Dr John Wright

Gastroenterologist
MbChB MRCP(UK) PhD

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Colonic hydrotherapy: The Toxic Tide

Dr John P Wright
Updated: 22 May 2007

The false concept that stool is toxic has found a multitude of willing believers served by equally confused therapists. The belief that our colon contains toxins has a long history going back to ancient Egyptian times when enemas and laxatives first found favour. Closer to home many of the population use enemas to purify themselves.

Stool is not simply a waste product of the colon. The colon absorbs water and electrolytes from the stool. An equally important function is to provide an environment where colonic bacteria can digest the fibre residue in the diet. In this process short chain fatty acids, hydrogen and methane are released which are further metabolised by the bacteria and colonic cells before being reabsorbed as carbohydrate derivatives for the nutrition of the body. In some mammals this colonic fermentation is even more important. In man this process may add 10% of the daily energy requirement but much more is provided in elephants by this fermenting process.

Stool is not toxic. The abdominal discomfort and vague symptoms sometimes associated with constipation are probably due to psychological factors and colonic distension. Stool consists of bacteria (95%), food residual and bile (5%). As the bacteria digest the fibre and the excess fluid is absorbed the stool volume slowly decreases. This is why some individuals can pass a stool once a week and still report no symptoms.

Stool does not “stick” in the colon like an old water pipe. The mucous layer and intrinsic motor activity ensure constant movement of the stool mass. When a colonoscope is passed into an unprepared colon the stool falls off the “roof” of the bowel leaving a spotless mucosa. It is only when the stool is watery in the more proximal colon that it may adhere to the mucosa but here a short wash of water clears the area completely. Diverticulae are little pouches in the colonic wall that usually appear with advancing age. These diverticulae may harbour stool and barium for some time after a barium enema. In the lderly or immobile the barium may be seen in diverticulae for a week or two before emptying spontaneously. The colon itself clears the barium out in the normal day or two. There is no evidence of a continuous collection of stool residue in the colon.

While the concept of removing stool from the colon by chemical or mechanical methods is fallacious the methods used are positively harmful. Laxatives will slowly but surely damage the colon and are generally used in ever increasing doses over the years. The recent fashion of colonic washouts and hydrotherapy can have fatal results. The mechanical process of running litres of fluid in and out of the colon can be painful. Perforation of the colon is well reported. The transmission of infection is an obvious danger. Case reports of amoebiasis after colonic hydrotherapy with deaths are even now the subject of criminal cases before the courts in the USA. The American Food and Drug Administration (FDA) has approved colonic hydrotherapy for cleaning the colon prior to examination by colonoscopy or sigmoidoscopy. No other indication is approved. The FDA is currently pursuing a number of individuals who have been offering hydrotherapy to the public outside of these parameters.

It is unfortunate that hydrotherapy has been promoted by a number of public figures and magazine articles. It is a dangerous, unnecessary, invasive and expensive procedure that lacks any rational basis as a promoter of good health.