popular diet book called “Fit for Life” stoked the idea, and colon hydrotherapy has been a fad ever since.

"High colonics," as the practice is sometimes called, got a publicity boost in the 1990s when Princess Diana acknowledged she used it.

As the fashion website Lumana wrote in 2006, “Colon cleansing has become all the rage ...After a therapy session, many people report a feeling of heightened energy, an increased sense of well-being and renewed vitality.”

But mainstream medicine warned the procedure was useless, if not dangerous.

“The practice of colonic irrigation by chiropractors, physical therapists, or physicians should cease. Colonic irrigation can do no good, only harm,” the California Health Department's Infectious Disease Branch said in a 1985 lawsuit against a provider.

In a 1997 paperthat appears on the website of the U.S. National Library of Medicine, a University of Exeter professor of complementary medicine wrote that colon hydrotherapy for autointoxication was quackery.

“Today we are witnessing a resurgence of colonic irrigation based on (little more than) the old bogus claims and the impressive power of vested interests,” wrote E. Ernst, an MD and PhD. “Even today's experts on colonic  irrigation can only provide theories and anecdotes in its support. It seems, therefore, that ignorance is celebrating a triumph over science.”

But mainstream medicine isn’t as fervent in its opposition to colon hydrotherapy as it is to many other alternative practices, such as chelation therapy for heart disease. The American Gastroenterological Association has not stated an official policy. 

Health News Florida called six past presidents of the Florida Gastroenterologic Society seeking opinions about the procedure and got only one lukewarm response.

“In 23 years of practice I’ve never recommended it to a patient, I can tell you that much,” said Dr. Steven Wexner, the chair of the department of colorectal surgery at the Cleveland Clinic in Miami.

On the other hand, Wexner said, he didn’t think he’d ever had a patient who had been injured by the procedure.

Hoenninger said his organization doesn’t have figures on how often the procedure is performed, because throughout most of the country it’s almost totally unregulated. The International Association of Colon Hydrotherapists claims 2,100 certified members in the United States and 400 in other countries.

Swain, the Mount Dora massage therapist, said she would probably have colonic hydrotherapy again if she knew a good practitioner in her area. But she said she
would not recommend the procedure to anyone who was not in very good health, unless they had consulted a physician beforehand.

--Marty Clear is an independent journalist in Tampa. Questions can be addressed to Editor Carol Gentry.