Can Colonics Really Treat Chronic Constipation Effectively?

Colonic: large intestine illustration over a photo of a person with stomachache

Chronic constipation or IBS-C can be stressful and frustrating, especially when there are so many potential therapies to choose from and you don’t know what direction to take. For this reason, colonics, also known as colon hydrotherapy, colon cleansing, or colonic irrigation, can seem like an attractive solution. 

However, colonics also have their downsides, and ultimately, they don’t likely address the root cause of constipation. 

In this article, we’ll review what a colonic is, discuss the potential benefits and drawbacks of colon hydrotherapy, and propose alternative solutions for addressing constipation and healing your gut. 

What Is a Colonic?

A colonic is a procedure that involves streaming purified water into the large intestine via a tube that is inserted into the rectum. The water flushes out waste, bacteria, and potentially other microbes like parasites. It also stimulates peristalsis in the colon to cause increased movement throughout the digestive tract during the session [1]. 

The goal is to flush out waste and pathogens that have built up in the colon and relieve constipation temporarily. The idea is that multiple colonics will allow a person to “clean” their colon and restore balance to the microbiome. 

Since the process can involve up to 60 liters of water in a constant stream that reaches around your entire large intestine, colonics have to be administered by a trained colon hydrotherapist. 

Alleged Benefits of Doing a Colonic

Proponents of colonics believe that colon cleansing has multiple health benefits, including [2]: 

  • Weight loss
  • Improved constipation
  • Prevention of “autointoxication” and promoting detox
  • Boost for the immune system
  • Resolved dysbiosis

Colon cleansing may achieve these benefits for some people. However, putting the potential risks and drawbacks aside, it is likely that these benefits will only be temporary. A colon cleanse doesn’t investigate or address the root cause of the issue, whether it’s SIBO, constipation, slow motility, candida overgrowth, or even inflammatory bowel disease. Therefore, colonics are unlikely to be helpful in the long term. 

There are always larger, systemic issues behind these gut imbalances, and they need to be unpacked and addressed carefully to heal. 

Drawbacks of Colonic Therapy

With any procedure, there are drawbacks involved, and colon hydrotherapy is no different. 

  1. It’s invasive: A colonic is a pretty invasive procedure and may cause cramping, bloating, abdominal pain, and discomfort. You can also lose a lot of electrolytes during the process, potentially leaving you feeling lightheaded or dehydrated. 
  2. It can be expensive: To get the longer-term benefits of colonic therapy, you may have to have multiple sessions over several weeks or even months. The cost could add up pretty quickly. 
  3. Colon cleansing only affects the large intestine: There is a valve called the ileocecal valve between your colon and small intestine. The ileocecal valve’s job is to let contents pass from the small intestine into the colon and block anything from returning back into the small intestine. So, if the root cause of your gut issue lies in the small intestine, like SIBO, colon cleansing won’t touch it. This also overlooks the many other parts of the digestive system as a whole. 
Colonic: water hose spraying water

Is Colon Hydrotherapy Safe? 

It’s not cause for panic, but there are safety risks involved in colon cleansing, including [1, 3]: 

  • Rectum perforation or bowel perforation
  • Electrolyte imbalance
  • Inflammation of the lining of the colon and rectum
  • Bloody stools 
  • Abdominal pain

These possible side effects should be carefully considered before attempting colon cleansing. 

Are Enemas Safe?

Enemas only involve a fraction of the water used in a colonic and fill just the rectum instead of the whole colon. They are typically less risky and may be just as useful as a colonic in acute instances of severe constipation or to prepare for a colonoscopy ​​[4]. 

Enemas can also be self-administered from the comfort of your own bathroom if you carefully follow instructions given from a trusted source. There are two main types of enemas: evacuative and retentive [5]. 

  • Evacuative enemas are released as soon as you feel the urge to do so to relieve constipation (instead of using laxatives). 
  • Retentive enemas are held in, usually to deliver medication directly to the colon. 

In general, enemas are considered to be safer and are more scientifically supported than colonics, but they also have associated risks, including perforation [3]. 

Colonic: baked salmon with asparagus and tomatoes

Alternatives to Colon Cleansing

So what can you try instead of a colonic? To address long-term gut issues, it’s better to follow a step-by-step process that sets up a foundation for a healthy diet and lifestyle. Ideally, this is followed by probiotic therapy, adding in gut-healing herbs and/or motility agents if needed, and addressing the vagus nerve, which largely controls digestion and peristalsis. 

Diet and Lifestyle

Before any other therapies or treatments, your diet should be your number one priority. A healthy diet:

  1. Provides adequate nutrition, giving the body the building blocks it needs to feed your cells and keep your body going.
  2. Eliminates problem foods that might be causing your digestive system to react, provoke inflammation, and worsen any imbalances in the microbiome.

For most people, a Paleo diet is a good place to start since it meets these two requirements without being too restrictive. In addition, research on Paleo has shown that it can lower inflammation, regulate blood sugar, and prevent common food reactions [6, 7, 8]. 

Others may do well on a low-FODMAP or low histamine diet, depending on their symptoms. A low-FODMAP diet restricts foods with certain sugars and starches that often cause common digestive symptoms like bloating, constipation, gas, and indigestion [9, 10, 11, 12]. A low histamine diet restricts foods with high histamine levels, which can also aggravate or trigger digestive problems. 

