The internal washing of the colon by introducing water, now known as "enemas," has a long history of use and probably began as an ancient medicinal practice to relieve constipated bowels. While academia and the medical community continue to debate its merits, ancient texts reflect a reliable and widespread practice of enemas in many different cultures across all continents. The Temecula Center for Integrative Medicine (TCIM) and the larger holistic community have long been aware of the benefits and routinely employ coffee enemas to address specific conditions, such as detoxification and liver and gallbladder support.
What do Enemas Do?
Enemas mechanically flush waste out of the large intestines, relieving constipation - a condition where waste becomes trapped in the large intestine and has difficulty exiting the body. In addition to easing the discomfort associated with constipation, enemas can reduce toxic breakdown products that result from the prolonged trapping of waste in the intestine, leading to fermentation and putrefaction. Frequent or chronic constipation also increases the risk of overburdening the liver by forcing it to constantly neutralize toxins. Assisting with the elimination of trapped waste via enemas alleviates uncomfortable fullness, helps prevent toxin buildup in the body, and reduces the strain on the liver.
Why Use Coffee Instead of Water for Enemas?
Dr. Max Gerson, M.D., popularized coffee enemas after successfully using cooled coffee in his own treatments and then on patients. One patient even reported that their skin tuberculosis cleared up after using the coffee enemas, prompting further research and application of this technique to address various ailments. This led to 30 years of case studies on coffee enemas (1), culminating in the publication of Dr. Gerson's book "A Cancer Therapy" in 1958, which is now in its 6th edition (2). While the FDA has not approved coffee enemas as a treatment for cancer (3), they are acknowledged for relieving constipation, supporting liver function, and addressing other non-life-threatening conditions.
How Does Using Coffee Work?
First, let's briefly review the functions of the liver and gallbladder. The liver is a major organ of detoxification - it adds or removes chemicals from toxic substances in the blood, rendering them harmless and preparing them for removal from the body.
The liver also creates bile and stores it in the gallbladder. When fat is sensed in the small intestine, the gallbladder contracts, forcing the fat-emulsifying bile into the small intestine, where it can break down fats into its smallest parts.
Under certain circumstances, bile can thicken or become hardened, forming gallstones and clogging the liver and gallbladder ducts. Overly thick bile and a gallstone-ridden gallbladder can lead to a variety of gastrointestinal issues that drive a patient to the doctor's office for relief.
Studies show that coffee enemas can positively impact liver and gallbladder functions in multiple ways. First, the natural compounds in coffee (when administered via enema) stimulate the liver, increasing bile production and flushing out some of the ducts between the liver and gallbladder. If bile builds up in these ducts, the sudden rise in bile production helps unclog the vessels (4).
Dr. Gerson found that the caffeine in coffee enemas also helped dilate (enlarge) the bile ducts, which helped move toxic cancer breakdown products out of the liver (1). Researchers have confirmed that more bile is created when coffee is used in the enema fluid (5).
Two compounds in coffee, kahweol and cafestol, stimulate the production of a glutathione S-transferase (GST), an enzyme involved in the detoxification process. Increased GST helps the liver change many different kinds of toxic substances to harmless molecules for disposal (4). Additionally, GST can scavenge free radicals in the colon, reducing inflammation and decreasing damage to cells (4).
To sum it up, using coffee as the liquid for an enema instead of water increases the likelihood of gently cleansing the bile ducts between the liver and the gallbladder, and aiding the liver in removing toxic elements from the blood.
Health Benefits of Coffee Enemas
While there is still some controversy over the safety of self-administered enemas, there are many evidence-based benefits of the correct use of a coffee enema:
Mechanically flushes out the lower bowel - Enemas address constipation. Adding a liquid to the bowel contents can help wastes leave the body.
Increases detoxification - Through the increase of enzymes and antioxidants involved in the detoxification process, the liver can get some assistance to deal with its workload of breaking down toxins.
Gently flushes bile ducts
Gently stimulates the liver to produce bile
Neutralizes free radicals - through the stimulation of glutathione S-transferase (GST).
Decreases inflammation in the bowel - through the neutralization of inflammation-causing free radicals (4).
Addresses pain caused by complications of constipation - By mechanically flushing out any backed-up stool, the pressure on the intestines can be relieved, often causing a reduction in abdominal pain.
Who Should Avoid Enemas?
