What is the Latest on Cleansing?
The Question
What is the evidence to support the use of cleanses (e.g. detoxification diets, herbal products, colon irrigation) to promote general health, for weight loss, to maintain bowel health and to prevent colon cancer?
Key Practice Point #1: Detoxification Diets
Recommendation
Commercial detoxification (detox) diets may be harmful and should not be recommended. There is no evidence to support the use of detox diets for weight loss, bowel health or to prevent colon cancer.
Evidence Summary
A 2015 narrative review noted that rigorous clinical research investigating commercial detox diets, including their effects on weight loss, has not been conducted and that the small amount of existing evidence has been primarily conducted in rodents or fish, is of very low quality and has significant methodological limitations. Risks associated with commercial detox diets include severe energy restriction, nutritional inadequacy, the potential overconsumption of supplements and the overuse of laxatives or diuretics. No benefits of commercial detox diets were described.
No clinical studies were found to support common detoxification diets (including macrobiotic, commercial cleanses or fasting) or herbal products to promote bowel health or prevent colon cancer in humans.
Grade of Evidence D
Remarks
Commercial detox diets are short-term diets (duration not defined) that try to eliminate “toxins” from the body and/or aid in weight loss through starvation or juice fasts and/or the use of laxatives, diuretics, vitamin or mineral supplements and “cleansing” foods.
In humans, the liver, kidney, gastrointestinal system, skin and lungs all play a role in removing toxins from the body through a variety of pathways.
See Additional Content:
What nutrients/dietary factors are associated with a decreased risk of developing colorectal, colon and rectal cancer?
Are probiotics, prebiotics and synbiotics effective in the prevention of colorectal cancer?
Key Practice Point #2: Bowel Cleansing and Colon Irrigation
Recommendation
Bowel cleanses and colon irrigation may be harmful and should not be recommended.
Evidence Summary
A 2009 systematic review found a lack of rigorous evidence for colonic hydrotherapy, enema therapy or orally administered bowel cleanses. Risks associated with these practices include rectal perforation, electrolyte imbalances and death.
Grade of Evidence D
To see the full practice question, including the Evidence Statements, Remarks, Comments and References, click here.
July 2022 ·
Volume 12
(7)