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== Regulation == |
== Regulation == |
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In the United States the [[Food and Drug Administration (United States)|Food and Drug Administration]] (FDA) regulates the production of equipment used in colon hydrotherapy in the USA but does not regulate their use, or the supplements used in oral colon-cleansing regimens and manufacturer claims do not require verification or supporting evidence. The contents of the products are also not verified or tested.<ref name = Tennen/> The FDA has issued several letters warning manufacturers and suppliers of colon hydrotherapy equipment about making false claims of effectiveness, safety issues and quality control violations.<ref name = Quackwatch/> |
In the United States the [[Food and Drug Administration (United States)|Food and Drug Administration]] (FDA) regulates the production of equipment used in colon hydrotherapy in the USA but does not regulate their use, or the supplements used in oral colon-cleansing regimens and manufacturer claims do not require verification or supporting evidence. The contents of the products are also not verified or tested.<ref name = Tennen/> The FDA has issued several letters warning manufacturers and suppliers of colon hydrotherapy equipment about making false claims of effectiveness, safety issues and quality control violations.<ref name = Quackwatch/> |
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"64B7-31.001 Colon Hydrotherapy. |
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(1) Intent. |
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(a) The Board of Massage finds that the colon hydrotherapy procedures, while falling directly within the scope of Chapter 480, F.S., presents a substantial danger to the public if performed by incompetent practitioners. |
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(b) The Board of Massage further finds that a significant proportion of licensees do not perform the colonic procedure and further that a significant proportion of those desiring to enter the profession do not intend to engage in the practice of colonic irrigation. |
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(c) This rule is promulgated to ensure that only those who have been determined duly qualified to practice colon hydrotherapy may do so in an effort to protect the health, safety and welfare of the public. |
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(2) Prior to the practice of colon hydrotherapy, any licensed massage therapist, or apprentice shall be required to present certification to the Board of successful completion of examination by a Board approved massage school after completion of a supervised classroom course of study in colonic irrigation or in the case of a duly authorized apprenticeship training program, evidence of having completed 100 hours of colonic irrigation training, including a minimum of 45 hours of clinical practicum with a minimum of 20 treatments given. |
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(3) Prior to the practice of colonic irrigation, any licensed massage therapist, or apprentice shall be required to successfully complete and pass the National Board for Colon Hydrotherapy Examination (NBCHT) which is approved by the Board. |
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(4) Any licensed massage therapist whose license has been in an inactive or retired status for more than two consecutive biennial licensure cycles shall be required to successfully complete and pass the NBCHT, prior to resuming the practice of colonic irrigation. |
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(5) Any applicant for massage therapist licensure or licensed massage therapist, who in conjunction with previous massage therapist licensure was certified to practice colonic irrigation, shall be required to successfully complete and pass the NBCHT prior to practicing colon hydrotherapy. |
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Rulemaking Authority 456.036, 480.035(7), 480.041(4) FS. Law Implemented 456.036, 480.032, 480.033, 480.041(4) FS. History–New 12-18-84, Formerly 21L-31.01, Amended 1-30-90, 2-13-91, Formerly 21L-31.001, 61G11-31.001, Amended 1-26-00, 5-5-04, 2-27-06, 8-9-10.<ref> https://www.flrules.org/gateway/ruleno.asp?id=64B7-31.001&Section=0 </ref> |
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==See also== |
==See also== |
Revision as of 05:06, 4 December 2013
![A room with a white plastic reclining seat, legs elevated above the head, with a series of nozzles and controls mounted on the wall behind](https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Colon_Hydrotherapy_Treatment_Environment.jpg/300px-Colon_Hydrotherapy_Treatment_Environment.jpg)
Colon cleansing (also known as colon therapy) encompasses a number of alternative medical therapies intended to remove feces and nonspecific toxins from the colon and intestinal tract. Colon cleansing may take the form of colon hydrotherapy (also called a colonic or colonic irrigation) or oral cleansing regimens, such as dietary supplements. During the 2000s internet marketing and infomercials of colon supplements increased.[1]
