I have heard about colon cleansers on the news and Internet. When—if ever—is colon cleansing a good idea?
A hundred years ago, it was felt that a daily bowel movement was important to good health. Prolonged retention of stool in the colon was thought to release toxins into the body and possibly be associated with colon cancer and other maladies. This was a driving force leading to the establishment of the breakfast cereal industry.
We now recognize that there is little difference in health between individuals who have three bowel movements a day and one bowel movement every three days—though we still do believe that adding fiber to the diet decreases the risk of constipation and helps to lower cholesterol. Whole grains provide better nutrition and are released into the body more slowly, thereby preventing reactive hypoglycemia. Apples, prunes, and bulking agents such as Metamucil, Citrucel, or FiberCon promote bowel regularity and can prevent some of the cramps and episodes of diarrhea and constipation associated with irritable bowel syndrome. Actual cleansing of the bowel is only necessary in preparation for diagnostic procedures such as colonoscopy or elective surgical procedures on the intestinal tract. Bulk electrolyte mixtures such as MiraLax can be taken in small quantities to keep bowels regular or in larger quantities to provide watery diarrhea, removing the vast majority of fecal material in the colon.
We are learning more about the concept of biological films of bacteria, fungi, viruses, etc., that naturally live on our skin and the mucous membranes of our mouth, vagina, and colon. Many of these living organisms are part of our host defense to protect us from disease-causing organisms. We have found that vaginal douching too frequently can upset vaginal flora in a negative way and actually cause more problems than it solves, and the same may be true of colon cleansers.
Some people think it's a good idea to use enemas and other high colonics mixed with coffee and other substances, but they are introduced under greater physiologic pressure than normally exists in the colon and may result in rupturing of diverticula, causing diverticulitis. In addition to altering one's normal colonic flora, colonics have been shown to introduce pathogenic bacteria, parasites, and viruses and should be discouraged. Clostridium difficile is a toxin-producing bacterium that flourishes when broad-spectrum antibiotics kill the normal flora of the colon. When taking antibiotics, patients should eat yogurt, take acidophilus capsules, or take any of the 20 or 30 new probiotic combinations of healthful bacteria and yeasts that are available to restore the normal flora to the colon and change the ecosystem for C. diff so that it no longer competes effectively and it recedes to an insignificant level.
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