Colon cleanses thrive despite scant proof
Detoxify your body! Increase your energy! Enjoy regularity!
These are just some of the benefits promised by the makers of internal "cleansing" products. Sold in health stores and over the Internet under a host of names including Cleanse 7, Dr. Natura's Colonix, and Colonblow, they offer "all-natural" relief to the toxified, the fatigued, and the clogged.
I don't fit any of these categories and am pretty skeptical about alternative therapies in general. But I have been curious about cleanses ever since an odd but undeniably radiant auntie treated shocked relatives to an enthusiastic, detailed account of her colonic purification.
And there is also something appealing about the phrase "I'm going on a cleanse." I've always admired friends and family members who have said these words to me. The experience sounds so ascetic, pure, elevating; a journey into the sacred unknown, with fascinating bowel movements.
So when my partner mentioned wanting to try a seven-day course of ReCleanse, a herbal-capsule product with the added cachet of being locally produced, I decided to do it as well. It was an educational experience, if not particularly magical. Only afterward did I decide to seek medical corroboration of its benefits.
To put it bluntly, there isn't much. PubMed, a service of the U.S. National Library of Medicine that includes over 16 million citations from biomedical and life-science journals, pulled up just 10 articles to a search for "colon AND cleanse"; none of them involved herb-and-fibre preparations like ReCleanse.
The one English article I could find for "herbal cleansing" was a piece in Annals of Emergency Medicine, from 2003, describing a near-fatal poisoning from cardioactive compounds.
I also searched in vain for scientific evaluations of "herbs AND constipation", given that relief of irregularity is the main theme to be found for sufferers on-line: one person refers to the agony of walking around "feeling like I'm 6 months pregnant and can't breathe" (Oxy-Powder Colon Cleanser); and a grateful user of Blessed Herbs writes, "The headaches, tiredness and constipation have all gone."
Unfortunately, anecdotal evidence, however vivid and compelling, isn't reliable. One would not expect all disappointed users to write in saying that a product acted poorly or indifferently, nor would such condemnations be likely to wind up on the seller's Web site.
The standard of scientific research is the placebo-controlled, randomized trial studies-preferably double blind. These, to date, do not seem to have been conducted on cleanse products.
There are two explanations for the dearth of scientific research. The first is money. Researchers interested in studying herbal and folk medicines are supported only by grants. Pharmacologist Emma Guns of UBC has a grant from the Canadian Institutes of Health Research to investigate the effect of alternative therapies (like ginseng) on prostate cancers. In a telephone interview, Guns surmises that a study into the effectiveness of a herbal cleanse would be "hard to get funded. No companies are looking at it." While acknowledging that drug companies have helped many people, and not wishing to contribute to the "evil pharmaceutical company stereotype", Guns notes that drug companies direct their efforts toward products that they can market, not some virtuous root.
The second obstacle is the disconnect, if not open enmity, between "natural" healers and the medical establishment. To simplify their respective positions, naturopaths and other alternative healers believe that conventional doctors treat symptoms, not the whole patient. Western medicine generally views "natural" therapies as unproven, subject to unreliable quality control and outright deception.
These positions are illustrated in debates on Quackwatch.org, which bills itself as "your guide to quackery, health fraud, and intelligent decisions". For example, take the term mucoid plaque, coined by naturopath Richard Anderson, founder of Arise and Shine herbal products, to describe a thick coating of food residue in the intestines, exacerbated by the fatty western diet that poisons the system and inhibits nutrient transfer. Edward Thuman, a pathologist at the University of Texas School of Medicine, replying to an inquiry on Quackwatch about mucoid plaque, says that he has "seen several thousand intestinal biopsies and have never seen any 'mucoid plaque.' This is a complete fabrication with no anatomic basis." Anderson replies to skeptics on his site and in his book Cleanse and Purify Thyself that, essentially, doctors don't know what to look for.
Anderson's motivation for defending mucoid plaque seems fairly clear: he sells products that remove it. Stephen Barrett, Quackwatch Web manager and a retired psychiatrist who has written books on health fraud and consumer health, defends scientific rigour. Reached by phone in Allentown, Pennsylvania, Barrett argues that "false beliefs are always harmful. The people who promote them promote other weird notions and are antagonistic to mainstream health care."
He acknowledges that a cleanse product might help some people feel better. "But if you're constipated because of fibre, that's when you want more fibre. It is better to do it with food, and do it gradually. Simply trying to flush it out is not going to make a change in the long run. It might be more harsh than necessary."
Whether or not mucoid plaque exists, cleanse products seem to be flourishing in the absence of objective proof of their merits. Rosemarie Pierce, ReCleanse's "holistic pharmacist", readily acknowledges that there's no scientific validation of her product. In a phone interview from her Sunshine Coast home, Pierce says that what they have are formulas that are "tried and true".
"We don't have double-blind studies. What we have is a tradition of use, from Ayurvedic and traditional Chinese medicine."
Without better corroboration, ReCleanse is unlikely to become a tradition of use in my home. This is not to say that the experience was entirely negative. The package comes with a recommended food plan, discouraging flour, fried food, dairy, sweeteners, potatoes, and even white rice. For a week, my partner and I subsisted on veggies, beans, and tofu. I was shocked at how much I missed candy, cookies, and pizza-and therefore how often I had been eating that junk. On the other hand, I was pleased to learn that taste buds adjust in time. You really can learn to enjoy plain, wholesome food. Mindful eating was a humbling and even spiritual experience, which I plan to repeat.
And I'll tell everyone I'm "on a cleanse".