During the past decade, the FDA has issued many warning letters to manufacturers for unapproved use of the devices for colon cleansing.
Raise the issue with patients Given the current popularity of colon cleansing, it’s important to recognize that some of your patients may engage in, or be thinking about, the practice. (See “4 things to tell patients about colon cleansing”.) Be sure to tell patients about the potential consequences of colon cleansing and to emphasize that there is a lack of evidence to back up supporters’ claims.
4 things to tell patients about colon cleansing
Colon irrigation is not wise—particularly if you have a history of gastrointestinal disease (including diverticulitis, Crohn’s disease, or ulcerative colitis) or a history of colon surgery, severe hemorrhoids, kidney disease, or heart disease. These conditions increase the risk of adverse effects.2,3,11,16
Side effects of colon cleansing include nausea, vomiting, diarrhea, dizziness, dehydration, electrolyte abnormalities, acute kidney insufficiency, pancreatitis, bowel perforation, heart failure, and infection. 2,3,11,16
The devices that practitioners use for the procedure are not approved for colon cleansing by the US Food and Drug Administration. Inadequately disinfected or sterilized irrigation machines have been linked to bacterial contamination.2,11,19
Colon cleansing practitioners are not licensed by a scientifically based organization. Rather, practitioners have undergone a training process structured by an organization that is attempting to institute its own certification and licensing requirements.
CORRESPONDENCE Ranit Mishori, MD, MHS, Georgetown University School of Medicine, 3900 Reservoir Road, NW, Washington, DC 20007; mishorir@georgetown.edu
