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Clinical Data


By Thomas Dorman, M.D.

Colonic irrigation is an ancient method of healing and it would never have survived until the present scientific age if it were without value. It is a curious fact that medical practitioners seem to be either in favour of this treatment (and usually quiet about it) or vehemently opposed to its use. The objectors never have any experience of it. Every grown creature probably has an instinctive dislike of it own waste products, and this may explain why the physician is generally so remiss in examining the feces of this patients. There are indications from ancient documents that the Egyptians and the Greeks practiced colon irrigation therapeutically, although their ideas and the benefit to their patients are unknown to us. Hollow reeds and gourds were used to introduce water through the rectum.

THE REPUTATION OF COLONICS I first heard the term colonics as a young doctor practising in {C}California. Immediately, I knew that it was a form of quackery. It is self evident that the bowel excretes the waste products of digestion regularly, naturally and automatically. There is no need to interfere with nature.

This pre-formed opinion (and I am uncertain how it came to be so firmly formed in my mind) was reinforced when I read comments from an official source, that I can no longer identify, condemning the use of colonics by lay practitioners in the state of California and, in due course, the medical association lobbied for its banning through the legislature.

This surprised me a little. If something is useless and harmful, why is it necessary to make laws about it? We don't have laws against swimming in sewage nor do we lobby our legislators to make such laws. The only sensible thing any person would do with sewage is dispose of it as hygienically as practical. This dilemma hung in my mind for a number of years. Since then, I have assiduously prescribed diuretics to my patients who retain water, laxative to those who were constipated and personally, I brush my teeth every day.

Think about it for a moment. Which is the cleaner part of your alimentary canal (The alimentary canal is the pipe through which the food passes in your body from mouth to anus). The mouth is cleaner than the rectum, and yet it is the mouth that I clean with a toothbrush, with paste, and even flossing. Why clean the clean end? I think, in finally analysis, the answer is that it is aesthetic. The dirty end should be beneath our dignity; or should it?

SUBTLE CONDITIONS There are many cases where alternative medicine looks at mild degrees of conditions generally accepted in medicine and enhances the public health through catering to them-what in a sophisticated way one might call a forme fruste of an illness, and I have alluded to, in previous newsletter, many such examples. Is constipation good for you? Well, obviously not. How often should the bowels move? In medical school I was taught that there is no rule on this matter; that if the bowels move once a week that is sufficient for some and normal; contrariwise, two bowel movements a day might be normal for others. I now know better.

Most people are better off if their bowels move two to three times a day. How do I know? Having developed an interest in nutrition and the function of the bowel, I have developed an interest in nutrition and the function of the bowel, I have developed the habit of asking my patients about the frequency of their bowel movements and can assure the reader that in general those whose bowels move two-three times a day fare better in their health and nutrition that those who are more constipated. I do admit, however, that there is no absolutely hard rule on the matter.







Which organ of our bodies is most responsible for waste disposal? It goes without saying that it is the bowel. Yes, in some ways, waste products are excreted by the lungs (carbon dioxide), by the skin, (scaling), sweat, by the kidneys (water and chemicals). The vast majority of waste products of life, however, are passed through the bowel. Some of this waste product is what I call pass through. Frankly, however, the majority of what appears in your stool is excreted, or altered, and therefore not simply a passive 'pass through' product; but, for the purpose of the 'pass through' products, we can reasonably think of the bowel as a pipe, for a first approximation. THE BOWEL AS AN EXCRETORY ORGAN The large bowel itself serves to concentrate the contents passed into it from the small intestine, through the resorption of water into the circulation.

Bacterial fermentation occurs in the colon. Several products of fermentation, some of which are only slightly understood, probably serve as useful nutrients when reabsorbed. I phrased this concept in a negative way because it is clear to me that, even in these days of know-all science, a great deal of information is lacking regarding the details of this process.

We do, however, know from respectable physiological studies, that many products are excreted into the lumen of the intestines and reabsorbed therefrom to circulate back-and-forth, usually through the liver via the venous blood system from the intestines to the liver, called the portal circulation. This enterohepatic circulation, as it is called, plays a very important role in balancing products between the bowel and the liver.

An excess of these products in the bowel, for instance bile salts, can provoke diarrhea and contrariwise, failure of adequate excretion can lead to the retention of toxicants which, in turn, are dammed back into the circulation and be associated with disease.

In this context, we often speak of liver or hepatic failure. We should remember that the liver is the major detoxifying biochemical factory in our bodies and that its waste products are passed through the bile passages (and sometimes with temporary storage in the gallbladder) into the duodenum, thence into the small intestine and colon.

You see, now, how there is an inherent relationship between the excretory function of the bowel in general, including the colon, and the biochemical excretory factory, the liver. It is not at all surprising, therefore, that by enhancing excretion through the bowel we can indirectly enhance excretion by the liver, the main detoxifying factory of the body. On thinking this over, these observations make such plain common sense, based on simple knowledge of anatomy and physiology of the gastrointestinal and hepatic tracts, that in retrospect,

I am amazed at my own stupidity of not working these things out for myself many years ago. It was, therefore, a salutary experience to read references about this in some books lent to me by a colon therapist friend that these ideas are by no means new.

