Detoxes and cleanses that promise to help you shed extra pounds, feel more energetic, and “get rid of toxins” have been around for ages. One that’s been popularized in recent years by self-pronounced “wellness gurus” is called a colon cleanse—also known as a colonic. But are colonics safe? And does your gut even need them?

While colonics (which is essentially just the emptying of your G.I. tract) can be beneficial for some things—like prepping for a colonoscopy, for example—they should always be approved by your doctor first, because they don’t come without risk.

Here, learn everything you need to know about colonics from three gastroenterologists, including what they are, their possible risks and side effects, and alternative ways to keep your gut healthy—minus the gimmicks.

First, what are colonics?

A colonic is a type of hydrotherapy that uses water to remove stool and gas from your colon, says Pratima Dibba, MD, a board-certified gastroenterologist with Medical Offices of Manhattan.

“It involves the insertion of a tube into your rectum, which then flushes out stool using a large amount of pressurized water,” she says.

There are other methods of colon cleansing, too, like taking certain oral laxatives or drinking “detox” teas, says Sarah Robbins, MD, gastroenterologist and founder of Well Sunday.

Most of these cleanses, though, are only approved by doctors when used in prep for a colonoscopy, says Dr. Robbins. An empty colon helps doctors get a clear view of anything unusual during the exam, like polyps or signs of colorectal cancer, for example. While some doctors may prescribe a colonic, the most common colonoscopy preparation is drinking a prescription laxative a day before the procedure, she adds.

Any other setting where colonics are offered (like a med spa, for instance) can come with potential risks. These businesses may claim there are benefits to regularly cleansing your colon, like toxin removal, improved digestion, improved immunity, and weight loss, says Dr. Robbins. “But there is little scientific evidence to back up any of these claims,” she adds.

5 possible risks of colonics

While the idea may seem harmless (and even appealing if you’re looking for quick fixes to “detox” or lose weight), colonics are not necessarily safe or healthy for most people. Here are a few potential risks and side effects to be aware of, according to experts.

1. Dehydration and electrolyte imbalance

Colonics can make you dehydrated and throw off your electrolytes, causing dizziness, weakness, headaches, and kidney damage, says Harsh Sheth, MD, a bariatric and gastrointestinal laparoscopic surgeon.

“When large amounts of water are pushed into your body and removed without replacing lost electrolytes, this can lead to a shift in those electrolytes and fluid balance,” adds Dr. Dibba.

For most people, this is a potentially dangerous side effect, especially for those with underlying conditions that affect their hydration, like kidney or heart disease, she adds.

Some people think that cleansing your colon regularly is essential for gut health, but this is far from the truth. Your gut does a great job at cleaning itself.

Disruption of the gut microbiome

Some people think cleansing your colon regularly is essential for gut health. But this is far from the truth. Your gut already does a great job at removing waste and cleaning itself, per the Mayo Clinic. In fact, getting colonics (or using other “cleansing” methods) too often can lead to a disruption in your gut’s microbiome—or the community of healthy bacteria living in your gut, per Dr. Robbins.

Basically, too much of your healthy bacteria gets flushed away, leading to an imbalance that could cause constipation, diarrhea, fatigue, or acid reflux, among other things, per the Cleveland Clinic.

While there aren’t many studies on the long-term effects of colonics on your gut’s microbiome, there are a few studies surrounding the laxative drink you’re often prescribed before a colonoscopy—a polyethylene glycol (PEG) based solution. Some studies suggest your microbiome will return to normal two to four weeks after this type of cleanse, per Mount Sinai.

But others, like a May 2016 clinical trial in the European Journal of Gastroenterology & Hepatology¹, have found that participants who took a PEG solution had long-lasting changes in their gut microbiome, particularly, a decrease in good bacteria called lactobacillaceae.

The bottom line? More studies are needed to figure out whether this shift in your gut’s microbiome is long lasting, if it leads to more serious health issues, and if other colon cleanses cause the same imbalances.

Infections

There is a risk of infection if the equipment used for a colonic is not sterile or if the water has harmful microorganisms like bacteria, viruses, fungi, or parasites, says Dr. Sheth. “These microorganisms can enter your bloodstream or your abdominal cavity through the colon wall or rectum, causing local or widespread infections,” he adds.

Older adults or people with compromised immune systems may especially be at higher risk of infection as a complication, says Dr. Robbins.

Rectal injury

If the tube used for a colonic is inserted too forcefully or too deeply, you can get cuts or tears in your rectum, says Dr. Sheth. And if the water’s too hot, too cold, or too pressurized, it can cause “tears, burns, or ulcers in your rectal lining, which can bleed or become infected,” he adds.

