In gastroenterology, the term "colonic irrigation" is also used to refer to the practice of introducing water through a colostomy or a surgically constructed conduit as a treatment for constipation.
Though colon hydrotherapy, colemas and enemas all have features in common, there are some significant differences between the modalities in terms of depth of colon cleansing, amount of water used, and the necessity for a practitioner to be present.
The practice has been known since ancient times for treating constipation which was believed to have been the root of many diseases and illnesses. The first recorded reference to colon cleansing date back more than 3000 years to the Ebers papyrus, an Egyptian medical document. This document outlines bowel and colon cleansing procedures using various herbal concoctions and water, and has been carbon dated to between 1500 and 1700 B.C.
In the early 1980s, there were a number of cases of amebiasis, leading to six deaths attributed to therapist Marissa Wright, who failed to maintain sanitary conditions. These are believed to be the only fatalities that can directly be attributed to colon hydrotherapy. There have been reports of electrolyte imbalances in children brought on by colonics using softened water. Such imbalances can also be caused by laxative use or diarrhea.
Current alternative medicine practitioners recommend it for a variety of ills stemming from accumulation of fecal matter in the large intestine, a process referred to as autointoxication (a theory no longer accepted in mainstream medicine). Some alternative medicine practitioners believe that autointoxication results from increased absorption of bacterial / fungal toxins as a result of an increased toxic load in the colon. Colonic irrigation can be useful in cases of incontinence, where it is tolerable to the patient.
Colonic irrigation should not be used in people with diverticulitis, ulcerative colitis, Crohn's disease, severe or internal hemorrhoids or tumors in the rectum or colon. It also should not be used soon after bowel surgery (unless directed by one's health care provider). Regular treatments should be avoided by people with heart disease or kidney disease (renal insufficiency). Colonics are inappropriate for people with bowel, rectal or anal pathologies where the pathology contributes to the risk of bowel perforation.
Controversy and regulation
While some hydrotherapists believe colonics lead to better overall wellness, others claim it helps ease specific diseases, including chronic fatigue, arthritis, and sinusitis. It is also claimed to improve muscle tone in the colon, leading to stronger peristaltic contractions. There is limited scientific research to support these claims.
The practice is currently only regulated in some states of the United States. Some practitioners go through a voluntary certification process, and may be members of one of the colon hydrotherapy associations worldwide, such as the International Association of Colon HydroTherapy (I-ACT)or The Guild of Colon Hydrotherapists. Prospective patients should ensure that the equipment used is sterile and that the practitioner is experienced.
The American College of Gastroenterology takes the position that in the unusual case of fecal impaction complicating chronic constipation, a 5 to 10 ounce tap water enema may be of benefit, but does not otherwise recommend its use. The orthodox medical establishment perceives colon hydrotherapy to be little more than a bowel rinse, or expensive laxative. The typical cost for a colonic treatment is about $65 to $100 in the US.