As with any treatment, there are caveats. Enemas are not for everyone, and it's a good idea to discuss the practice of enemas with a knowledgeable doctor. Additionally, it is best to discover the root cause of your symptoms or condition so it can be properly treated.
Pregnant women and those who experience any of the following conditions should consult with a doctor to discuss risks before attempting to self-administer an enema (6-8):
Chronic constipation or diarrhea
A compromised immune system
Kidney conditions
Chemotherapy
Certain GI conditions, including ulcerative colitis and Crohn's Disease
Rectal prolapse
Severe fecal impaction, bowel obstruction, or history of bowel obstruction
Extreme abdominal pain
Recent abdominal, rectal, bowel obstruction, or colon surgery (including colon removal)
History of colon or colorectal cancer
Electrolyte imbalances
How to Administer a Coffee Enema
If a doctor determines that a coffee enema might benefit you, it is helpful to understand how the enema is administered. Because many topics around defecation and waste matter are taboo, there is a lack of readily available, detailed information for patients to understand the procedure. Even the devices used for enemas can have vague directions! Therefore, the information presented here is designed to take the mystery out of the therapy.
1. Buy an enema kit. Many grocery and natural foods stores carry enema kits, and they can be easily found online. Use the search term "coffee enema kit for liver cleansing organic," or ask your healthcare practitioner for a recommendation. Make sure you purchase an enema kit that has the straight, short tip that is used in the rectum (versus a long, flared tip that is used for douching the vagina. Sometimes kits have both, so read the pamphlet to make sure you select the correct tip).
2. Purchase coffee made for enemas. A good coffee brand will be organic, have a high caffeine content, and contain a high amount of palmitic acids. Some brands test their coffee to ensure low mold and bacteria levels - these cost more but are less likely to introduce microorganisms. Lighter beans, even green coffee beans, are used as coffee for enemas due to their caffeine and beneficial acid ratios.
3. Purchase distilled or highly filtered water for your coffee. Do not use tap water - there are too many possibilities for contamination.
4. Hydrate! Pay attention to your hydration in the days before an enema. Ensure you are well hydrated in the few days before the enema (and afterward).
5. The day of the enema, prepare the coffee. Typically, 1-3 tablespoons of ground coffee (for enemas) is added to one quart of boiling water. (Use one tablespoon if this is your first time.) Use highly filtered or distilled water. (Do not use tap water!) Boil the water with the coffee grounds in a pot without a cover for 5 minutes, then pull it off the heat and let it sit for 15 minutes. Wait until the coffee is cooled to 98-100 degrees or until a sprinkle on your wrist feels lukewarm (barely warm). Waiting for the coffee to cool could take up to 30 minutes. Be patient - you can burn your insides if your coffee is too hot! Do not rush this step!
6. Strain the coffee to remove the grounds. This step is crucial because putting coffee grains in the colon is unhealthy.
7. Pour the coffee into the enema bag. Close the valve on the tubing, open the cap at the top, then pour the cooled coffee into the bag. Close the cap. Hold the tubing over a sink, open the valve, and let a little coffee pour out. Then, close the valve again. This process gets the air out of the tube. You should see coffee in the tube from the bag all the way to the valve. Hang the bag about two feet above where you plan to lay, making sure the tubing can reach your buttocks and possibly even the toilet. The ability to reach the toilet becomes important later.
8. Prepare a place to lie down in the bathroom near the toilet. A mat with some towels works fine. Just note that coffee does stain, so use towels set aside for that purpose. A timer and something to play music or read are helpful for distraction. Have the lubricant for the enema tip nearby (coconut oil, castor oil, or personal lubricant works). You may also want to have a towel to cover yourself as well.
9. Urinate and empty your bowels, eliminating as much as possible. Some people wait until they naturally have a significant bowel movement, then do the enema afterward.
10. Wash your hands and dry them.
11. Lay on your right side and insert the tip of the enema. Remove your clothing and lie down on your right side. Pull one or both of your knees up to your chest. Lubricate the tip of the enema and insert it in the anus. Please don't force it, but keep a light, steady pressure until the sphincter allows the enema tip past its muscles. Try to relax the anal sphincter purposefully. There is some resistance at first, but if the enema tip is well-lubricated and your angle is correct, it will pass the sphincter quickly, and the muscles will form a seal around the tip. Do not rush this step! Be gentle with yourself - it is in this step that many people damage the delicate tissues of the anus.
