Colon cleansing
Encyclopedia
Colon cleansing encompasses a number of alternative medical therapies
Alternative medicine
Alternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....

 intended to remove feces
Feces
Feces, faeces, or fæces is a waste product from an animal's digestive tract expelled through the anus or cloaca during defecation.-Etymology:...

 and nonspecific toxins from the colon
Colon (anatomy)
The colon is the last part of the digestive system in most vertebrates; it extracts water and salt from solid wastes before they are eliminated from the body, and is the site in which flora-aided fermentation of unabsorbed material occurs. Unlike the small intestine, the colon does not play a...

 and intestinal tract. Colon cleansing may take the form of colon hydrotherapy (also called a colonic or colonic irrigation) or oral cleansing regimens such as dietary supplements. During the 2000s internet marketing and infomercial
Infomercial
Infomercials are direct response television commercials which generally include a phone number or website. There are long-form infomercials, which are typically between 15 and 30 minutes in length, and short-form infomercials, which are typically 30 seconds to 120 seconds in length. Infomercials...

s of colon supplements increased.

Some forms of colon hydrotherapy use tubes to inject water
Water
Water is a chemical substance with the chemical formula H2O. A water molecule contains one oxygen and two hydrogen atoms connected by covalent bonds. Water is a liquid at ambient conditions, but it often co-exists on Earth with its solid state, ice, and gaseous state . Water also exists in a...

, sometimes mixed with herbs or with other liquids, into the colon via the rectum using special equipment. Oral cleaning regimes use dietary fiber
Dietary fiber
Dietary fiber, dietary fibre, or sometimes roughage is the indigestible portion of plant foods having two main components:* soluble fiber that is readily fermented in the colon into gases and physiologically active byproducts, and* insoluble fiber that is metabolically inert, absorbing water as it...

, herbs, dietary supplement
Dietary supplement
A dietary supplement, also known as food supplement or nutritional supplement, is a preparation intended to supplement the diet and provide nutrients, such as vitamins, minerals, fiber, fatty acids, or amino acids, that may be missing or may not be consumed in sufficient quantities in a person's diet...

s, or laxative
Laxative
Laxatives are foods, compounds, or drugs taken to induce bowel movements or to loosen the stool, most often taken to treat constipation. Certain stimulant, lubricant, and saline laxatives are used to evacuate the colon for rectal and/or bowel examinations, and may be supplemented by enemas under...

s. People who practice colon cleansing believe that accumulations of putrefied feces line the walls of the large intestine
Large intestine
The large intestine is the third-to-last part of the digestive system — — in vertebrate animals. Its function is to absorb water from the remaining indigestible food matter, and then to pass useless waste material from the body...

 and that these accumulations harbor parasites or pathogenic gut flora
Gut flora
Gut flora consists of microorganisms that live in the digestive tracts of animals and is the largest reservoir of human flora. In this context, gut is synonymous with intestinal, and flora with microbiota and microflora....

, causing nonspecific symptom
Symptom
A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...

s and general ill-health. This "auto-intoxication" hypothesis is based on medical beliefs of the Ancient Egypt
Ancient Egypt
Ancient Egypt was an ancient civilization of Northeastern Africa, concentrated along the lower reaches of the Nile River in what is now the modern country of Egypt. Egyptian civilization coalesced around 3150 BC with the political unification of Upper and Lower Egypt under the first pharaoh...

ians and Greeks
Ancient Greece
Ancient Greece is a civilization belonging to a period of Greek history that lasted from the Archaic period of the 8th to 6th centuries BC to the end of antiquity. Immediately following this period was the beginning of the Early Middle Ages and the Byzantine era. Included in Ancient Greece is the...

 and was discredited in the early 20th century.

No scientific evidence supports the alleged benefits of colon cleansing. The bowel itself is not dirty and barring drugs, disease or mechanical blockage, cleans itself naturally without assistance. Certain enema preparations have been associated with heart attack
Myocardial infarction
Myocardial infarction or acute myocardial infarction , commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die...

s and electrolyte
Electrolyte
In chemistry, an electrolyte is any substance containing free ions that make the substance electrically conductive. The most typical electrolyte is an ionic solution, but molten electrolytes and solid electrolytes are also possible....

 imbalances, and improperly prepared or used equipment can cause infection or damage to the bowel. Frequent colon cleansing can lead to dependence on enemas to defecate
Defecation
Defecation is the final act of digestion by which organisms eliminate solid, semisolid or liquid waste material from the digestive tract via the anus. Waves of muscular contraction known as peristalsis in the walls of the colon move fecal matter through the digestive tract towards the rectum...

 and some herbs may reduce the effectiveness of prescription drug
Prescription drug
A prescription medication is a licensed medicine that is regulated by legislation to require a medical prescription before it can be obtained. The term is used to distinguish it from over-the-counter drugs which can be obtained without a prescription...

s.

