If you’ve not seen Kitty Flanagan’s skit on current coffee culture...it’s essential viewing.  In true Kitty-fashion, she wants to simplify coffee ordering down to 2 basic lines – White or Black – says all our pretentious coffee orders; macchiato, skinny, decaf, half strength, latte etc can essentially be reduced down to  a much faster 2 queue system. But she’s forgotten the line for taking your coffee rectally.  Sorry – did I make you just spill your coffee? Knowing How across health trends Kitty is, she’ll add this 3rd queue soon, if the number of patients asking me about this or telling me they’re already doing it. Now, while enemas had a place in naturopathic history, my training never covered them and, consequently, I’ve never included them in my practice. But the more hype I heard around coffee enemas specifically, the more I thought we better find out as much as we can, so at least we can better inform ourselves and our patients. And of course the monkey on your back, called FOMO, jumps up and down, incessantly asking, “Are you (and your patients) missing out on an amazing therapy?”

The first patient who told me they were using coffee enemas daily was a celeb.  A very anxious one. Who also told me she couldn’t possibly drink chai let alone coffee because of the caffeine.  This had me a bit stumped…I knew she wasn’t inserting decaff up there and I thought…well given the colon is SUCH an absorptive surface surely this is why she reported feeling, ‘so energised, more clear headed’ etc. with every enema?

But I wanted to find out for sure

Most patients’ rationale for starting coffee enemas is either constipation, ‘sluggish bowel’ or for improving ‘detox’ (that ol’ vague & mysterious term!).  Certainly most patients I’ve encountered report increased bowel motions post-enemas and most of us would equate that with the simple act of using an enema of any sort, but the question for me was what the coffee really contributed to this action and was doing to their digestive tract in general, given it’s normally passed through metres of digestive tract during which, like all products of digestion, it undergoes serious chemical transformation. What happens when the bowel essentially drinks a long black, retains it for 10-15mins and then spits it right back out? 

What’s the effect on the patient’s transit time, reliance on cathartics (it’s a risk with any regular enema use), composition of the stool, upstream digestive function and even their microbiota?

Many of you will know that one important part of the coffee enema’s history is as a cornerstone part of Gerson’s cancer protocol.  Max Gerson was a German Physician who ended up (mostly by accident) working with cancer patients.  If you don’t know his story and his treatment ideas this article is really worth a read, just to appreciate some of the roots of this practice and how this has also influenced modern day thoughts on the merits of coffee enemas.  Gerson got the idea to use them from a colleague who had observed that injecting animals rectally with coffee changed the behaviour of their biliary system in particular, which fitted perfectly with Gerson’s ideas about the need to ‘open the elimination channels’ especially via the gut to improve the health of his patients. As it turns out, the bile duct actions reported in animals in the 1940s have held their validity to a large extent..but a lot of other assumptions and theories have been challenged.

If you read nothing else about coffee enemas, then read this There are significant risks, well documented cases of adverse effects and even death with self-administered coffee enemas. I think the minimum we need to know when our patients are using these or thinking about it, is the risks.

Are you keen to know the rest of the facts about this popular DIY detox – like, where did this practice really stem from? The answers will surprise you!  What evidence do we have about the positives and possible negatives? Is there a place for this practice and if so, in which patients & conditions?  And possibly most importantly, what are the real risks? Coffee enemas have been used medically for 100s of years and don’t appear to be going anywhere anytime soon…time to get across this! 

Hear all about it by listening by my latest Update in Under 30:
Coffee Enemas – the truth about this DIY detox.
For all Update in Under 30 Subscribers, it’s now available in your online account and if you are not a subscriber you can purchase this individually here.