Intestinal cleansing is a dangerous fashion. The doctor observes

The “clean gut” trend is gaining ground. We are eagerly looking for ways to get rid of deposits, we use detox or juice diets. The list of bowel cleansing methods also includes hydrocolonotherapy, i.e. rinsing them with pressurized water. This is a procedure that even beauty salons offer. What does the doctor say? We ask the gastroenterologist Dr. Robert Dudkowiak.

1. Colon irrigation procedures are even advertised by beauty salons as a fashionable slimming method. The performance of the service may be hazardous to your health
2. A patient who decides to undergo hydrocolonotherapy is not aware of the pathological changes in the intestine. It can be an inflammatory process or neoplastic changes
3.  The administration of water to the large intestine may contribute to the disturbance of the physiological composition of the intestinal flora
4. More current information can be found on the Onet homepage.

Edyta Brzozowska, Medonet: We do not pay much attention to our intestines every day. We call them unsympathetically “guts” and we associate them with the fact that the “dirt” remaining in them simply needs to be emptied in the toilet. This is wrong thinking?

Dr n. with Robert Dudkowiak, gastroenterologist: Of course. After all, it is because of the intestines that digestion and absorption processes take place, without which a person would not be able to obtain energy from fats, proteins and carbohydrates. This process is essential for it to function. The intestines not only perform their functions in absorbing what we eat, but also provide the body’s immune defense. Which means that the intestines are responsible, among other things, for our immunity.

The small intestine has a different task and the large intestine.

The small intestine starts right behind the stomach. Its first section is the duodenum, and the next, the so-called jejunum. The name of this segment of the small intestine comes from the fact that when an autopsy is performed after the patients die, no intestinal contents are found in the jejunum. It is emptied. The ileum is the next segment of the small intestine, comparable in length to the previous segment. It measures about 1,5 m. The proper functioning of the digestive tract is of fundamental importance for our health, and even enables our existence.

How?

The small intestine is first digested and then absorbed. Everything that comes out of the mouth after being bitten, preliminarily shredded and mixed with saliva into the stomach is then crushed and “treated” with gastric juice. It is worth mentioning that the hydrochloric acid contained in gastric juice is a physiological method of protection against microorganisms reaching the gastrointestinal tract along with food. The food, which then goes to the duodenum, is further “processed” and broken down into even smaller particles, as the digestive juices from the pancreas and gall bladder are secreted into the lumen of the small intestine. They contain enzymes that break down carbohydrates, proteins and fats. The absorption of nutrients takes place mainly in the duodenum and jejunum, and peristalsis plays an important role in this process. Simply put, they are cyclical contractions of the intestines that allow the intestinal contents to move and move along the entire digestive tract from the esophagus to the rectum. In a word, without the small intestine, we cannot function because we do not have the energy necessary for life.

Is this why patients with short bowel syndrome are at risk of serious complications?

Short bowel syndrome is a condition in which the function of the small intestine is lost. This could be the case, for example, if a patient was involved in a car accident in which he had an abdominal injury and damage to the superior mesenteric artery, one of the major branches of the abdominal aorta. This can lead to intestinal ischemia and necrosis. Such a person requires surgery and removal of a large part of the small intestine, but thus loses the absorption area. The consequence of malnutrition and electrolyte disturbances, which may also occur when the patient has the entire small intestine, but loses a large part of the digestive surface and absorption as a consequence of inflammatory or radiation changes (so-called functional short bowel syndrome) that damage the small intestine mucosa, may be extreme devastation leading to death. It is said that the heart is the most important organ in humans. Meanwhile, we must be aware that it is impossible to function without the intestine, which supplies “fuel” for life.

What is the difference between the small intestine and the large intestine?

The large intestine is separated from the thin intestine by an anatomical barrier, the so-called the Bauhin valve, also called the ileocecal valve. The large intestine, as one of the most important parts of the digestive system, is primarily responsible for the compaction of the intestinal contents, including undigested food debris, and the proper course of defecation. In addition, bacteria that are beneficial to humans live in the large intestine. From the matter provided in food, they produce compounds that nourish this organ, i.e. short-chain fatty acids (including butyric acid, which has already been used in medicine in the form of a dietary supplement). In addition, it is here that vitamin K is produced, extremely important for humans. It is responsible for the proper course of the blood clotting process.

For several years, medicine has emphasized the huge role of bacterial flora, the so-called microbiota that occurs in our body, especially in the large intestine. Interestingly, the bacteria inhabiting our intestines constitute at least 2 to 3 kg of human body weight.

Does the colon irrigation make sense due to the microbiota? Even beauty salons advertise such a service as also conducive to weight loss.

I had a patient who complained of constipation and abdominal pain. Before going to the gastroenterologist’s office, she underwent such a “procedure” of deep colon lavage with warm water. Of course, hydrocolonotherapy did not help her. From the point of view of physiology, our body does not need the intervention of rinsing the colon with pressurized water. Among other things, because the absorption and digestion processes that take place in the intestines are naturally accompanied by the secretion of a large amount of liquid content (even above 1,5 l), which is the digestive juices and liquid content from meals. This can be compared to washing in a washing machine. Therefore, as a doctor, I do not know what the purpose of additional intestinal lavage is. It is an interference against the natural direction of the body’s work, not to mention the fact that during this activity, perforation may occur, i.e. perforation of the intestinal wall.