History

The rationale for colon cleansing is the concept of "auto-intoxication", the idea that food enters the intestine and rots. The ancient Egypt
Ancient Egypt
Ancient Egypt was an ancient civilization of Northeastern Africa, concentrated along the lower reaches of the Nile River in what is now the modern country of Egypt. Egyptian civilization coalesced around 3150 BC with the political unification of Upper and Lower Egypt under the first pharaoh...

ians believed that toxins formed as a result of decomposition within the intestines, and moved from there into the circulatory system
Circulatory system
The circulatory system is an organ system that passes nutrients , gases, hormones, blood cells, etc...

 causing fever
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...

 and the development of pus
Pus
Pus is a viscous exudate, typically whitish-yellow, yellow, or yellow-brown, formed at the site of inflammatory during infection. An accumulation of pus in an enclosed tissue space is known as an abscess, whereas a visible collection of pus within or beneath the epidermis is known as a pustule or...

. The Ancient Greek
Ancient Greek
Ancient Greek is the stage of the Greek language in the periods spanning the times c. 9th–6th centuries BC, , c. 5th–4th centuries BC , and the c. 3rd century BC – 6th century AD of ancient Greece and the ancient world; being predated in the 2nd millennium BC by Mycenaean Greek...

s adopted and expanded the idea, applying their belief in the four humours
Humorism
Humorism, or humoralism, is a now discredited theory of the makeup and workings of the human body, adopted by Greek and Roman physicians and philosophers, positing that an excess or deficiency of any of four distinct bodily fluids in a person directly influences their temperament and health...

. In the 19th century, studies in biochemistry
Biochemistry
Biochemistry, sometimes called biological chemistry, is the study of chemical processes in living organisms, including, but not limited to, living matter. Biochemistry governs all living organisms and living processes...

 and microbiology
Microbiology
Microbiology is the study of microorganisms, which are defined as any microscopic organism that comprises either a single cell , cell clusters or no cell at all . This includes eukaryotes, such as fungi and protists, and prokaryotes...

 seemed to support the autointoxication hypothesis, and mainstream physicians promoted the idea. The idea was promoted most strongly by Ilya Ilyich Mechnikov
Ilya Ilyich Mechnikov
Ilya Ilyich Mechnikov was a Russian biologist, zoologist and protozoologist, best remembered for his pioneering research into the immune system. Mechnikov received the Nobel Prize in Medicine in 1908, shared with Paul Ehrlich, for his work on phagocytosis...

, who thought that these toxins could shorten the lifespan. Over time, the concept broadened to "auto-intoxication" which supposes that the body cannot fully dispose of its waste products and toxins, which then accumulate in the intestine. In some cases, the concept led to radical surgeries to remove the colon for unrelated symptoms.

Auto-intoxication enjoyed some favor in the medical community from the late nineteenth to the early twentieth century, but was discarded as advances in science failed to support its claims. A 1919 paper Origin of the so-called auto-intoxication symptom in the Journal of the American Medical Association
Journal of the American Medical Association
The Journal of the American Medical Association is a weekly, peer-reviewed, medical journal, published by the American Medical Association. Beginning in July 2011, the editor in chief will be Howard C. Bauchner, vice chairman of pediatrics at Boston University’s School of Medicine, replacing ...

marked the beginning of the rejection of the auto-intoxication hypothesis by the medical community.

Despite this, "auto-intoxication" persists in the public imagination. The practice of colon cleansing has undergone a resurgence in the alternative medical
Alternative medicine
Alternative medicine is any healing practice, "that does not fall within the realm of conventional medicine." It is based on historical or cultural traditions, rather than on scientific evidence....

 community, supported by testimonial
Testimonial
In promotion and of advertising, a testimonial or show consists of a written or spoken statement, sometimes from a person figure, sometimes from a private citizen, extolling the virtue of some product. The term "testimonial" most commonly applies to the sales-pitches attributed to ordinary...

s and anecdotal
Anecdotal evidence
The expression anecdotal evidence refers to evidence from anecdotes. Because of the small sample, there is a larger chance that it may be true but unreliable due to cherry-picked or otherwise unrepresentative of typical cases....

 evidence and promoted by manufacturers of colon cleansing products.

Medical imaging

Colon cleansing is done for its own sake, prior to surgery, colonoscopy, or similar procedures. The colon is cleansed of solid matter with a regimen of liquid foods then a day before the procedure a whole bowel irrigation
Whole bowel irrigation
Whole bowel irrigation is a medical process involving the rapid administration of large volumes of an osmotically balanced polyethylene glycol solution , either orally or via a nasogastric tube, to flush out the entire gastrointestinal tract.-History:Whole bowel irrigation was originally developed...

 can be performed.

Relationship to medical symptoms

The symptoms that are attributed to auto-intoxication—headache
Headache
A headache or cephalalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the...

, fatigue, loss of appetite
Anorexia (symptom)
Anorexia is the decreased sensation of appetite...

 and irritability
Annoyance
Annoyance is an unpleasant mental state that is characterized by such effects as irritation and distraction from one's conscious thinking. It can lead to emotions such as frustration and anger...

