Do enough research into health and wellness and you’ll inevitably encounter information about at-home colon cleanses that promise a host of benefits. But when Bottom Line Personal asked Brooks Cash, MD, chief of gastroenterology at University of Texas Health Science Center at Houston, how to cleanse your colon, he said there’s little, if any, evidence that colon cleansing is beneficial…and there’s even some degree of risk.
Celebrities, social-media influencers and boutique spa owners ascribe numerous benefits to colon cleanses, including improved colon health…whole-body detoxification…resetting the gut microbiome…and relief from constipation, headaches, allergies, asthma, joint pain and skin disorders.
Approaches to colon cleansing, which employ many methods and substances, fall into two broad categories…
Cathartic cleanses involve consuming some kind of purgative to flush out the gastrointestinal tract and bring on diarrhea. These can include high doses of polyethylene glycol (Miralax) or bisacodyl (the active ingredient in Dulcolax)…and even the bowel preps prescribed to colonoscopy patients.
Retrograde cleanses involve inserting a substance through the rectum, usually through an enema to flush out the colon with water, coffee or other concoctions marketed for that purpose.
Although colon cleansing has existed in various forms at least since the Middle Ages, it has never found its way into evidence-based Western medicine, and that’s because the practice lacks high-quality data supporting its supposed benefits.
Many people report feeling lighter and healthier after a colon cleanse, and no doubt this is true. A cleanse, like any significant bowel movement, will make you feel less bloated or full and may relieve some abdominal discomfort. But there’s probably also a placebo effect, and that good feeling usually is brief.
The fact is, cleansing the colon is unnecessary. Our bodies generally manage their own equilibrium quite efficiently, and the colon is self-cleaning.
Beyond being ineffective and unnecessary, colon cleansing may cause harm. A colon cleanse can cause a perforated colon, dehydration and electrolyte imbalances, colon inflammation and bleeding, and even liver toxicity. And a cleanse may upset the balance of bacteria in the gastrointestinal tract. While some proponents of colon cleansing actively promote such disturbance, the more we learn about the importance of the gut microbiome for health throughout the body, the more we believe that gut flora should be left alone.
Special caution: Be particularly careful to avoid colon cleansing if you have preexisting gastrointestinal diseases such as a history of small bowel obstruction, delayed stomach emptying or inflammatory bowel disease. Also avoid the practice if you have congestive heart failure, chronic kidney disease or chronic liver disease.
If you’re having digestive issues, get a referral to a gastroenterologist, many of whom work with skilled dietitians to help patients find relief. If you’re concerned about general colon health, follow a plant-heavy eating pattern…and don’t neglect routine colon cancer screening, which for most people should begin at age 45.
