Sunday, October 13, 2019

Colonic Hydrotherapy. Is it Time to Bend Over?

From time to time, patients asks my advice on colonic hydrotherapy, vigorous sessions of enemas that aim to cleanse the body of toxins that are reputed to cause a variety of ailments.   The logic sounds plausible to interested patients.  Over time, toxins accumulate and leech into the body wreaking havoc.  Indeed, using the label ‘toxins’ already suggests that these are noxious agents.  If one accepts this premise, it is entirely logical that cleansing the body of these injurious agents would have a salutary effect.

Not surprisingly, the health benefits of hydrotherapy usually target very stubborn and vague symptoms and conditions that conventional medicine do not treat adequately.  It makes sense that if your own physician is not making sense of your chronic fatigue, for example, that you would entertain other options.  I get this.  Who wouldn’t want to enjoy having more energy, better concentration, an enhanced immune system or delayed aging?  But, in medicine and in life, just because one pathway seems blocked, doesn’t mean that an alternative pathway will be a better avenue. 


Let the Cleansing Begin!


The reason that I do no actively recommend hydrotherapy is because there is absolutely no persuasive and credible medical evidence that it is effective.  While their advertising materials may boast of ‘clinical studies’, there is no firm scientific basis for their claims.  And, these sessions can be costly as patients are often advised that several visits are necessary to address years of toxin build up.

If gastroenterologists did believe that the treatment works, we would be offering it in our ambulatory surgery centers along with our standard endoscopic amusement activities.  (A cynic might suggest here that if medical insurance covered these treatments, then we would!) 

It may very well be that practitioners of this treatment believe in the therapy and genuinely want to provide healing.  And, I have no doubt that many who undergo hydrotherapy feel better.  I’ll never talk a patient out of success from my or anyone’s treatment.  If a hydrotherapy patient were to tell me that his depression has eased, I would express great satisfaction over this.

I admit readily that I, along with every other breathing physician, prescribe treatments and remedies for which no supportive medical evidence exists.   We physicians may sanitize this fact by claiming that our action is an example of ‘the art of medicine’, but we are more likely hoping for the placebo effect.  

Physicians who deviate from evidence-based medicine shouldn’t casually criticize other practitioners who practice off the grid, particularly when patients have great faith in complimentary and integrative medicine.

However, all of us who claim to be healers should aspire for supportive scientific evidence for our recommendations, and we should admit to patients when such evidence is lacking. 

If you opt for periodic colonic cleanses, and you perceive a personal benefit, then be aware that you are engaging in an ‘art’, and not a science.  




2 comments:

Lucas W Trengove said...

I love your take on how to handle alternative therapies. Too many doctors put down what they don't know about or can't explain. If it is not hurting, why not?

Michael Kirsch, M.D. said...

@Lucas, thanks for the comment. I agree that many physicians are arrogant about complimentary medicine, even when many of our 'conventional treatments' are not based on solid evidence. With regard to your comment, "if it is not hurting...", I do think patients need to be told if the recommendation has solid medical evidence supporting the advice.

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