Turns out, humans have long fretted over poisoning themselves with poop.
In the last two decades, Americans have seen a surge in complementary and alternative treatments to common ailments. Therapies like acupuncture, oil pulling, and aromatherapy have exploded—with mixed results for those trying them.
During this period of “natural” remedies, it’s no surprise that the enema (also called “colon hydrotherapy,” “colonics,” or “colon cleansing”) is making a comeback as well. The methods have evolved over time, but in general, an enema is a procedure that injects fluid through the rectum with the intention of “cleansing” the bowels.
The Ancient Practice of Colon Cleansing
While it might not be a mainstream therapy now, enemas have been a popular practice throughout history, and across many cultures and countries. The first mention of enemas was in the earliest medical text known to man: the Egyptian Ebers Papyrus, which dates back to 1500 BCE.
In fact, the Egyptians were famous for their “clean bowels,” and other cultures admired them for it. The Egyptians believed “residual decaying materials” lingered in the colon and could potentially enter the bloodstream and increase the risk of disease, according to an article from The Journal of the Royal College of Physicians of Edinburgh.
They didn’t have the fancy equipment doctors have now: Enemas were typically self-induced by sitting in a river and using a hollow reed to direct water into the rectum. (Um, yikes.)
The Popularity of Enemas
While the theory behind enemas hadn’t changed much, the methods did: By the 17th century, “enema jugs” were a fashionable household item. Enemas were so valued that Louis XIV allegedly had over 200 enemas in his last year of life.
As the centuries passed, the idea of waste lingering in the colon and causing a disease became an obsession—if not total paranoia. Medical scientists posited a theory of “intestinal autointoxication,” meaning people who didn’t regularly clean out their colons were poisoning themselves from their own wastes.
According to James Whorton, a professor of history of medicine from the University of Washington School of Medicine, one health manual in the United States warned readers in the 1850s that “daily evacuation of the bowels is of the utmost importance to the maintenance of health,” and without that daily BM, “the entire system will become deranged and corrupted.”
This really shook people up in the 19th century. Colon health became a constant worry. Experts recommended high-fiber foods, daily bowel movements, and, of course, regular enemas. Constipation was greatly feared by all: People worried their bodies were being poisoned from the inside out.
To capitalize on this, many brands started marketing various foods, devices, drugs, and treatments that would allegedly ward off constipation and keep the colon “clean” and healthy. Rectal dilators, enema devices, laxatives, and abdominal massage machines were just a handful of the products hitting the market that claimed to prevent the ever-feared constipation.
Colon Cleansing + the Impact of Germ Theory
When germ theory emerged in the late 19th century, it debunked many ancient treatment methods, most notably bloodletting. Colon cleansing was an exception: If anything, many believed germ theory *proved* the danger of colon waste. After all, what could be more germy and foul than fecal matter?
Of course, the stance of physicians slowly started changing after the discovery of germ theory. As research increased, more and more diseases were found to have other causes, and they could no longer be reasonably blamed on a “dirty bowel.” Obviously, someone can become infected with tuberculosis whether they’ve had a bowel movement that day or not.
The Downfall (and Upswing) of Enemas
The American Medical Association officially discredited enemas in the early 1900s. Most physicians stopped recommending enemas for regular "cleansing" by the 1930s, and enemas stopped being available at the doctor’s office. However, as is often the case, the public was slower to give up the habit, and many continued getting enemas for decades, until around the 1960s.
Why the fall? Knowledge was increasing about the body, the colon, and digestive diseases. In fact, doctors now know that having enemas too often may actually cause the body to become dependent on them—ironically, leading your body to stop having normal bowel movements without stimulation.
Despite this, colon cleansing has made a comeback in the past couple of decades, even though research hasn’t proved any significant benefits to colon hydrotherapy as a means of achieving "clean bowels." Today, you can get a “colonic” at specialized spas or clinics by people who call themselves “colon hygienists,” who aren’t required to undergo medical training.
A 2011 study by doctors at Georgetown University actually found that colon cleansing for the average person comes with few real benefits—but plenty of side effects, including cramping, bloating, vomiting, electrolyte imbalance, and even kidney failure. Furthermore, a single enema can cost hundreds of dollars, despite the lack of evidence that cleansing your colon has any real benefits to your overall health.
There are a few exceptions. Enemas are still used in certain medical cases, especially for young children. For example, children with Down syndrome commonly have gastrointestinal defects that make regular bowel movements challenging, and enemas may be used as a treatment.
But for the average person, the key to colon health is much more simple than an enema—although it might require a bit more discipline: yep, good ol’ diet and exercise. Check out these tips for digestive health:
Caine SR. The illustrated history of surgery. Abingdon, UK: Routledge, 2018.
Colon cleansing has no benefit but many side effects including vomiting and death, doctors say. (Accessed on October 25, 2019 at https://www.sciencedaily.com/releases/2011/08/110801122948.htm.)
Concerned about constipation? National Institutes on Aging. (Accessed on October 25, 2019 at https://www.nia.nih.gov/health/concerned-about-constipation.)
Doyle D. Per rectum: a history of enemata. J R Coll Physicians Edinb. 2005;35:367-370.
History of colonics. Mt. Rainier Clinic. (Accessed on October 25, 2019 at http://www.mtrainierclinic.com/_fileUploads/MRC-History-of-Colonics.pdf.)
Whorton J. Civilisation and the colon: constipation as the “disease of diseases.” BMJ. 2000 Dec;321(7276):1586-9.
—. Inner hygiene: constipation and the pursuit of health in modern society. Oxford, UK: Oxford University Press, 2000.