Do you really need a colon cleanse?

Unless you’re prepping for a colonoscopy, probably not.

Cleaning out the colon is sometimes necessary — for example, before a medical procedure, such as a colonoscopy. But some people do it in the belief that the process will rid their colon of excess toxins that accumulate over time from the foods they eat, the air they breathe, the water they drink and the lifestyles they lead.

Medical professionals say that the body comes well-equipped with its own built-in mechanisms to eliminate harmful substances: the liver and kidneys. In fact, colon cleansing that is done to help remove toxins is an unnecessary and potentially dangerous practice, especially colon hydrotherapy.

“Every week, someone asks me whether colon cleansing is safe and whether a person should be doing it,” said Dr. Jacqueline Wolf, a gastroenterologist at Beth Israel Deaconess Medical Center in Boston and the author of “A Woman’s Guide to a Healthy Stomach” (Harlequin, 2011).

Wolf tells her patients there is little research on colon-cleansing methods, and that most physicians don’t believe in these treatments or advise their use.

One circumstance in which medical professionals recommend cleaning out the colon is before a colonoscopy, a procedure in which a tiny camera at the end of a lighted tube is inserted through the anus, through the rectum and into the large intestine to enable the doctor to look for pre-cancerous polyps, cancer or other diseases, according to the American College of Surgeons. The need for cleaning out the colon in this case is simple: “If you don’t clean out the stool, you can’t see anything. You need to be able to see the [intestinal] wall, and to do that you need a clean colon,” Wolf said.

Three days before a colonoscopy, patients typically follow a low-fiber diet so that their stool will not be too hard. The day before a colonoscopy, patients follow a liquids-only diet. The night before, patients drink a colonoscopy prep solution, which is a laxative that induces diarrhea in order to empty the bowel. Different colonoscopy preps work in slightly different ways, but they all stimulate bowel movements, Wolf said. Diarrhea is not a problem in this case, but the goal. Without it, the colon won’t be empty and the doctor may not be able to see what they need to.

Colonoscopy preps can have a few potential side effects. For example, they may change the body’s levels of electrolytes, which are ions of chemicals such as potassium and sodium that conduct electricity when dissolved in water, Wolf said. On one hand, drinking lots of water before a colonoscopy has the potential to dilute electrolytes like sodium and magnesium. On the other hand, diarrhea could have the opposite effect and result in increased concentrations of those chemicals, Wolf said. Shifting levels of sodium might cause lightheadedness, and low potassium levels may cause leg cramps or abnormal heart rhythms, she said.

Additionally, any laxative that draws water into the colon brings the risk of dehydration, if the individual does not drink enough fluids, Wolf said. She recommends that people drink water with added electrolytes when preparing for a colonoscopy.

Other side effects of colonoscopy preps can include bloating, nausea and vomiting, and abdominal pain, according to the American Society for Gastrointestinal Endoscopy.

People go through the discomfort of colonoscopy prep and the procedure itself because it’s a means to an end. Colonoscopies enable doctors to detect and remove precancerous polyps and to spot colorectal cancer early, when treatment is most likely to work, according to the Centers for Disease Control and Prevention (CDC). The colon cleansing that happens before a colonoscopy does not have any other health-related purpose, Wolf said.

Colon-cleansing enthusiasts believe that periodically cleaning from the inside out removes excess waste stuck to the colon walls. This waste buildup also supposedly produces toxins that enter the blood and may slowly poison people. Wellness companies claim that colon cleansing can help relieve a variety of symptoms — such as fatigue, bloating, irritated skin and weight gain — and alleviate a range of health problems, from depression and allergies to arthritis and cancer.

Cleansing proponents promote two, or perhaps three, ways to clean the colon. One method involves taking bowel-clearing laxatives, powders or supplements; using enemas; or drinking herbal teas to purportedly release colon waste and discharge toxins. But using this method might feel more like frequently running to the bathroom 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. This procedure can cost from $55 to $95 per session, according to The Colon Therapists Network.

A third method is dietary colon cleanses, such as juice cleanses and high-fiber diets.

Wolf said people’s curiosity about cleansing possibly stems from the idea that the bowel is a dirty place, and that getting rid of waste is a good idea. She said she usually doesn’t recommend colon hydrotherapy, but has suggested it for a few people to use as colonoscopy preparation when traditional methods have failed. She also recommended it for patients who had severe constipation, before there were strong drugs that could help remedy this problem.

But does colon cleansing flush out toxins, as its supporters suggest, or does it flush money down the toilet?

“We don’t know enough about colon cleansing to know the real truth,” Wolf told Live Science. “It’s an area we should learn more about.”

A review study published in 2009 in the American Journal of Gastroenterology concluded that there were no rigorous studies to support the practice of colon cleansing as a way of improving or promoting general health.

And because cleansing products and methods rarely name the specific toxins they supposedly remove from the body, there’s been no research measuring how effective cleansing practices may be at actually eliminating these substances, or demonstrating the health benefits of removing them, Wolf said.

There’s also no evidence that a colon cleanse can cause meaningful weight loss. A cleanse may help a person lose a few pounds initially, but that is a temporary loss, resulting from the removal of water weight and stool, and not from a permanent loss of fat. Although it could be motivating to see results on the scale for a few days, cleansing is not a long-term solution to a weight problem, Wolf said.

 

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