Bowel perforations, in rare cases

A bowel perforation—or hole in the wall of your colon—is a rare but serious side effect of colonics that can cause bleeding, infection, or peritonitis (inflammation of your abdominal lining), says Dr. Sheth. You’re at a higher risk of this if your colon wall is already weakened from a G.I. condition like Crohn’s disease, ulcerative colitis, or inflammation, he adds. “The fluid pressure may cause those weak spots to rupture.”

“This can potentially cause the stool and water in your colon to spill into your abdominal cavity, causing inflammation, infection, or in severe cases, septic shock,” says Dr. Sheth.

A tip to keep in mind

If you choose to get a colonic, or it’s been prescribed by your doctor, make sure you’re getting it done at the doctor’s office or a doctor-approved location. Check that the equipment and water is sterile and that technicians are licensed and qualified to do colonics and other medical procedures. If you’re feeling unsure, call your doctor for guidance.

Who’s most at risk of complications from colonics?

Several groups of people are more at risk of complications from these cleanses, says Dr. Sheth. They include:

• People with a history of bowel diseases like diverticulitis, ulcerative colitis, Crohn’s disease, or colorectal cancer
• Those with a history of abdominal surgery like appendectomy (removal of the appendix), colectomy (removal of part of the colon), or hysterectomy (removal of the uterus)
• People with a history of kidney disease, heart disease, or electrolyte disorders
• Those with a history of allergic reactions or anaphylaxis to any ingredients or substances used in a colonic
• People who are immunocompromised
• Pregnant people
• Older adults

If any of these apply to you, talk to your doctor before trying any kind of colon cleanse, so they can help you weigh out any potential benefits versus risks.

Alternatives to colonics

Because your colon doesn’t really need to be cleansed (it does that on its own), there is really no need to search for alternatives to colonics, per se.

“There’s little scientific evidence to support the idea that stool accumulates on the walls of a healthy colon, or that toxins from your colon are major sources of bodily toxins,” says Dr. Robbins.

In fact, your colon naturally sheds its lining every five to seven days, according to The Harvard Gazette. Plus, your colon, liver, and kidneys work together to remove waste and toxins from your body, preventing the buildup of harmful substances, she adds.

As mentioned, a colon cleanse is really only needed to prepare for a colonoscopy or a similar procedure called a flexible sigmoidoscopy, says Dr. Dibba. Rarely, you may need a colon cleanse in the case of severe constipation, but this will only be prescribed by a doctor.

All that said, if you’re dealing with chronic constipation or you’re looking to improve your gut health overall, there are some things you can do instead of getting colonics, including the following, per Dr. Robbins:

Eat a high-fiber diet

Eating plenty of fiber helps with regular bowel movements and the natural removal of waste. Try to eat whole foods like fruits, vegetables, whole grains, and beans, which are all great sources of fiber. You can also try a fiber supplement like psyllium husk, which can be added to smoothies or mixed with water or juice.

Stay hydrated

Drinking plenty of water is important for digestive and overall health. It helps by softening your stool and promoting regular bowel movements. Because of this, it’s best to get between 11.5 to 15.5 cups of water per day, through drinking and eating hydrating foods, per the Mayo Clinic.

Exercise regularly

Physical activity can help get your bowels moving and keep you regular. Aim to get at least 150 minutes of moderate-intensity exercise per week, per the Centers for Disease Control and Prevention. Even getting short bursts of movement throughout the day, like walking around the block, doing jumping jacks, or following a yoga video can help you “go.”

Try taking probiotics

Probiotics are live, healthy bacteria that may be able to help balance your gut’s microbiome and keep you regular. They can be found in foods like yogurt, kefir, and other fermented foods, or taken as supplements.

Eat less processed foods

Reducing the amount of ultra-processed and high-fat foods you eat (like candy, packaged snack foods, fried foods, etc.) may help improve your digestion and prevent constipation.

So, how bad is it really to get a colonic?

Some people, websites, and businesses may tout the benefits of colonics, saying they will “rid you of toxins,” give you more energy, or help you lose weight, but there’s no scientific evidence to back these claims. Beyond that, the potential risks and side effects of colonics are often not talked about.

“The consensus in the medical community is that the risks of colon cleansing often outweigh these purported benefits, especially considering the lack of evidence supporting its effectiveness,” says Dr. Robbins.

In other words? Only get a colonic if it’s been prescribed by a trusted, qualified doctor. If not, skip the med spa and instead focus on healthy habits like eating more fiber, exercising regularly, and drinking enough water.

—reviewed by Jennifer Logan, MD, MPH