Public discussions about colon hydrotherapy often collapse every technique, practitioner and client into one category. A more useful safety conversation asks what procedure is being performed, who is performing it, how clients are screened and when treatment should be declined.
In June 2025, Cleveland Clinic published an article advising people to avoid colon cleansing. The article identifies genuine risks and important contraindications that should not be dismissed. But it also speaks broadly about “colon cleansing”, without examining how practitioner training, equipment, screening and treatment protocols may differ between services.
This is our response—not an argument that colon hydrotherapy is risk-free, suitable for everyone or proven to treat disease. It is a call for a more precise, evidence-informed discussion of colon hydrotherapy safety.
Key points
- Colon hydrotherapy has recognised risks and is not appropriate for everyone.
- Professional screening should identify contraindications and situations requiring medical assessment.
- Training, hygiene, equipment, technique and practitioner judgement are relevant safety variables.
- The direct clinical evidence for colon hydrotherapy remains limited; adjacent transanal-irrigation research is informative but not interchangeable.
- Historical reports show that bowel irrigation has a long medical history, but they do not constitute modern proof of safety or effectiveness.
The safety line that deserves closer attention
Within its discussion of bowel perforation, the Cleveland Clinic article states:
“This risk increases if the procedure is performed by someone without proper training.”
That sentence points to an essential part of the safety question: practitioner competence matters. Yet the article does not explore what appropriate training should include, how competency is maintained or what a responsible practice should screen for before treatment.
At Bottoms Up Colonics, every client completes a health-history intake before treatment. The purpose is not administrative—it is to identify contraindications, clarify symptoms, understand relevant medical and surgical history and decide whether treatment is appropriate. Complex or uncertain cases can be escalated to senior practitioners or referred back to a GP or relevant medical professional.
Health screening
A detailed intake helps identify contraindications, red flags and reasons to seek medical assessment first.
Current training
Competency should be maintained through continuing education, supervision and updated safety knowledge.
Defined protocols
Hygiene, equipment use, treatment monitoring and infection-control processes should be explicit and consistent.
Referral pathways
Practitioners need to recognise the limits of their scope and know when to decline treatment or refer onward.
Contraindications are not a footnote
Cleveland Clinic advises avoiding colon irrigation in circumstances including active diverticulitis, Crohn’s disease, ulcerative colitis, ischaemic colitis, previous colon surgery, kidney disease and heart disease. These conditions can increase vulnerability to complications such as fluid imbalance, infection or perforation.
A list like this should not be treated casually. It belongs at the centre of screening and clinical decision-making. Depending on the individual circumstances, a practitioner may need to decline treatment, request medical clearance or refer the person for medical assessment.
Important: training and screening can reduce avoidable risk, but they cannot make any procedure risk-free. Rare serious complications have been reported following colon cleansing. Anyone with severe or persistent symptoms, rectal bleeding, significant abdominal pain, fever, vomiting or a known gastrointestinal, kidney or heart condition should seek medical advice rather than self-selecting treatment.
What does the evidence actually say?
The honest answer is that the direct modern evidence base for professional colon hydrotherapy remains limited. There is not enough high-quality research to support sweeping claims that it improves general health, “detoxifies” the body or treats medical conditions.
That is different, however, from saying that no relevant research exists. A 2026 peer-reviewed review in Gastrointestinal Disorders examined transanal irrigation and colon hydrotherapy in chronic constipation and discussed their possible place alongside established bowel-management strategies. The authors described potential clinical utility while also emphasising the need for stronger studies, standardised protocols and careful patient selection.
Transanal irrigation is not the same procedure as Rojas Colon Hydrotherapy®. Its devices, indications and administration differ. Its literature can help researchers ask better questions about water-assisted bowel evacuation, but its outcomes should not simply be transferred to a different technique.
For that reason, we would not describe either the Cleveland Clinic article or the 2026 review as the final word. One is a general patient-education article based primarily on a clinician interview; the other is a narrative review proposing a broader research framework. Neither replaces well-designed clinical trials of clearly defined professional colon hydrotherapy protocols.
Constipation may require medical investigation
The Cleveland Clinic article is right that constipation can have underlying causes. Hypothyroidism is one example; medications, pelvic-floor dysfunction, neurological conditions, structural disease and other factors may also contribute.
Colon hydrotherapy does not diagnose or treat hypothyroidism—or any other underlying medical condition. When a client’s history or symptoms suggest that investigation is needed, responsible practice means referring them to their GP or another appropriate healthcare professional rather than presenting colon hydrotherapy as a catch-all solution.
