Former customers of two colon cleansing services in Thunder Bay, Ont. are getting tested for Hepatitis B and C as well as HIV after complaints of poor hygiene practices at the businesses. The city's health unit is warning clients may have been exposed to improperly cleaned instruments by having the service.
Earlier this year, Gwyneth Paltrow's celebrity lifestyle website, Goop, recommended a do-it-yourself coffee enema to as a detox "supercharge." She also endorses colonics.
But health experts say there is no scientific evidence to support colon cleaning treatments, which are popping up in Canadian cities.
What is it?
Colonics are also known as colon cleaning, colonic irrigation or colonic hydrotherapy. Colonic hygienists or colon therapists usually perform the procedure. People also perform it on themselves.
It works like an enema but with much more fluid — up to 60 litres or 16 gallons. That's the equivalent of a gas tank in a Honda Civic.
The patient usually lies on a table and water is slowly pumped into the rectum through a tube. Sometimes herbs or compounds are added. Fluids and waste are expelled.
Why do people do it?
Colonics are promoted as a way to clean out the colon of waste.
"For things like weight loss, anti-aging and natural beauty there can be a lot of appeal," said Monica Black, who offers the service in Toronto and flushes her own colon monthly.
Dr. Ranit Mishori of Georgetown University School of Medicine in Washington, D.C. reviewed colon cleansing for a 2011 paper published in the Journal of Family Practice.
People hear about it from a variety of celebrities like Paltrow, as well as internet and magazine marketing campaigns, she said.
"I think they don't know that a) there are risks and b) that there's no evidence whatsoever behind all of these claims for feeling better, losing weight, battling depression, enhancing your immunity," Mishori, a professor of family medicine, said in an interview with CBC News.
"None of these things have been studied or have been proven to be correct in terms of the marketing."
What does the science say?
Stool is a waste product in and of itself and the colon does not build up toxins, said Dr. Constantine Soulellis, a gastroenterologist at the McGill University Health Centre in Montreal.
"Trying to help along a system that's already perfected biologically is pointless," Soulellis said.
What are the risks?
In Mishori's review, complications ranged from:
An imbalance of minerals and electrolytes such as salts after absorbing so much water. Electrolyte disturbances can lead to heart failure and kidney damage.
Interference with bacteria that are supposed to line the colon.
- Slight tears in the intestines to full perforations and even death.
Soulellis has treated serious complications. "I did see a patient once with a colonic perforation and wound up with an ostomy," or a waste bag, he said.
"The colon had to be diverted away from the rectal and anal area because of the damage that was done."
Other side effects include:
- Pancreatitis .
There have been warnings about infection risk, such as the one issued by Thunder Bay's public health unit in the most recent case.
Who polices it?
Health Canada said it regulates the sale, advertising and importation for sale of licensed medical devices, including 10 colonic irrigators that are authorized for use before surgery.
The clinics, however, are not always checked. Health Canada said it does not inspect clinics that perform colonic hydrotherapy. Most Canadian cities also don't.
"There's no standard for cleanliness, there's no standard for sterilization," Soulellis said. "It's very much an issue of buyer beware."