Perhaps equally important, patients who decide to have a colon lavage may be unaware of the pathological changes in their intestine.

Exactly. During this time, their intestines may become inflamed or there may be strictures, neoplastic lesions or frequent diverticula of the large intestine. When talking about diverticula, we must remember that the elderly, obese people who complain about a problem with defecation, i.e. constipation, have a predisposition to create them. Colon diverticula may be asymptomatic. Thus, without performing a colonoscopy or visualizing them in abdominal cavity imaging using ultrasound or computed tomography, we are not able to determine whether a person, especially those with a predisposition to their formation, has them.

What other complications can pressurized water lead to?

The administration of water to the large intestine may contribute to the disturbance of the physiological composition of the intestinal flora by mechanically removing strains of bacteria living there. Proceeding against the natural mechanisms of the functioning of the large intestine, which include on recovering from the water that reaches its light, it can disturb the composition of the microbiota that lives there, which is shaped by what we eat, what physical activity we conduct, what medications we take. Water administered from the outside in an unnatural way may contribute to the development of dysbiosis, the importance of which is more and more often emphasized in the development of diseases, not only in the gastrointestinal tract. It is worth knowing that the genetic material of bacteria living in our intestines is many times greater than that present in human cells. Thus, the bacteria that live with us have a significant impact on the well-being of our body and it will not necessarily be improved by hydrocolonotherapy. To sum up: I do not know any evidence that hydrocolonotherapy has a positive effect on the digestive process and the absorption of nutrients, as well as the composition of the intestinal flora. Thus, this procedure seems to me to be an unnatural procedure, contrary to physiology, which may adversely affect our functioning and immunity.

Is an enema safe to remove stools from the colon?

An enema is a procedure to “rinse” the end of the large intestine, ie the rectum and the sigmoid colon. The cleansing then has a short range, from 20 to 30 cm. An enema kit, colloquially known as enema, can be purchased at a pharmacy. However, I would warn against doing it too often. The best solution is to look for the cause of constipation and stool retention in the intestine. Only a properly collected medical history, taking into account the medications used, previous operations and concomitant diseases, will allow you to properly plan the diagnosis of the causes of constipation and determine whether it is a consequence of too little fiber in the diet or too little fluid intake during the day. This problem may also be related to functional diseases of the gastrointestinal tract, which are simply a disturbance of the intestinal motility. The most common forms of this type of disease include irritable bowel syndrome or functional constipation.

It was calculated that as much as 67 percent. Poles are eager to buy dietary supplements, including those for the intestines. As a gastroenterologist, what do you think about taking them?

These are preparations that do not pass all the necessary tests, and therefore are not approved by the relevant state pharmaceutical authorities. It is not advisable to use them on their own, and especially if they are extended, without consulting a specialist. Better to have a balanced, varied diet. Dietary hygiene, including regularity of meals, is crucial for the intestines, it affects the efficiency of digestion and absorption processes, and the composition of the intestinal flora. Thus, I do not consider prophylactic, without medical consultation, prolonged use of dietary supplements, including probiotics, justified.

What should we eat to keep our intestines in good condition?

In order to avoid problems with bowel movements and not to resort to even unproven hydrocolonotherapy, it is worth avoiding food rich in saturated fatty acids and simple carbohydrates. So do not eat too much fast food and sweets, but let’s take care of such meals that contain fiber, are rich in macro- and microelements and vitamins. That is why vegetables, fruits, groats, pasta and dark bread, i.e. products rich in fiber, have a beneficial effect on intestinal peristalsis and prevent stool retention. Of course, one should remember about physical activity, which – if you look at the current healthy eating pyramid – is the basis of our well-being.

Some people believe in the magic power of kefir and buttermilk, which are good for the gut flora.

And they are right. Because kefir, buttermilk or whey provide the intestines with important bacteria, just like silage. Dairy products are a source of valuable short-chain fatty acids, which are a source of energy for intestinal epithelial cells. More and more is said about the role of the gut microbiota in the context of diseases such as Parkinson’s disease, Alzheimer’s disease, schizophrenia, depression and autism. The results of research conducted in recent years suggest that the intestinal microflora is important for the so-called the entero-brain axis, so important in functional diseases of the gastrointestinal tract. Hence the increasingly frequent slogan of psychobiotics. In addition, disturbances in the composition of the intestinal flora, changes in its diversity towards, above all, strains showing pro-inflammatory properties, may affect autoimmune diseases, obesity and diabetes. If, as I have already mentioned, these bacteria can be around 2-3 kg in the human body, then it would be strange if they were not to exert – to a greater or lesser extent – on our well-being and functioning.

We encourage you to listen to the latest episode of the RESET podcast. This time we devote it to ecology. How to be eco and not go crazy? How can we care for our planet on a daily basis? What and how to eat? You will hear about this and many other topics related to ecology in the new episode of our podcast.