12. Open the valve on the tubing, but be prepared to close it off periodically. Open and close the valve in small increments to let a little coffee in at a time. It may take you 5 to 10 minutes to empty the bag. (If it's your first time, you may not empty the bag, and that's okay; do as much as you can.) When you feel as though you need to use the bathroom, tighten your anal sphincter and try to hold it in - the feeling usually passes. After you get used to it, it will get easier.
13. Try to hold the coffee inside for 15 minutes. Read or listen to music to distract yourself.
14. Expel the wastes. When time is up, or it becomes unbearable to hold in, remove the enema tube and get on the toilet to expel your waste. Some people get on the toilet first, then remove the tubing. Others can remove the tubing first and maneuver themselves over the toilet without making a mess. You'll figure out what works best for you.
15. Stay on the toilet for about 10 minutes, massaging your abdomen in big circles, clockwise and counterclockwise. Shift your hips a little bit, and make sure you get all your waste out. Move your bowels as much as possible.
16. Clean your kit and wash your towels. The enema kit usually has instructions on how to clean it. If there are no instructions, use 3% hydrogen peroxide to soak the tip and clean it with a Q-tip. Put 3% hydrogen peroxide and water in the bag (half and half), and let it pour through the tubing. Let everything air dry. Towels can be washed in regular washing detergent. Wash your hands when you're through cleaning your kit.
17. Take a shower to clean yourself from top to bottom.
Best Practices for Coffee Enemas
Once the mechanics of self-administering an enema are learned, the risks of an adverse event go down. The rare (but severe) risks are (9):
- accidentally poking a hole in the intestines or harming the tissues of the anus
- burning the inner lining of the intestines with liquid that is too hot
- triggering inflammation (colitis) or rectum inflammation
- electrolyte imbalance (too many minerals being removed from the system)
The following steps can be taken to minimize risks. While some are mentioned in the step-by-step instructions above, they are discussed here as well to highlight their importance to your safety.
Get clearance from your doctor for a coffee enema, especially if you've had electrolyte imbalances, unexplained dizziness or fainting, colon or abdominal surgery, or infections in or around the anus.
Learn from a trained professional how to administer enemas.
There are different types of enema kits available online. New, comfortable silicone tips can be purchased separately from the enema kit if the plastic tip is uncomfortable.
Use coconut oil or castor oil as a lubricant for the tip that gets inserted into the rectum.
Make sure you are hydrated in the days preceding an enema.
Use distilled or highly filtered water to make your coffee. Do not use tap water; you could accidentally introduce microorganisms into your colon.
When using coffee as the enema liquid, cool it to body temperature before using it. It should feel lukewarm and have a temperature of 100 degrees or below.
Use a mold, fungus, heavy metal, and mycotoxin-free coffee specially made for enemas and colon hydrotherapy, as some coffee could introduce bacteria (6).
Follow the instructions on the enema kit to learn how to clean it properly.
Follow an enema session by drinking plenty of water and relaxing your body (no endurance sports).
Ask your healthcare provider how frequently you should do a coffee enema. Doing them too frequently can lead to dehydration and electrolyte imbalances.
An Alternative - Colon Hydrotherapy with Coffee
One way to minimize risks is to go to a professional for colon hydrotherapy. Many professionals can add safe coffee to the colon hydrotherapy water. It may not be as effective as a 100% coffee enema for the liver and gallbladder; however, it can introduce someone to the internal washing of the intestines and provide other benefits. You can learn more in our article about colon hydrotherapy here.
Summary
There is a consensus among holistic and integrative health practitioners that coffee enemas are useful complementary and standalone therapies for specific health conditions. Temecula Center for Integrative Medicine's practitioners can evaluate your situation, help discover the root causes of your symptoms, and create a personalized treatment plan. If you are a good candidate for coffee enemas, we are happy to explain the process and answer any of your questions. It is our privilege to help you gain optimal health.
Jonathan Vellinga, MD is an Internal Medicine practitioner with a broad interest in medicine. He graduated Summa cum laude from Weber State University in Clinical Laboratory Sciences and completed his medical degree from the Medical College of Wisconsin.
Upon graduation from medical school, he completed his Internal Medicine residency at the University of Michigan. Dr. Vellinga is board-certified with the American Board of Internal Medicine and a member of the Institute for Functional Medicine.
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