Different expertise contributes different information
A colorectal surgeon brings essential expertise in diagnosing and treating colorectal disease and in recognising serious gastrointestinal risk. A trained colon hydrotherapist brings procedure-specific knowledge about their equipment, client positioning, treatment monitoring and practice protocols.
These roles are not interchangeable, and they do not need to compete. A stronger safety model respects medical diagnosis and referral while also expecting complementary-health practitioners to demonstrate rigorous training, clear boundaries and accountable procedures.
Colon irrigation has a long history—but history is not proof
Discussion of bowel irrigation within medicine is not new. In 1917, physician J. H. Kellogg published an article in JAMA titled “Should the Colon Be Sacrificed or May It Be Reformed?” describing his clinical experience at the Battle Creek Sanitarium and arguing against surgical removal of the colon in many cases.
This historical record is relevant because it shows that bowel-focused therapies were once debated within mainstream medical journals. It should not, however, be treated as modern evidence that current colon hydrotherapy is effective or safe. The report predates randomised trials, contemporary diagnostic standards, modern adverse-event reporting and present-day research ethics.
The strongest case for further research comes from contemporary questions and contemporary methods—not from asking a century-old clinical report to carry more weight than it can.
What responsible professional practice looks like
Bottoms Up Colonics uses practitioner-operated, closed-system Rojas Colon Hydrotherapy®. Our internal safety approach centres on trained therapists, detailed health screening, hygiene and infection-control procedures, client monitoring, ongoing education and referral when a person’s needs fall outside practitioner scope.
Bottoms Up Colonics is an IICT-approved training provider for colon hydrotherapy in Australia. Our practitioners are expected to keep their training current rather than treating one qualification as the end of professional development.
These safeguards do not prove clinical benefit and do not eliminate every risk. They do address the practical variables that broad discussions of “colon cleansing” often leave unexplored.
What we would like from the safety conversation
Not a fight between conventional and complementary care. A more precise conversation.
That means distinguishing one technique from another, trained practice from untrained practice, a contraindicated client from a potentially suitable client, and established evidence from professional opinion. It also means being transparent about uncertainty and supporting more independent research.
Clients deserve to know both that risks exist and that safety is shaped by more than the label attached to a procedure. They deserve careful screening, honest explanations, professional boundaries and the freedom to discuss their decision with their healthcare team.
Learn about our practitioner-supported approach
Explore how Rojas Colon Hydrotherapy® works, what happens during an appointment and why client screening is an essential part of the process.
Explore Rojas Colon Hydrotherapy®Frequently asked questions
Is colon hydrotherapy completely safe?
No medical or complementary procedure is completely risk-free. Colon hydrotherapy has recognised risks, including rare serious complications, and it is not suitable for everyone. Screening, trained practitioners and appropriate protocols are important risk-management measures.
Who should avoid colon hydrotherapy?
Suitability depends on individual health circumstances. Conditions such as active inflammatory bowel disease, diverticulitis, previous bowel surgery, kidney disease and heart disease may make treatment inappropriate or require medical advice. Severe symptoms or possible red flags should be medically assessed first.
Can colon hydrotherapy treat the cause of chronic constipation?
It cannot diagnose or treat an underlying disease such as hypothyroidism. Persistent or severe constipation should be assessed by a GP or gastroenterologist so potential causes and appropriate treatment options can be considered.
Does research on transanal irrigation prove that colon hydrotherapy works?
No. Transanal irrigation and professional colon hydrotherapy share the use of rectally introduced water, but they differ in equipment, protocols, clinical indications and administration. Transanal-irrigation research is relevant context, not direct proof of outcomes for Rojas Colon Hydrotherapy®.
Why does practitioner training matter?
Training supports appropriate screening, hygienic practice, safe equipment use, treatment monitoring, recognition of adverse responses and timely referral. It reduces avoidable risk but cannot guarantee that complications will never occur.
Sources
- Cleveland Clinic. “Why You Should Avoid Colon Cleansing.” Published 13 June 2025.
- Borghini R, Borghini F, Spagnuolo A, Borghini A, Borghini G. “Usefulness of Transanal Irrigation and Colon Hydrotherapy in the Treatment of Chronic Constipation and Beyond: A Review with New Perspectives for Bio-Integrated Medicine.” Gastrointestinal Disorders. 2026;8(1):6.
- Kellogg JH. “Should the Colon Be Sacrificed or May It Be Reformed?” JAMA. 1917;68(26):1957–1959.
