The Difference Between a High Colonic and an Enema

toilet for enema or colonics
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Colonics and enemas both aim to cleanse the colon by introducing water by way of the rectum. Although the treatments are similar in approach and in their supposed health benefits, there are some key differences between colonics and enemas.

For example, enemas involve a one-time infusion of water into the colon. Also known as colonic hydrotherapy or colon irrigation, colonics involve multiple infusions of water into the colon.

What's more, the main objective of enemas is to evacuate the lower colon, while colonics are meant to cleanse a larger part of the colon.

Another key difference between colonics and enemas: colonics require specialized equipment and must be administered by a trained colon hydrotherapist while enemas are often performed at home with the help of do-it-yourself kits (commonly sold in drugstores).

Enema kits are classified by the Food and Drug Administration as class 1 medical devices and can be purchased over the counter. Colonic irrigation equipment is classified as class II medical devices when the device is intended for medically indicated colon cleansing (for example, before a radiological examination). When intended for other uses, such as colon cleansing for general health improvement, colonic irrigation equipment is classified as class III medical devices.

Colonics vs. Enemas: What to Expect from Your Treatment

Usually lasting 45 minutes to an hour, a typical colonic begins with the client completing a health history form and consulting with the colon hydrotherapist.

After changing into a gown, the client lies face up on a treatment table, where the therapist inserts a disposable speculum into the anus. This speculum is connected to a long disposable plastic hose, which is in turn connected to the colon hydrotherapy unit (a system that enables the pressure, temperature, or flow of water through the nozzle to be controlled.

There may be a console-type toilet and fittings to allow the device to be connected to water and sewer pipes, and an electrical power source to warm the water.)

During the treatment, filtered warm water is slowly released into the colon. The water promotes contraction of the colon muscles, which is a process called peristalsis. Through peristalsis, waste matter is pushed out through the hose (later to be disposed of in a closed waste system).

In many cases, the client may experience abdominal discomfort during his/her colonic. In order to facilitate the process, the therapist may apply light massage to the client's abdominal area.

Once the treatment is completed, the client may sit on a toilet to pass any residual water and stools.

Often performed in the bathroom, enemas typically involve lying on your back and inserting the enema kit's nozzle several inches into the anus. This nozzle is connected to a tube that leads to a container holding the fluid for the infusion.

Releasing the tube's clamp initiates the flow of fluid into the rectum and stimulates peristalsis.

The next step in an enema is to retain the fluid for several minutes, then sit on the toilet to expel the fluid.

Referred to as "retention enemas," some treatments involve holding liquid in the colon for extended periods of time. There are several different types of retention enemas, including coffee enemas and enemas involving infusions containing red raspberry leaf, probiotics, minerals, and other natural substances.

Colonics vs. Enemas: The Health Benefits

Colonics and enemas are each said to enhance overall health, promote detoxification, protect against constipation, improve digestion, and support weight loss.

In addition, colonics are said to improve the body's absorption of water and nutrients, as well as fight the growth of harmful bacteria and yeast in the colon. 

Meanwhile, proponents suggest that enemas can help treat or prevent a number of health issues said to arise from the buildup of waste in the colon. According to such proponents, these health issues include allergies, bad breath, back pain, depression, fatigue, headache, hemorrhoids, indigestion, sinus problems, and skin conditions such as eczema and psoriasis.

However, despite the many claims for the supposed health benefits of colonics and enemas, scientific support for such claims is currently lacking.

In a research review published in the American Journal of Gastroenterology in 2009, for instance, scientists looked at the available studies on the effects of various types of colon cleansing and found no evidence that these practices can improve or promote general health.

Although there's some evidence that enemas may be beneficial in preparing the bowels for colonoscopy, further research is needed before enemas or colonics can be recommended for any health-related purpose.

Health Risks & Side Effects

Colonics and enemas carry similar health risks, including serious complications like bowel perforation and infection. If you're considering either procedure, consult your primary care provider

Colonics and enemas may also produce similar side-effects, such as nausea and fatigue.

Furthermore, both colonics and enemas should be avoided by people with conditions such as diverticular disease, ulcerative colitis, Crohn's disease, severe hemorrhoids, heart disease, severe anemia, abdominal hernia, gastrointestinal cancer, and intestinal tumors.

Pregnant women and people who have recently had colon surgery should also avoid colonics and enemas.


Acosta RD, Cash BD. "Clinical effects of colonic cleansing for general health promotion: a systematic review." Am J Gastroenterol. 2009 Nov;104(11):2830-6; quiz 2837.

Horiuchi A, Nakayama Y, Kajiyama M, Kato N, Kamijima T, Ichise Y, Tanaka N. "Colonoscopic enema as a rescue for inadequate bowel preparation before colonoscopy: a prospective, observational study." Colorectal Dis. 2012 Oct;14(10):e735-9.

Niv G, Grinberg T, Dickman R, Wasserberg N, Niv Y. "Perforation and mortality after cleansing enema for acute constipation are not rare but are preventable." Int J Gen Med. 2013 Apr 26;6:323-8.

Disclaimer: The information contained on this site is intended for educational purposes only and is not a substitute for advice, diagnosis or treatment by a licensed physician. It is not meant to cover all possible precautions, drug interactions, circumstances or adverse effects. You should seek prompt medical care for any health issues and consult your doctor before using alternative medicine or making a change to your regimen.

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