Colonic Contraindications:

Most contraindications for colon hydrotherapy are theoretical in nature but represent areas where physiological disturbance may present theoretical or actual dangers to the patient’s life or health.  The following contraindications are from the manufacturer of my colonic hydrotherapy unit.  My unit is from Specialty Health Products and it is considered to be a "closed system".

Most contraindications result from fears of disturbing blood volume/electrolyte balance, or from direct dangers related to bowel pathology. Below each contraindication is a brief explanation.

I will not perform a colonic on you if you have any of the following:  

  • Severe cardiac disease; uncontrolled hypertension:  Water tends to be absorbed in the colon during the procedure: this will increase blood volume transiently, and may further increase the workload on the heart as well as blood pressure.

  • Congestive heart failure or organic valve disease:  Similar reasons as above: heart efficiency is reduced, and blood pressure may be raised.

  • Aneurysm:  An increase in blood volume could lead to a worsening of the aneurysm. If the aneurysm were to rupture, it could be fatal within minutes.

  • Severe anemia:  Oxygen carrying ability of the blood is already impaired: an increase in blood volume will tend to worsen the state of anemia and could cause unconsciousness.

  • GI hemorrhage:  This indicates that there is a bleed from the bowel. Causes include internal hemorrhoids, colonic polyps, colon cancer, ulceration, and others.  The cause of the bleeding must be ascertained, and the patient should be referred back to their physician for investigation if they are not already under orthodox care.

  • GI perforation:  Though it would be unusual for a patient to present to a colon hydrotherapist’s office with this condition, it could happen. The symptom picture is difficult to diagnose as the effects are systemic and will generally result in acute abdominal pain, fever, and malaise, which progresses rapidly. Death may ensue within hours or days if the condition is left untreated, depending on the size of the perforation and the state of health of the patient. The patient with perforation is typically elderly with a history of constipation, though steroid medication overuse may cause the bowel to become vulnerable at much younger ages.

  • Severe hemorrhoids:  Severe hemorrhoids, both internal and external, may make speculum insertion excessively painful or difficult.  It is also possible to damage the hemorrhoid with the speculum tip, which will generally result in bleeding and frequently great distress to the patient.

  • Severe Ulcerative Colitis / Advanced Crohn’s Disease:  Both of these conditions are ulcerative bowel pathologies: not only could the procedure be considerably painful, but it may also result in hemorrhage by disturbing the colon environment. Though Crohn’s disease typically affects the distal small intestine, it can also involve the proximal part of the colon. Blood in the stools will be a common finding with these patients, even if they are not in a severe phase of the condition. Remissions happen commonly during the course of these conditions, and it is during remission periods that hydrotherapy is best performed. These two conditions share much in common and can be virtually impossible to tell apart in certain circumstances.

  • Advanced ileitis:  Ileitis is an inflammation of the ileum. In advanced phases, the ileocecal valve will often be involved and maybe incapable of normal function. Frequently the valve will not be able to close properly, and therefore presents a risk of introducing colon hydrotherapy treatment waters into the small intestine. Absorption is facilitated through the walls of the small intestine compared to the colon, and the patient could feel quite unwell for a few days following this procedure.

  • Cirrhosis:  The liver is functioning at reduced capacity, and may not be able to handle to toxic load released from the colon during the procedure. This especially applies if the hydrotherapy treatment did not allow for complete evacuation of the bowel. This may transiently increase liver toxic load as many toxins in the colon have been ‘stirred up’ and mixed with water, allowing them to be absorbed. To a healthy liver, this is not a problem (remember the liver is continuously dealing with colon toxins every day).

  • Carcinoma of the colon or rectum:  Cancers of the bowel could be theoretically spread by the action of colon hydrotherapy. A more important consideration may be that the risk of perforation of the colon in the presence of a tumor is high.  Polyps (which are considered pre-cancerous) are however not a contraindication. Polyps have been frequently successfully treated with hydrotherapy and dietary modification, reducing the need for surgical intervention.

  • Abdominal hernia / inguinal hernia:  Both these types of hernia involve a portion of the bowel pushing through into another cavity. The risks with both are potential strangulation of the herniated segment of the small intestine. The theoretical risks of administering colon hydrotherapy to a patient presenting with an untreated hernia include worsening the degree of pressure in the herniated segment, potentially increasing the risk of strangulation. Strangulation if untreated will usually progress to gangrene through the restricted blood supply to the affected segment.

  • Recent colon or rectum surgery:  Recent bowel surgery will require time to heal and allow the tissues of the bowel to renormalize and redevelop their strength. Increasing the pressure in the bowel could theoretically rupture stitches and lead to peritonitis and other complications. Generally, no colon hydrotherapy treatment should be given for at least 2 to 3 months post-surgery and should be performed with the attending physician’s knowledge and agreement.

  • Fissures/fistulas:  Anal fissures can be extremely painful, and highly sensitive to stretch. Speculum insertion in such patients can present considerable distress to the patient, and scar tissue in the anal canal may prohibit speculum insertion. Fistulas present the risk of leakage through the fistula of contaminated colon ‘water’ into the cavity to which the fistula is draining with the consequent risks.

  • Recent abdominal surgery:  The abdominal wall is repairing and needs time for the muscles and tendon sheaths of the abdomen to knit together. Avoidance of increasing pressure in the abdomen is advised to reduce the risk of rupturing stitches.

  • Pregnancy:  Pregnancy is contraindicated for a variety of reasons depending on the stage of the pregnancy. Theoretical risks include damage to the unborn child through increased entero-hepatic circulation. In addition potential changes in electrolyte levels as a result of treatment present unknown risks.

To summarise:

First trimester: colon hydrotherapy is absolutely contraindicated.

Second trimester: relative contraindication, but the safest time for treatment during

pregnancy. Treatment must only be given under a physician’s orders and supervision.

Third trimester: absolute contraindication as colon hydrotherapy could theoretically trigger uterine contractions and labor.