Some forms of colon hydrotherapy use tubes to inject water, sometimes mixed with herbs or with other liquids, into the colon via the rectum using special equipment. Oral cleaning regimes use dietary fiber, herbs, dietary supplements, or laxatives. People who practice colon cleansing believe that accumulations of putrefied feces line the walls of the large intestine and that these accumulations harbor parasites or pathogenic gut flora, causing nonspecific symptoms and general ill-health. This "auto-intoxication" hypothesis is based on medical beliefs of the Ancient Egyptians and Greeks and was discredited in the early 20th century.[2]
No scientific evidence supports the alleged benefits of colon cleansing,[2] and it "has no known medical value and risks damage to the rectum or bowel." The bowel itself is "not dirty” and, unless disease or medication interfere, "nature does a fine job of clearing out wastes."[3] Certain enema preparations have been associated with heart attacks and electrolyte imbalances, and improperly prepared or used equipment can cause infection or damage to the bowel. Frequent colon cleansing can lead to dependence on enemas to defecate and some herbs may reduce the effectiveness of prescription drugs.[4]
Effectiveness and risks
The symptoms that are attributed to auto-intoxication—headache, fatigue, loss of appetite and irritability—are actually caused by mechanical distention within the bowel, such as irritable bowel syndrome, rather than toxins from putrefying food.[5][6][7] The benefits anecdotally attributed to colon cleansing are vague and the claims made by manufacturers and practitioners are based on a flawed understanding of the body.[8][9] There is little evidence of actual benefit to the procedure, and no evidence that it can alleviate the symptoms that are attributed to the theories of colon cleansing.[10]
As the colon normally expels waste, colon cleansing is generally unneeded.[3][11] Colonic irrigation can disrupt the bowel's normal flora and if done frequently can result in electrolyte depletion with dehydration.[11] Rare but severe adverse events have been rectal perforation[12] and amoebic infection from poorly sterilised equipment.[13] Another claim is that it may impede the colon's shedding of dead cells.[14]
Excessive use of enemas has also been associated with cardiac problems, such as heart failure,[11] and heart attacks related to electrolyte imbalances when performed as coffee enema.[15] Frequent enemas or other colon-cleansing tools may lead to dependence and inability to defecate without assistance or withdrawal symptoms.[4][5] Herbs taken orally may interfere with drug absorption or activity of prescription drugs.[4]
Colon hydrotherapy
Colonic irrigation also known as colon hydrotherapy, colonic hydrotherapy, or a "colonic", is a treatment which is used "to wash out the contents of the large bowel by means of copious enemas using water or other medication."[16]
Colonic hydrotherapy is not the same as colon cleansing which uses aloe vera, laxatives or supplements taken orally. Colonic hydrotherapy is used to clean out the colon of fecal matter. It is done using equipment. There are various types of equipment available designed for colonic irrigation. The most modern methods use FDA approved medical equipment. Colonic irrigation treatment usually takes about 40 minutes. Colonic irrigation is not the same as an enema as colonic irrigaion clears the is bowel thoroughly cleared where an enema does not does not clear the complete bowel but merely the sigmoid colon area. During an enema, the water is retained in the colon for approximately 15 minutes. During a colonic, water is introduced into the colon and then it is flushed out and this is repeated until the entire colon is cleared. [17]
Colonic irrigation has been described as an "unwise" procedure as it carries the risk of serious harm and has no proven benefit.[18]
Supplement effectiveness
The consumer advocacy news program Marketplace conducted a consumer trial with 3 women on the effectiveness of two colon supplements versus fiber.[1] The results showed the supplements did not assist in weight loss and provided no additional benefit over a basic fiber supplement. According to the American Cancer Society, "Available scientific evidence does not support claims that colon therapy is effective in treating cancer or any other disease".[2]
History
The concept of "auto-intoxication", the idea that food enters the intestine and rots, provides a rationale for colon cleansing.[5][19] The ancient Egyptians believed that toxins formed as a result of decomposition within the intestines,[citation needed] and moved from there into the circulatory system, causing fever and the development of pus. The Ancient Greeks adopted and expanded the idea, applying their belief in the four humours. In the 19th century, studies in biochemistry and microbiology seemed to support the autointoxication hypothesis, and mainstream physicians promoted the idea.[6] Daly notes that, historically, "purging was one of the few procedures that a physician could perform with visible, often impressive results and without immediate or obvious dangers".[20]
