Like most men, Ed Bradley, a forty-something Decatur, Georgia, resident, was somewhat reluctant to get a colonic, a process that cleanses the colon by irrigating it with water. Yet he had heard of a connection between poor colon health and disease, especially colon cancer. So he gave it a try. “If garbage stays in your house, it rots,” he says. “So why wouldn’t colon ‘garbage’ in your body create problems?” He believes a colonic (also called colon hydrotherapy or colon cleaning) helps the body “take out the trash.”

Although health professionals often dispute the usefulness of colonics, countless Americans are concerned about their eliminatory health. When Michael Roizen, MD, and Mehmet Oz, MD, bestselling authors of You: The Owner’s Manual (HarperCollins) and You: On a Diet (Free Press), appear on The Oprah Winfrey Show, viewers frequently quiz them on the indelicate subject of feces and bowel movements, which the doctors state offer a vital window into our health.  

Some holistic practitioners take this even further, professing, “All disease begins in the colon.” These providers encourage people to cleanse their large intestine proactively. But do illnesses really begin in our bowels? And does the colon really need routine maintenance?

The process of elimination
The colon, part of the large intestine, is five to six feet long and connects the small intestine to the rectum and anus. “Its main job is to take digested foods [which are liquids], suck out the water and then package the poop” so you can move your bowels, says Patricia Raymond, MD, a Chesapeake, Virginia–based gastroenterologist. It also transports chemicals and toxins ingested through food, water, medication, air and other sources out of the body.

Eating plenty of high-fiber foods, like whole grains, fruits and vegetables; drinking lots of water; and exercising can help keep your colon healthy. Feces that form an S or C, the shape of the rectum near the anus, usually mean your colon is operating well, say Drs. Mehmet and Oz. “Gumball-size pellets” tell you that your colon is temporarily not functioning optimally, they write in You: The Owner’s Manual.

In addition to the curvy stools Drs. Mehmet and Oz describe, naturopath Roni Deluz, RN, ND, PhD, of Martha’s Vineyard, Massachusetts, considers wholesome those that are four to ten inches long and “golden brown” in color. If we see “little clumps in the toilet,” we should ask, “Where’s the rest?” Deluz suggests. Dark, rocky stools should cause us to question: “Why is it so hard? Where’s the moisture? Where’s the fiber?” she says. And “a horrible smell like it’s been hanging around forever,” should spur us to improve our eating habits.

Other signs of colon health headed downhill include any change in bowel habits—either going more or less or battling diarrhea or constipation. While the American Gastroenterological Association (AGA) defines constipation as more than three days without a bowel movement, many holistic practitioners believe the bowels should empty following every meal. “Whatever is typical for you, whether it’s five times a day or once every three days, any change in that is concerning,” Dr. Raymond says. Additional warning signs include frequent indigestion and gas and bloating.  

The cause of all disease?
But health practitioners disagree on whether the colon is ground zero for a host of illnesses.

“I don’t know where that statement came from, but I don’t think there’s any evidence to say ‘all diseases start in the colon,’ ” says Frank Hamilton, MD, chief of the Digestive Diseases Program Branch of the National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK).

Deluz believes a congested large intestine undermines many other bodily functions and can even cause colon cancer. “Not having a clean colon contributes to backup in the entire system. When you can’t clean out your colon, your liver suffers. If your liver suffers, then your kidneys can suffer. If your kidneys suffer, then your lymphatic system suffers,” she says of the body’s other waste-elimination systems. “There’s a connection [between organs]. That’s why diseases start in the colon.”  

Dr. Hamilton and Deluz do agree that a healthy colon is important. “If it’s not functioning properly, it can lead to other disorders of the gastrointestinal [GI] tract,” Dr. Hamilton says. “For instance, you can subsequently have out-pouchings within the large bowel, from longstanding constipation.” Such out-pouchings, called diverticular disease, can cause bloating, mild cramping and abdominal pain. If untreated, surgery may be needed. Research has shown an association between diverticular disease and cancer on the left side of the colon.

Is cleansing the colon the answer?
As a substitute for (or complement to) dietary changes and increased physical activity, some people turn to holistic approaches, like colonics, to improve their large intestine’s health.

During a colon cleansing, “a small tube or speculum is inserted into the rectum and warm, filtered water is introduced into the colon to start the release of waste, gas, mucus and undigested food,” says colon therapist Dorothy Chandler, RN, of Chicago’s Chandler’s Health Emporium. Practi-tioners believe the procedure eliminates toxic buildup on the colon wall, reducing the risk of illnesses.

“Cleansing removes toxicity from the body and allows the colon to have good muscular contraction,” says Deluz. “Your entire digestive system is helped, and removing the toxins takes a load off your liver.”

But not all experts agree with the practice. “When the colon empties, there is still a thin layer of stool coating it; however, there is no need to ‘steam clean’ it,” says Dr. Raymond. “It’s sort of like plumbing,” she explains. “You don’t need Drano un--less there is a problem such as blockage or near blockage.”

Others disagree or ask where the proof is. “Colonic cleanings have never been done in a rigorous, scientific manner to evaluate that approach versus just nutritional intervention,” Dr. Hamilton says. While on Oprah, Dr. Oz stated that he doesn’t believe colonics are necessary.

Still, “It’s a good idea to keep your colon healthy because when it’s not happy, you’re not happy,” Dr. Raymond adds.

Other colon care options include  taking fiber or herbal supplements that claim to “scrub” or irritate the colon wall to remove hardened mucus and feces. The AGA believes laxatives “should be taken as a last resort and only under a doctor’s supervision.” However, Deluz likes the natural laxative aloe vera, which she says softens impacted stools.

Bradley is sticking with colonics. “Afterward, your whole body feels lighter, you feel more awake and aware that you’re managing your health,” he says. “If this helps even a little to prevent colon cancer and other problems, I’m all for it.”  

With a few lifestyle changes, you can reduce your risk

Colorectal cancer (cancer of the colon and/or rectum) is the third most common cancer and second leading cause of cancer deaths among Americans. The American Cancer Society estimates that colon cancer rates among African Americans are about 15% higher and deaths about 40% higher than among whites. No one is certain why. Yet several lifestyle habits common to black Americans overlap with colon cancer’s risk factors—being overweight, being physically inactive and eating lots of fat and red meat and few fruits and vegetables, for instance. Smoking, a family history and having an inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease, also increase one’s probability. To reduce your chances of developing the disease, try implementing these lifestyle changes.

  • Eat less fat. “Diets high in fat, predispose one to colon cancer,” says Edith Mitchell, MD, clinical professor of medicine and oncology at Kimmel Cancer Center in Philadelphia. “One should increase the amount of fresh fruits and vegetables in the diet.”
  • Eat less meat, particularly if it’s processed. One American Cancer Society study found that men who ate three ounces (about the amount in a small hamburger) of red meat (beef, pork, lamb) daily and women who ate two ounces were 30% to 40% more likely to develop colon cancer. Women who ate one ounce (one slice of lunch meat or four slices of bacon) of processed meats (bacon, sausages, lunch meat) two to three times per week and men who ate one ounce five to six times per week were 50% more likely to develop colon cancer than people who ate less.
  • Eat more fish and chicken. Research has shown that diets high in fish and chicken actually reduce the risk of colon cancer.
  • Take vitamins. “There’s been some evidence that increasing vitamin D and calcium intake can reduce the chance of developing polyps in the colon,” Dr. Hamilton says.

Tamekia Reece is a health and parenting writer in Houston. She has written for Parenting, Oxygen and Fit Pregnancy.