Helpful lifestyle changes can look different for each person. For many people, focusing on their habits around eating is a great place to start, tying into the diet changes you’re also making. For example, eating your food slowly and calmly, sitting down at a table, preferably in community with others, allows you to relax and promotes better digestion. 

Unfortunately, many of us eat on the go, in the car, while looking at our smartphones, or working on a computer. You aren’t necessarily conscious of it, but this puts your body in a state of stress and slows digestion. 

Other simple changes like taking time to go for a daily walk or doing some other kind of exercise, expressing gratitude, and mindful breathing can add up to better digestive health.


Once you’ve been on your ideal diet for at least three weeks, if your symptoms have not improved enough, you can consider adding a probiotic supplement. 

Probiotics have a large volume of high-quality research backing up their effectiveness for a number of digestive and non-digestive conditions, including constipation

We recommend Probiotic Triple Therapy, which combines all three categories of probiotics to create a synergistic effect. We have seen tremendous success with this therapy for improving transit time and frequency, reducing bloating and gas, and gently rebalancing the gut microbiome [13, 14, 15, 16, 17].

Ginger root and leaves

Gut Supporting Herbs and Prokinetic Agents

The next step, if there is still active dysbiosis in the gut, is to consider adding gut-supportive supplements such as promotility herbs or antimicrobial agents

Helpful yet gentle herbal compounds can help stimulate peristalsis in the colon and improve transit time. Some of these include: 

  • Ginger: Soothes nausea and may speed up stomach emptying into the small intestine, encouraging motility [18, 19, 20]
  • Peppermint oil: May speed up motility, reduce inflammation, and rebalance the gut microbiome [21, 22, 23, 24]
  • Triphala: An Ayurvedic laxative that combines three different dried fruits — amalaki, bibhitaki, and haritaki — has been shown to improve bowel movement frequency and consistency in one clinical trial [25]
  • Iberogast®: An herbal formula shown to be as effective as prokinetic medication [26, 27, 28]

Antimicrobial agents can also help resolve dysbiosis and restore colonic motility. Here are a few examples: 

  • Oil of oregano: Oregano isn’t just for sprinkling atop your pizza. Oil of oregano is a powerful antimicrobial extract with antibacterial, antifungal, antiviral, and antioxidant effects. It may even act as an antidepressant, protect the liver, and relieve pain [29, 30, 31].
  • Berberine: Berberine is another antimicrobial and anti-inflammatory agent. It can also help improve diarrhea in cases of IBS-D and fight H. Pylori bacteria [32, 33, 34, 35, 36, 37]. 
  • Sweet wormwood (Artemisinin): Besides its antimicrobial, antiparasitic, antifungal, and anti-inflammatory properties, sweet wormwood or artemisinin can modulate the gut microbiome [38, 39, 40, 41, 42].

These are just a few of the possible antimicrobial and prokinetic agents available to support your gut healing. When you reach this step, it’s best to consult with an integrative health provider who can help you create a plan and evaluate your symptoms as you progress. You may also have to rotate or use more than one herb at a time, so a healthcare provider can help you find the right combination too. 

Healing the Vagus Nerve

The vagus nerve connects your brain to your gut and your gut to your brain: signals via neurotransmitters go both ways. It is the primary driver of the parasympathetic nervous system, the “rest and digest” mode of the body. Normally, the vagus nerve plays a significant role in telling your gastrointestinal system to relax, digest your food, and move waste through the colon. It also lowers systemic inflammation and influences the hypothalamus-pituitary-adrenal axis that manages the body’s stress response [43, 44, 45]. 

But chronic stress, chronic infections like Lyme disease, inflammation, and other factors can disrupt the vagus nerve, causing motility to slow down or stop completely [46, 47]. This may result in constipation, bloating, and many other digestive symptoms. 

Healing the vagus nerve is often an overlooked part of restoring proper digestive function, but it remains an essential one. Having a balanced nervous system is just as critical to digestion as having the right digestive enzymes or enough stomach acid to break down your food. 

A few strategies to begin retraining and reconnecting the vagus nerve include [48]:

  • Deep breathing exercises
  • Hypnosis
  • Meditation
  • Laughing, singing, or humming 
  • Yoga 

These practices can help activate your vagus nerve and the parasympathetic nervous system, encouraging you to be more relaxed, centered, and prepared to digest. 

Woman laying on the grass, reading a book

Achieve Digestive Wellness With a Non-Invasive Approach

Getting a colonic is a procedure with certain risks and is pretty invasive compared to many other gut healing strategies. Colonics or enemas may be temporarily helpful in cases of severe constipation, but they aren’t a long-term solution for restoring gut health. 

To build a strong foundation for your gastrointestinal system, start with finding the right therapeutic diet for you, add probiotics, and experiment with gut-supporting herbs and supplements where needed. Balancing the nervous system by improving communication via the vagus nerve is a great strategy too. 

If you need an experienced integrative health professional to guide you along the journey to optimal gut health, please reach out to us at the Ruscio Institute for Functional Medicine.


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