—are actually caused by mechanical distention within the bowel, such as irritable bowel syndrome
Irritable bowel syndrome
Irritable bowel syndrome is a diagnosis of exclusion. It is a functional bowel disorder characterized by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits in the absence of any detectable organic cause. In some cases, the symptoms are relieved by bowel movements...

, rather than toxins from putrefying food. The benefits anecdotally attributed to colon cleansing are vague and the claims made by manufacturers and practitioners are based on a flawed understanding of the body. There is little evidence of actual benefit to the procedure, and no evidence that it can alleviate the symptoms that are attributed to the theories of colon cleansing. No surgeries
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

, autopsies
Autopsy
An autopsy—also known as a post-mortem examination, necropsy , autopsia cadaverum, or obduction—is a highly specialized surgical procedure that consists of a thorough examination of a corpse to determine the cause and manner of death and to evaluate any disease or injury that may be present...

 or other observations of colons have discovered any evidence of compacted feces or other evidence to support the theory of auto-intoxication or the need for colon cleansing.

Complications and risks

The human body naturally removes waste material, and colon cleansing is not necessary except preparatory to a colonoscopy
Colonoscopy
Colonoscopy is the endoscopic examination of the large bowel and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. It may provide a visual diagnosis and grants the opportunity for biopsy or removal of suspected...

. Colon cleansing may disrupt the balance between bacteria
Bacteria
Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...

 and natural chemicals in the bowel, and may interfere with the colon's ability to shed dead cells.

Other rare but serious complications include gastrointestinal perforation
Gastrointestinal perforation
Gastrointestinal perforation is a complete penetration of the wall of the stomach, small intestine or large bowel, resulting in intestinal contents flowing into the abdominal cavity. Perforation of the intestines results in the potential for bacterial contamination of the abdominal cavity...

 from improper insertion, and amoebic infection
Amoebiasis
Entamebiasis is a term for the infection more commonly known as amoebiasis.It became the preferred term in MeSH in 1991, but the term amoebiasis is used by the World Health Organization and by those working in the field of amoebiasis research....

 from poorly sterilised equipment. Some colon cleansing regimens disrupt fluid and electrolyte balance which may lead to dehydration
Dehydration
In physiology and medicine, dehydration is defined as the excessive loss of body fluid. It is literally the removal of water from an object; however, in physiological terms, it entails a deficiency of fluid within an organism...

 and salt depletion, whilst repeated or excessive cleansing programs can lead to anemia
Anemia
Anemia is a decrease in number of red blood cells or less than the normal quantity of hemoglobin in the blood. However, it can include decreased oxygen-binding ability of each hemoglobin molecule due to deformity or lack in numerical development as in some other types of hemoglobin...

 and malnutrition
Malnutrition
Malnutrition is the condition that results from taking an unbalanced diet in which certain nutrients are lacking, in excess , or in the wrong proportions....

. Excessive use of enemas has also been associated with cardiac problems such as heart failure, and heart attacks
Myocardial infarction
Myocardial infarction or acute myocardial infarction , commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die...

 related to electrolyte imbalances when performed as coffee enema
Coffee enema
Coffee enemas are the enema-related procedure of inserting coffee into the anus to cleanse the rectum and large intestines. This procedure, although well documented, is considered by most medical authorities to be unproven, rash and potentially dangerous....

. The frequent use of enema
Enema
An enema is the procedure of introducing liquids into the rectum and colon via the anus. The increasing volume of the liquid causes rapid expansion of the lower intestinal tract, often resulting in very uncomfortable bloating, cramping, powerful peristalsis, a feeling of extreme urgency and...

s or other colon cleansing tools may lead to dependence and an inability to defecate without assistance or withdrawal symptoms.

Herbs that are consumed for colon cleansing and taken as oral preparations may also interfere with drug absorption
Absorption (Pharmacokinetics)
In pharmacology , absorption is the movement of a drug into the bloodstream.Absorption involves several phases...

 and effectiveness of prescription drug
Prescription drug
A prescription medication is a licensed medicine that is regulated by legislation to require a medical prescription before it can be obtained. The term is used to distinguish it from over-the-counter drugs which can be obtained without a prescription...

s.

Supplement effectiveness

Marketplace
Marketplace (TV series)
Marketplace is a Canadian television series, broadcast on CBC Television. Launched in 1972, the series is a consumer advocacy newsmagazine, which shows investigative reports on issues such as product testing, health and safety, fraudulent business practices and other news issues of interest to...

 conducted a consumer trial with 3 women on the effectiveness of two colon supplements versus fiber. The results showed the supplements did not assist in weight loss and provided no additional benefit over a basic fiber supplement.

United States

The U.S. Food and Drug Administration (FDA) regulates the production of equipment used in colon hydrotherapy in the USA but does not regulate their use, or the supplements used in oral colon cleansing regimens and manufacturer claims do not require verification or supporting evidence. The contents of the products are also not verified or tested. The FDA has issued several letters warning manufacturers and suppliers of colon hydrotherapy equipment about making false claims of effectiveness, safety issues and quality control violations.
The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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