Edzard Ernst on the Futility and Dangers of CAM Detox Regimes

In a scathing blog article at the Guardian called Detox: flushing out poison or absorbing dangerous claptrap?, Edzard Ernest professor at Peninsula Medical School, Exeter and a leading critical investigator of so called complementary and alternative medicine (CAM) argues that CAM detox regimes, such as colon irrigation is a dangerous delusion based on faulty science.

The central idea with things like detox (in the CAM sense) is that we ingest harmful “toxins” and that we need to get rid of them. However, proponents of detox can almost never specify what exactly these “toxins” are or why their procedure eliminates them. If you cannot even identify what it is you are supposedly are treating, then buyer beware.

Alternative detox is all the rage and comes in many guises – anything from diet or supplements to steam-baths or ear-candles. The common denominator is that, allegedly, the body is stimulated to eliminate poisonous substances. The claim is that, if we are not treated in this way, such toxins would cause ill health in all of us. Yet, these assumptions are both wrong and dangerous.

It should be an easy claim to test though. Why not just do a double-blind, placebo controlled study on the effects of these so called detox regimes? If the proponents of CAM detox really believed that their products worked, then they have nothing to lose. Performing clinical trails that give a positive results could be used to strengthen their case for their detox regimes. So why are they not doing it? Ernst has an entertaining answer.

Proponents of alternative detox have never been able to demonstrate that their treatments actually decrease the level of any specific toxin in the body. Yet such studies would be very simple to conduct: name the toxin, measure its level before and after the treatment and compare the readings. Why do such studies not exist? I suspect it is because the promoters of detox treatments know only too well that their results would not confirm their assumptions. And that would, of course, be bad for business.

There is another problem, also touched by Ernst, namely that unless you are really, really sick, the body has organs, such as liver and kidneys that break down and remove many toxic and harmful substances we ingest. So why exactly would a healthy person need CAM detox regimes? Ernst wrote a paper called Colonic irrigation and the theory of autointoxication: a triumph of ignorance over science that was published in Journal of Clinical Gastroenterology back in 1997, where he detailed the history and scientific problems with colon irrigation.

But what is the harm exactly? If people want to spend their money on worthless therapies, why should then not be able to? Ernst explains the risks with colon irrigation.

There are several reasons why this argument is problematic. The perceived benefit after the treatment is based on a wrong impression; even the weight lost is not real, it merely corresponds to the contents of the colon which fills up again in a matter of hours – true body weight loss does not occur. Moreover, there are risks associated with colonic irrigation. The side-effects include nausea, vomiting, diarrhoea, nervous disturbances, cramps and irritations as well as electrolyte depletion, water intoxication, bowel perforation and infection, kidney failure, pancreatitis or heart failure. One also wonders what colonic irrigation does to the bacteria on our gut. Severe side-effects might be rare but, considering the lack of true benefit from colonic irrigation, they still mean that the risks of this treatment do not outweigh its benefits.

Ernst also references a paper by Mishori et. al. (2011) in J Fam Pract where two cases of life-threatening side-effects are discussed. Perforated colon or heath failure is not a very nice thing to experience.

Go read the entire article and bookmark or write down those references for the scientific papers. You will never known when you might need them.