Ilya Ilyich Mechnikov (1845-1916) became the strongest supporter of the idea of colon cleansing; he thought that toxins could shorten the lifespan. Over time, the concept broadened to "auto-intoxication", which supposes that the body cannot fully dispose of its waste products and toxins, which then accumulate in the intestine.[19] In some cases, the concept led to radical surgeries to remove the colon for unrelated symptoms.[21]
Auto-intoxication enjoyed some favor in the medical community in the late 19th and early 20th centuries, but clinicians discarded it as advances in science failed to support its claims.[19][8][10] A 1919 paper entitled "Origin of the so-called auto-intoxication symptom" in the Journal of the American Medical Association marked the beginning of the rejection of the auto-intoxication hypothesis by the medical community.[22][6]
Despite a lack of scientific support, "auto-intoxication" persists in the public imagination. The practice of colon cleansing has undergone a resurgence[when?] in the alternative-medical community, supported by testimonials and anecdotal evidence and promoted by manufacturers of colon-cleansing products.[19][8]
Regulation
In the United States the Food and Drug Administration (FDA) regulates the production of equipment used in colon hydrotherapy in the USA but does not regulate their use, or the supplements used in oral colon-cleansing regimens and manufacturer claims do not require verification or supporting evidence. The contents of the products are also not verified or tested.[14] The FDA has issued several letters warning manufacturers and suppliers of colon hydrotherapy equipment about making false claims of effectiveness, safety issues and quality control violations.[5]
"64B7-31.001 Colon Hydrotherapy. (1) Intent. (a) The Board of Massage finds that the colon hydrotherapy procedures, while falling directly within the scope of Chapter 480, F.S., presents a substantial danger to the public if performed by incompetent practitioners. (b) The Board of Massage further finds that a significant proportion of licensees do not perform the colonic procedure and further that a significant proportion of those desiring to enter the profession do not intend to engage in the practice of colonic irrigation. (c) This rule is promulgated to ensure that only those who have been determined duly qualified to practice colon hydrotherapy may do so in an effort to protect the health, safety and welfare of the public. (2) Prior to the practice of colon hydrotherapy, any licensed massage therapist, or apprentice shall be required to present certification to the Board of successful completion of examination by a Board approved massage school after completion of a supervised classroom course of study in colonic irrigation or in the case of a duly authorized apprenticeship training program, evidence of having completed 100 hours of colonic irrigation training, including a minimum of 45 hours of clinical practicum with a minimum of 20 treatments given. (3) Prior to the practice of colonic irrigation, any licensed massage therapist, or apprentice shall be required to successfully complete and pass the National Board for Colon Hydrotherapy Examination (NBCHT) which is approved by the Board. (4) Any licensed massage therapist whose license has been in an inactive or retired status for more than two consecutive biennial licensure cycles shall be required to successfully complete and pass the NBCHT, prior to resuming the practice of colonic irrigation. (5) Any applicant for massage therapist licensure or licensed massage therapist, who in conjunction with previous massage therapist licensure was certified to practice colonic irrigation, shall be required to successfully complete and pass the NBCHT prior to practicing colon hydrotherapy. Rulemaking Authority 456.036, 480.035(7), 480.041(4) FS. Law Implemented 456.036, 480.032, 480.033, 480.041(4) FS. History–New 12-18-84, Formerly 21L-31.01, Amended 1-30-90, 2-13-91, Formerly 21L-31.001, 61G11-31.001, Amended 1-26-00, 5-5-04, 2-27-06, 8-9-10.[23]
See also
References
- ^ a b "Do you really need to clean your colon?". Marketplace. CBC Television. 2009. Retrieved 2010-05-03.
- ^ a b c "Colon Therapy". American Cancer Society. 2008-01-11. Retrieved 2010-05-04.
- ^ a b Brody, J (2008-07-22). "Health 'Facts' You Only Thought You Knew". The New York Times. Retrieved 2012-10-06.
- ^ a b c Schneider, K (2003-02-27). "How Clean Should Your Colon Be?". American Council on Science and Health. Retrieved 2008-09-02.
- ^ a b c d Barrett, S (2008-03-09). "Gastrointestinal Quackery: Colonics, Laxatives, and More". Quackwatch. Retrieved 2008-09-02.
- ^ a b c Wanjek, C (2006-08-08). "Colon Cleansing: Money Down the Toilet". LiveScience. Retrieved 2008-11-10.
- ^ Donaldson, AN (1922). "Relation of constipation to intestinal intoxication". JAMA. 78 (12): 884–8. doi:10.1001/jama.1922.02640650028011.
