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Intestine & digestion

Cleansing the intestine: here is what you need to know about colon cleansing

October 25, 2018

We know that to keep it in shape you need a balanced diet, based on the right amount of water and fiber, and regular physical activity. When, on the other hand, the intestine is disturbed by a series of more or less serious problems, it is more difficult to understand how to behave. With Dr. Federica Furfaro, gastroenterologist at Humanitas, we talked about the techniques to keep the intestine clean and healthy.


The importance of knowing how to read the intestine

Stool with a too soft and foul-smelling consistency or, on the contrary, hard and goat-like stools are among the most evident signs that our intestines can send us to tell us that they are unhealthy. But intestinal disorders, accompanied by excessive production of intestinal gases and spasms, are often the wake-up call for eating disorders, an unbalanced diet or a level of excessive stress. “Reading” the intestine is therefore the first step. The second step is knowing how to detoxify it effectively.


The ancient practice of colon cleansing

Colon cleansing consists in washing the intestine to improve the functioning of the colon by eliminating toxins and digestive residues. The practice, widespread since ancient times, is often proposed as a remedy to eliminate intestinal disorders and constipation problems. “The practice of colon cleansing dates back to the time of the ancient Egyptians when it was thought that purifying the body of waste could prevent any disease – explained Dr. Furfaro, gastroenterologist at the Humanitas hospital. The Egyptians first, but then also the ancient Greeks and Romans used enemas for over 20 different gastric and intestinal symptoms. Today, even if there is no scientific evidence to support the prescription, intestinal washing finds indications as an adjunct in the preparation for colonoscopy and in certain conditions including stubborn constipation, spinal cord injury, in cases of alteration of bacterial flora, and skin allergies. There is, however, no scientific data to suggest the use of colon cleansing in healthy subjects,” says the specialist.


A 2011 study by Georgetown University, USA, also examined possible side effects and contraindications: “Side effects may be the development of an electrolyte alteration, following excessive diarrhea, or a perforation caused by the placement of the tube inside the colon. Contraindications are mainly acute bowel diseases, such as diverticulitis, or chronic inflammatory bowel diseases. Hydrocholon therapy – concluded Dr Furfaro – is also not recommended in immunosuppressed patients”.

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Themes and ways of intestinal washing

“I recommend colon cleansing only in selected cases, particularly in patients with stubborn constipation problems not responding to medical therapy,” said Furfaro. However, I do not believe that this technique is a solution to the problem, it can rather be used as a palliative procedure to improve the quality of life of the patient, but has a limited effect in time. However, it is not advisable to perform this procedure very often because of the risk of developing hydroelectrolytic imbalances.


Medical centers often propose this treatment: but should we trust the proposed packages of sessions? “It is necessary to carefully evaluate the type of procedure proposed and the interval between administrations, in order to avoid possible complications,” concluded the specialist.


FodMap, the diet that puts the intestine to rest

FodMap is an acronym that stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols, or oligosaccharides, disaccharides, fermentable monosaccharides and polyols, sugars that can ferment in the intestine thanks to the action of intestinal bacteria.


These components are present everywhere, in different types of fruit and vegetables, in some cheeses and dairy products and in cereals. Foods to be avoided because they are highly fermentable include, for example, artichokes and cauliflower, mushrooms, garlic and onions, apples and pears, cow’s, goat’s and sheep’s milk.


Low-Fodmap products, therefore with a low content of these fermentable molecules and allowed by the Australian diet, include canned chickpeas and lentils, courgettes, ginger, radish, broccoli, fennel and lettuce, milk and lactose-free derivatives, berries, kiwis and grapes.


To improve the symptoms of irritable bowel syndrome, often characterized by swelling, cramping and alteration of intestinal regularity, this type of diet is credited as a valid option. It was developed by two researchers at Monash University in Melbourne, a gastroenterologist and a dietitian. Since its first publication, more than ten years ago, the effectiveness of the diet has been validated by various scientific researches and has entered into clinical practice.


Supplements and probiotics

Numerous supplements based on fibers, probiotics and prebiotics, are proposed to improve the functionality of the intestine. In particular, the fibers improve intestinal emptying; probiotics are living micro-organisms that, administered in adequate quantities, promote an improvement of the intestinal microbial balance through inhibition of pathogenic bacteria, bringing a benefit to the health of the patient; prebiotics are non-digestible organic substances, capable of selectively stimulating the growth and/or activity of beneficial bacteria present in the colon.


The opinion of Humanitas

“In fact, there is no accredited method of “intestinal purification”, the same for all patients, and it is not necessary to program an “intestinal purification” if the function is regular – concluded Furfaro. In selected cases, for example in patients with stubborn constipation, it is advisable to use laxatives to “cleanse” the intestine, before evaluating the use of invasive techniques such as colon cleansing. In subjects with alteration of the microbiota or bacterial overgrowth it is advisable to use selective antibiotic therapies for the intestine and then the use of probiotics, to restore the correct intestinal bacterial flora, thus “cleaning” the body from “pathogenic” bacteria.

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