INCREASE IN PERISTALSIS We know that a lot of movement in the pipes of the body occurs through peristalsis. The action of the muscle of the heart is one such example although, of course, the blood does not go backwards into the chambers because of the action of the valves. These valves are flaps of fibrous tissue that come together and stop return flow. Valves are present in the veins, as well, directing the blood in the appropriate direction. The lymphatic system has valves, and the term valves is also used in reference to the pipe we call our gastrointestinal tract, or gut. Muscles contract in a rhythmic manner, causing a wave of contraction down the pipe.

This is seen best on inspecting the movements of the esophagus and the small intestine; but as these organs do not have one-way valves, like those in the heart, fluid can travel back-and forth in spite of these peristaltic waves. Indeed the digestive processes in the gut are dependent on slushing the fluid, the digestive juices, mixing them and churning them and, therefore, this peristaltic phenomenon is not exclusively unidirectional.

Peristalsis as such, however, is not a prime feature of the large bowel. Here we speak of contractions of the whole organ or, at least sections of it, particularly contractions of the longitudinal fibres, and large quantities of contents are propelled forward, and occasionally backward, through what is called mass action.

Most people are familiar with the phenomenon that the urge to move their bowels occurs sometimes after a meal, typically breakfast and very often after ingesting a stimulant such as coffee.

This is an example of a generalized contraction of the organ (the colon) that propels the contents into the vestibule where it is held temporarily before evacuation. The contents of the small intestine pass through the sphincter that separates it from the first part of the colon, called the 'cecum' (on the left side of the abdomen), and the circular muscle at the lower end of the terminal ilium, the small bowel, is indeed mostly contracted or closed.

The liquid contents of the small intestine are squirted in small quantities, following peristaltic activity, into the cecum. The cecum itself serves predominantly as a reservoir, the site where the dehydrating process begins and the site where bacterial fermentation begins and occurs predominantly.

The cecum, is to a certain extent, a dead end; and its appendage, the appendix, is a complete dead end. It is here, of course, that chronic inflammations and infection occurs most frequently, hence the disease of appendicitis. It is interesting that there are accounts of instances which casts of the lining of a colon are reputed to be excreted en masse; almost certainly these represent mostly a combination of shed lining from the cecum with contents which had become inspissated and adherent to the lining of the cecum, the continuous flow of contents from the small intestine into the bowel beyond the cecum, passing through these concretions.

There are multiple, though infrequent, accounts of people passing contents from their bowels that are recognized to have been ingested a long time earlier. Almost certainly these concretions are held, therefore, in the periphery of the cecum while the otherwise continuous flow of contents passes through the center of the cecum into the ascending colon. It is also not unlikely that some of this phenomenon of sluggishness, of stasis, at the bowel surface can occur in the ascending and transverse colons, as well, with the contents merely going through the center and being propelled through the phenomenon of mass action.

Is it an advantage for a person to have long standing concretions in this organ? Of course, it is not. I must report, however, that in the process of inspecting the lining of this organ with a colonoscope, a procedure that I have had occasion to perform many times, one does not ordinarily see large residues in this site.

How might this be? How can it be there are reliable accounts of these casts that are not seen by the endoscopist? I have come to the conclusion that the answer is that, in preparation for endoscopy, the patient invariably is asked to take a strong purgative clean out the contents of the bowel so the endoscopist can indeed inspect the lining.

Almost certainly these purgation's remove any material that might have been static in this situation and therefore not observed when the endoscopic inspection is performed.





Is there a place for the use of colon irrigation (colonics) in patients who have illnesses such as ulcerative colitis, chronic diarrhea, chronic dilatation of the bowel (such as Hirschprung's disease), a tendency to spasms (often called irritable bowel syndrome) and diverticulitis?

My answer to these is affirmative in all cases. It is, however, true that the colon therapist need to be skilled. Excessive distention, in the case of diverticulitis or ulcerative colitis, may theoretically pose the risk of leakage, although one has never encountered such a case. The use of remedies in the contents of the bowel needs to be practiced with skill and experience.

CONCLUSION In summary, I have come to the conclusion that colon therapy is not mysterious, is a useful adjunct to detoxification in a variety of illnesses in which the accumulation of toxins plays a major or contributory role to a person's ill health; therefore, washing the lining of the bowel is just a sensible as maintaining cleanliness in other parts of ourselves and, in modern living environment, there is a tendency for the accumulation of toxins, increased constipation, increased concentration of the residue in the bowel because of a shortage of roughage in the diet; thus cleaning and irrigation is an advantage.
TECHNIQUE Before concluding this article, a comment about technique. The modern colon therapist will use an instrument that allows a continuous exchange of fluid in and out of the bowel, and irrigation. It will allow the therapist to have continuous inspection, through a glass component of the outflow pipe, to inspect the contents of the effluent, and the experience therapist will learn to recognize when the effluent indicates enhanced excretion from the bowel proper, from the liver indirectly through the bowel, or merely when particles of stool are washed out.

With modern technology, the procedure is both comfortable and entirely hygienic without the unpleasant aromas or any spillage. The practical details vary little between therapists, but essentially a small tube is passed, with the individual in side-lying position, into the individual's rectum.

Most colon therapists then choose to place the patient on his back, and the irrigation takes place in this position. Typically 10 colonic treatments, perhaps, at four-six day intervals are recommended for most conditions, and many people who have significant but not inherently destructive disease, such as the examples given above, can obtain lifelong benefit from a series of colon therapies without the necessity to follow-up, although certain individuals do benefit from infrequent follow up long term.

Thomas Dorman MD