Colonic Irrigation: Therapeutic Claims by Professional Organisations, a Review

E. Ernst

Disclosures

Int J Clin Pract. 2010;64(4):429-431. 

In This Article

Discussion

The question therefore arises whether these hypotheses have been tested and, if so, what the results of such investigations suggest? In conventional healthcare, colonic irrigation is occasionally used for postoperative defecation disorders, faecal incontinence or for the prevention of postoperative enterocolotis – and there is at least some evidence in support.[10–15] Patients suffering from slow transit constipations sometimes report symptomatic relief after colonic irrigation; yet this is short lived and achievable with evidence-based treatments. Using searches in Medline and Embase, I was unable to find a single controlled clinical trial to substantiate the claims shown in Table 1 . The previous reviews of the subject have also failed to find such evidence (e.g. [16,17]). Therefore, it seems fair to say that the therapeutic claims made by professional organisations of colonic irrigation are unsubstantiated.

A recent survey suggested that colonic irrigation is totally devoid of risks: during 8470 treatments administered by UK members of the 'Association of Colonic Hydrotherapists', no adverse events were noted.[3] The previous reviewers also gave the impression that the procedure is safe (e.g. [18]). However, other authors have stated that side-effects include nausea, diarrhoea, nervous disturbances[16] as well as cramps and irritations.[19] Moreover, the documented risks include electrolyte depletion,[20,21] water intoxication,[22,23] bowel perforation[24–27] and infection.[28]

In view of both the absence of evidence of effectiveness and the possibility of harm, any attempt at a risk-benefit analysis must yield a negative verdict. Proponents of colonic irrigation seem to think that such a statement indicates 'hostility towards colonics by the opponents of quackery'. I would argue that it reflects mere medical common sense. Moreover, one has to ask why the organisations concerned do not submit their chosen treatment modality to test.

In conclusion, this analysis shows that professional organisations of colonic irrigation make therapeutic claims that are not based on scientific evidence. In the interest of our patients, we should find ways to correct this situation.

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