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Maybe Colons Aren't Meant To Be Cleaned

I confess, there are times when the idea of colon-cleansing has a certain appeal. During relentless bloating. Or when juice fast types propound the canard that the average American man has five pounds of meat backed up in his colon. Or when brinksmanship in Washington leaves me with such lingering nausea that I feel like the whole country just needs a giant enema.

But a paper just out today in the Journal of Family Practice debunks the notion that we can so easily cleanse away our sins. Examining 20 previous studies, it finds that no matter how many celebrities may tout it, there is no medical evidence that colon cleansing is healthful, but plenty of evidence that it can cause harm. Researchers at Georgetown University School of Medicine and Providence Hospital report that the cleaning can cause bacterial complications and punctures.

The study is reported widely today, including in The Telegraph and on MSNBC here. Time's Healthland has some particularly nice quotes from researcher Ranit Mishori in its piece here, including:

“I totally understand where people are coming from in wanting to detoxify,” says Mishori, “You want to get all the gunk out. But there is no evidence that [the cleanses] are doing anything, and physiologically it doesn't make sense. The body has a system for detoxifying itself—it's called pee and poop. And for healthy people, that's all it takes.”

And while the idea of cleaning out the intestines sounds like a good idea, you actually need a good growth of bacteria in your gut to ease digestion and voiding of waste.

But what concerned Mishori and her team wasn't simply the fact that patients didn't appear to be getting any benefit from the cleanses, but that the procedures were causing harm. “Every time you put something where it's not supposed to be in the body, you can poke tissue, make holes and disrupt architecture,” she says. And that's exactly what the studies found.

A bit of history from The Telegraph:

Colon cleansing has been carried out for thousands of years, with the ancient Egyptians the first to believe that pumping water through a tube inserted in the rectum was good for you. They thought it rid the body of waste accumulating on the walls of the intestines that released toxins into the bloodstream.

According to a paper published in The Journal of Family Practice, the theory of “auto-intoxication” was largely debunked in the early 20th century but has made a comeback in recent decades as part of a general interest in alternative medicine procedures that are seen as more natural and traditional than taking drugs or undergoing surgery.

And this from MSNBC:

The theory behind the need to cleanse your colon is called “autointoxication.” Food gets trapped in the colon, rots, and causes the release of toxins. The theory was largely discounted in the early 20th century.

But everything that’s old is new again, and detoxing is hot, stemming largely from people’s fears of the copious amounts chemicals and pesticides found in food and the environment. With claims that a cloggy, toxin-filled colon can lead to a litany of ills including skin problems, sexual dysfunction, asthma, obesity, memory loss and even cancer, detox devotees are making colon cleansing trendy again.

You can get your colon clean a few ways. Herbal concoctions, some of which are mixed with coffee or laxatives, can be taken orally or in the form of a suppository. Although they promise rejuvenation and well being, herbal preparations, none of which are FDA regulated, can cause serious side effects like dehydration and liver toxicity. Other DIY cleanses, such as the lemon-juice based Master Cleanse, are reportedly used by celebrities such as Gwyneth Paltrow.

Readers, if it's not too intimate, have you ever tried this? How did it go?
Note: The study does not appear to be available online. Have asked the journal and will post a link if available.

This program aired on August 1, 2011. The audio for this program is not available.

Carey Goldberg Twitter Editor, CommonHealth
Carey Goldberg is the editor of WBUR's CommonHealth blog.

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