How clean is your colon? If you're tempt­ed to find out by get­ting a colon cleanse, don't both­er. You're quite like­ly to de­vel­op com­pli­ca­tions from the pro­ce­dure and there's no ev­i­dence that flush­ing out your colon has any health ben­e­fits. That's the con­clu­sion re­searchers reached af­ter re­view­ing 20 stud­ies on colonic cleans­ing. Dr Ran­it Mishori and her team at George­town Uni­ver­si­ty School of Med­i­cine and Prov­i­dence Hos­pi­tal re­port in the Jour­nal of Fam­i­ly Prac­tice that colonic cleans­es-whether with wa­ter or via sup­ple­ments or herbal reme­dies, don't ac­tu­al­ly do much-oth­er than po­ten­tial­ly cause some un­com­fort­able, and in some cas­es dan­ger­ous side ef­fects. Spas and well­ness fa­cil­i­ties like to tout the "detox­i­fy­ing" ben­e­fits of colonic cleans­es, and these claims in­clude im­prove­ments in well-be­ing and en­er­gy and even weight loss. Some reme­dies go so far as to list boosts in im­mune func­tion. The con­cept is cer­tain­ly al­lur­ing-stress, not to men­tion our un­healthy di­ets and the var­i­ous chem­i­cals and pol­lu­tants we're ex­posed to every­day-can build up in our gut, slow­ly poi­son­ing us from the in­side out. Why not pe­ri­od­i­cal­ly clean out the sys­tem and start anew?

The prob­lem with that ar­gu­ment, says Mishori, is that there is no med­ical ev­i­dence to sup­port it. Colonic cleans­es were pop­u­lar more than a cen­tu­ry ago, un­til the Amer­i­can Med­ical As­so­ci­a­tion quashed any no­tion that the prac­tice was worth­while by con­demn­ing cleans­es as not med­ical­ly nec­es­sary in 1919. But in re­cent years, celebri­ties, with the help of heavy mar­ket­ing by spa fa­cil­i­ties, have brought the cleans­es back. Noth­ing, how­ev­er, has changed on the med­ical front. "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.

Those who un­der­went colon hy­drother­a­py, in which tech­ni­cians in­sert a tube in the rec­tum and flood the colon with litres of flu­id, of­ten wa­ter, ex­pe­ri­enced in­fec­tions and com­pli­ca­tions from bac­te­ria that were in­tro­duced in­to the colon or from ac­ci­den­tal punc­tures made by the hose. Peo­ple who opt­ed for less in­va­sive meth­ods, in­clud­ing sup­ple­ments, teas, lax­a­tives, or herbal reme­dies to emp­ty the colon didn't nec­es­sar­i­ly fare any bet­ter-they ex­pe­ri­enced cramp­ing, ab­dom­i­nal pain, nau­sea, vom­it­ing, and, in se­vere cas­es, im­bal­ances in their elec­trolytes and kid­ney fail­ure. Dick Hoen­ninger, ex­ec­u­tive di­rec­tor of the In­ter­na­tion­al As­so­ci­a­tion for Colon Hy­drother­a­py, a pro­fes­sion­al or­gan­i­sa­tion that cer­ti­fies tech­ni­cians in the pro­ce­dure, says the group is aware of well-be­ing claims made for colon cleans­ing, but notes that there isn't much sci­ence be­hind them. "We sug­gest to our ther­a­pists and any­body do­ing colon hy­drother­a­py that it should be done for med­ical­ly in­di­cat­ed pur­pos­es and at the in­di­ca­tion of a physi­cian," he says.

In­deed, the on­ly rea­sons for which the FDA ap­proves colon hy­drother­a­py de­vices that use flu­ids to cleanse the colon, are med­ical needs such as to clean out the colon be­fore a ra­di­o­log­i­cal ex­am, or colonoscopy, or for con­sti­pa­tion. But iron­i­cal­ly, while peo­ple are will­ing to un­der­go cleans­ing for un­proven pur­pos­es of well-be­ing, un­der the premise that they are detox­i­fy­ing them­selves, they're a lit­tle less will­ing to get the pro­ce­dure done when it might ac­tu­al­ly lead to med­ical ben­e­fits. Cleans­ing with lax­a­tives or oth­er reme­dies, for ex­am­ple, is sim­i­lar to the prepa­ra­tion re­quired be­fore a colonoscopy to check for can­cer­ous le­sions, but many peo­ple would rather risk miss­ing the tu­mour than sub­ject them­selves to the dis­com­fort of emp­ty­ing out their colon. That may speak to the fact that spas and well­ness fa­cil­i­ties might be bet­ter at mar­ket­ing their ser­vices than doc­tors. But giv­en the lack of ev­i­dence sup­port­ing the prac­tice, the ben­e­fits of colon cleans­ing, it seems, re­main more psy­cho­log­i­cal than phys­i­o­log­i­cal. -www. health­land.time.com