Colonic Irrigation for Treating Psychological Disorders

Colonic irrigation, colonic hydrotherapy may be helpful for some medical conditions, but for treatment of addiction, chronic fatigue syndrome and insomnia, there's little proof it's effective.

Before engaging in any complementary medical technique, you should be aware that many of these techniques have not been evaluated in scientific studies. Often, only limited information is available about their safety and effectiveness. Each state and each discipline has its own rules about whether practitioners are required to be professionally licensed. If you plan to visit a practitioner, it is recommended that you choose one who is licensed by a recognized national organization and who abides by the organization's standards. It is always best to speak with your primary health care provider before starting any new therapeutic technique.

• Background
• Theory
• Evidence
• Unproven Uses
• Potential Dangers
• Summary
• Resources

Background

Colonic irrigation, also called colonic hydrotherapy, is a variant of enema treatment, which involves flushing the bowel with water in different quantities, temperatures and pressures. Through a tube inserted via the rectum, water may be introduced alone or with added enzymes, coffee, probiotics or herbs. Treatment sessions usually last about one hour. During a "high colonic," water goes in through one tube in the colon and is removed along with debris through another tube called an obturator.

Colonic irrigation may have been used as early as ancient times in Egypt, China, India and Greece. This practice gained some popularity in 19th century European spas, and it has been used in modern times for general well being and a variety of other conditions.

Theory

Colonic irrigation is proposed to improve mental outlook, modulate the immune system and eliminate toxic substances. Some practitioners suggest that intestinal flora (bacteria that normally live in the intestine) or waste products can affect the entire body's immune system and may therefore be involved with diseases outside of the gastrointestinal tract. It is proposed but unproven that washing away these flora or waste products may have beneficial effects.

There are numerous anecdotes about the benefits of colonic irrigation, although there is limited published scientific research in this area.

Evidence

Scientists have studied colonic irrigation for the following health problems:

Fecal (stool) incontinence
There is early research regarding the use of regular irrigation of the lower part of the colon in people with fecal incontinence. Further study is necessary to determine if benefits are likely to occur in most patients.

Ostomy care
Special types of colonic irrigation may be used in patients with ostomies (surgically created connections between the intestine and the side of the body). This area has been studied scientifically, and use of colonic irrigation in this setting should be conducted only under the strict supervision of a qualified ostomy health care provider.

Colonic spasm (during colonoscopy)
Evidence from some studies has shown that irrigation with warm water during colonoscopy may help reduce the incidence of colonic spasm. Further research is needed.

Surgical uses
Surgeons or other health care practitioners may use colon irrigation before or during some bowel surgeries (for example, colon cancer resection) for purposes such as cleansing or toward improved healing.

Unproven Uses

Colonic irrigation has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially life-threatening. Consult with a health care provider before using colonic irrigation for any use.

Potential Dangers

Colonic irrigation can potentially cause severe adverse effects and must be carefully administered. People receiving frequent treatments may absorb too much water, leading to electrolyte imbalances in the blood, nausea, vomiting, heart failure, fluid in the lungs, abnormal heart rhythms or coma. Infections have been reported, possibly because of contaminated equipment or as a result of clearing out normal colon bacteria. There is a risk of bowel perforation (breakage of the bowel wall), which is a severe complication. Deaths have been reported.

Colonic irrigation should not be used in people with diverticulitis, ulcerative colitis, Crohn's disease, severe or internal hemorrhoids or tumors in the rectum or colon. It also should not be used soon after bowel surgery (unless directed by your health care provider). Regular treatments should be avoided by people with heart disease or kidney disease (renal insufficiency). Be sure that the equipment used is sterile and that the practitioner is experienced. Colonic irrigation should not be used as the sole treatment (instead of more proven therapies) for severe conditions, and it should not delay consultation with a qualified health care provider for a potentially severe symptom or illness.

Summary

Colonic irrigation has been recommended for many conditions. There are numerous anecdotes about successful treatment with colonic irrigation, although effectiveness and safety have not been thoroughly studied scientifically. Because of the potential risks involved, colonic irrigation may not be safe for many individuals.

The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.

Resources

1. Natural Standard: An organization that produces scientifically based reviews of complementary and alternative medicine (CAM) topics
2. National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research

Selected Scientific Studies: Colonic Irrigation

Natural Standard reviewed more than 40 articles to prepare the professional monograph from which this version was created.

Some of the more recent studies are listed below:

1. Anon. Amebiasis associated with colonic irrigation: Colorado. MMWR Morb Mortal Wkly Rep 1981;30(9):101-102.
2. Briel JW, Schouten WR, Vlot EA, et al. Clinical value of colonic irrigation in patients with continence disturbances. Dis Colon Rectum 1997;40(7):802-805.
3. Chen WS, Lin JK. A potential alternative treatment of uncomplicated painful diverticular disease by trans-colonoscopic irrigation technique: a preliminary report. J Chin Med Assoc 2003;May, 66(5):282-287.
4. Church JM. Warm water irrigation for dealing with spasm during colonoscopy: simple, inexpensive, and effective. Gastrointest Endosc 2002;Nov, 56(5):672-674.
5. Ernst E. Colonic irrigation and the theory of autointoxication: a triumph of ignorance over science. J Clin Gastroenterol 1997;24(4):196-198.
6. Istre GR, Kreiss K, Hopkins RS, et al. An outbreak of amebiasis spread by colonic irrigation at a chiropractic clinic. N Engl J Med 1982;307(6):339-342.
7. Lim JF, Tang CL, Seow-Choen F, et al. Prospective, randomized trial comparing intraoperative colonic irrigation with manual decompression only for obstructed left-sided colorectal cancer. Dis Colon Rectum 2005;48(2):205-209.
8. Sisco V, Brennan PC, Kuehner CC. Potential impact of colonic irrigation on the indigenous intestinal microflora. J Manipulative Physiol Ther 1988;11(1):10-16.
9. van der Berg MM, Geerdes BP, Heij HA, et al. Defecation disorders in children: treatment with colonic irrigation through an appendicostomy. Ned Tijdschr Geneeskd 2005;149(8):418-422.

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