- ^ a b c
Ernst E (1997). "Colonic irrigation and the theory of auto-intoxication: a triumph of ignorance over science". Journal of Clinical Gastroenterology. 24 (4): 196–8. doi:10.1097/00004836-199706000-00002. PMID 9252839.
{{cite journal}}
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ignored (help) - ^ "Colon Cleansing: Don't Be Misled By the Claims". Ebsco. 2013-01-14. Retrieved 2013-11-13.
- ^ a b Adams, C. "Does colonic irrigation do you any good?". The Straight Dope. Retrieved 2008-09-02.
- ^ a b c Picco, M (2007-03-21). "Colon cleansing: Is it helpful or harmful?". The Mayo Clinic. Retrieved 2008-11-09.
- ^ Handley DV, Rieger NA, Rodda DJ (2004). "Rectal perforation from colonic irrigation administered by alternative practitioners". Med. J. Aust. 181 (10): 575–6. PMID 15540974.
{{cite journal}}
: Unknown parameter|month=
ignored (help)CS1 maint: multiple names: authors list (link) - ^
- Centers for Disease Control (CDC) (1981). "Amebiasis associated with colonic irrigation—Colorado". MMWR Morb. Mortal. Wkly. Rep. 30 (9): 101–2. PMID 6789134.
{{cite journal}}
: Unknown parameter|month=
ignored (help) - Istre GR; Kreiss K; Hopkins RS; et al. (1982). "An outbreak of amebiasis spread by colonic irrigation at a chiropractic clinic". N. Engl. J. Med. 307 (6): 339–42. doi:10.1056/NEJM198208053070603. PMID 6283354.
{{cite journal}}
: Unknown parameter|author-separator=
ignored (help); Unknown parameter|month=
ignored (help)
- Centers for Disease Control (CDC) (1981). "Amebiasis associated with colonic irrigation—Colorado". MMWR Morb. Mortal. Wkly. Rep. 30 (9): 101–2. PMID 6789134.
- ^ a b Tennen M (June 2007). "The Dangers of Colon Cleansing". HealthAtoZ.com. Archived from the original on 2008-06-13. Retrieved 2008-09-01.
- ^ Eisele JW, Reay DT (1980). "Deaths related to coffee enemas". JAMA. 244 (14): 1608–9. doi:10.1001/jama.1980.03310140066036. PMID 7420666.
{{cite journal}}
: Unknown parameter|month=
ignored (help) - ^ McFerran, Tanya (21 February 2008). Martin, Elizabeth A (ed.). Colonic irrigation. Oxford University Press. p. 103. ISBN 0-199-21177-9.
{{cite book}}
:|work=
ignored (help)CS1 maint: date and year (link) - ^ Youngson M.D. et all, Robert M. (2005). Encyclopedia of Family Health. Vol. 3. USA: Marshall Cavandish. p. 384. ISBN 0-7614-7489-7.
- ^ Mishori, Ranit; Jones, Aminah Alleyne; Otubu, Aye (2011). "The dangers of colon cleansing: patients may look to colon cleansing as a way to 'enhance their well-being,' but in reality they may be doing themselves harm" (pdf). Journal of Family Practice. 60 (8): 454.
- ^ a b c d Chen TS, Chen PS (1989). "Intestinal autointoxication: a medical leitmotif". J. Clin. Gastroenterol. 11 (4): 434–41. doi:10.1097/00004836-198908000-00017. PMID 2668399.
- ^
Daly, Ann (1997). Fantasy Surgery 1880-1930. The Wellcome Institute Series in the History of Medicine. Vol. 38. Rodopi. p. 67. ISBN 9789042000094. Retrieved 2013-11-25.
[...]purging was one of the few procedures that a physician could perform with visible, often impressive results and without immediate or obvious dangers.
- ^
Smith JL (1982). "Sir William Arbuthnot-Lane, 1st Baronet, chronic intestinal stasis, and autointoxication". Annals of Internal Medicine. 96 (3): 365–9. doi:10.7326/0003-4819-96-3-365. PMID 7036818.
{{cite journal}}
: Unknown parameter|month=
ignored (help) - ^ Alvarez, WC (1919). "Origin of the so-called auto-intoxication symptom". JAMA. 72 (1): 8–13. doi:10.1001/jama.1919.02610010014002.
- ^ https://www.flrules.org/gateway/ruleno.asp?id=64B7-31.001&Section=0