The idea of irrigating the lower bowel in order to rid it of noxious substances and bathe it with healing ones is not by any means a modern contrivance. Anyone familiar with the history of medical colitis treatments will tell you that, from time to time throughout the last few hundred years, the colon irrigation craze has taken hold, flourished for a while and then gone back to its cocoon.
At the present the idea is in the breaking out once again from the cocoon stage, though there are still sufficient numbers of irrigation advocates to warrant a few words on the subject. Perhaps it might be well to explain exactly what is meant by irrigation.
Through a double tube which is inserted into the cavity of the colon, a stream of solution is allowed to flow in to the bowel until it completely fills the colon. Through the second of the tubes, the solution is simultaneously withdrawn. Thus the solution is continually renewed and the bowel flushed out.
Theoretically, the process is as simple as washing one’s mouth. Actually there are possibilities of considerable harm. If the pressure under which the colon irrigation is administered is too great, the bowel can be seriously damaged from overdistention. Indeed, perforation itself may occur in a diseased bowel. Where diverticula (pockets) are present, this danger is very real. The possible good from the irrigation, in my opinion, does not counterbalance the risks.
Unless the temperature of the solution be correct, there is danger of thermal shock not only to the tissues of the colon but to neighboring organs. Finally, if chemicals which in themselves are irritant are employed in the solution, we add a chemical injury to the already damaged lining of the colon. This is the greatest danger attendant upon the use of irrigation.
It is a prevailing custom to use sodium bicarbonate in the irrigation. This in itself is definitely irritating. Naturally it evokes a response on the part of the lining of the colon. That response is a tremendous secretion of mucus. The reason why the mucus secretion poured out in so great a quantity is that it is a means of diluting and washing away the irritating bicarbonate. Yet how many times have I heard nurses and even doctors call the attention of the patient to this abundant mucus, saying: “See how it brings all that mucus out?” What they should say is, “See how much mucus this bicarbonate is causing!”
Anyone recommending irrigations of this kind is most certainly either a knave or a fool. In either event, he is not fit for the trust the patient reposes in him since he is harming him by the very colitis treatment which he pretends will help him.
Others use a saline solution which, if it be of the proper concentration, is not irritating or harmful from a chemical point of view. However, it carries with it another danger. Where there is any kidney irritation, the absorption of excessive amounts of salt may be harmful.
My own opinion is that plain water at a temperature of 100° administered under low pressure can accomplish anything that the medicated solutions are supposed to. And the ordinary cornstarch enema mentioned earlier, if faithfully given, is capable of just as much good as any irrigation.
Before leaving the matter of irrigations, I should like to add a word of warning with regard to courses of treatment for colitis. In some places where irrigations are given, the patient is urged to sign up for a course of ten or some other number of treatments, usually at a discount if the entire course is taken.
From a scientific standpoint, this is, of course, unacceptable. If he needs but one and takes ten, he may actually do himself harm or become the victim of an irrigation habit which can be just as troublesome as the cathartic habit.
Before embarking on any set ot irrigation treatments, you’d do well to talk over with your friend, the family physician, your intentions. Get him to specify how many are to be taken, what solution is to be used and at what temperature the solution should be administered. By so doing, you may well spare yourself not only unnecessary expense but also injury and regrets.
