It might not occur to you, sipping your morning coffee, that TikTok influencers are suggesting you can derive tremendous health benefits by bypassing your mouth, and firing that beverage directly into your rectum. I first wrote about coffee enemas in 2013 and like other pseudoscientific fads, coffee enemas seem to come and go: Each generation seems to turn to the same “greatest hits”. Coffee colonics are no exception.Since I can’t easily post an array of TikToks, I’ll turn to an old post, where I looked at a column by Suzy Cohen, who calls herself, “America’s Pharmacist™” and also “America’s Most Trusted Pharmacist®”. Cohen is a proponent of coffee enemas. Her syndicated column Ask the Pharmacist contained this question and response:
Question: I see a naturopathic doctor for chronic fatigue and fibromyalgia. She recommended coffee enemas. Suzy, I’m a faithful reader, do you think this is safe? V.A., Seattle, Washington
Answer: Yes. Coffee enemas are used by holistic physicians for all sorts of conditions including cancer. Lots of people find help with constipation, fatigue and liver detoxification concerns. I know this sounds bizarre because you prefer to taste your coffee, not insert it rectally! Agreed. You may be hearing about coffee enemas today, but they are nothing new and complications from coffee enemas are highly unusual. Hey, I just thought of a new franchise concept called Starbutts … entrance in the rear.
Seriously, coffee enemas may help relieve constipation, insomnia and cognitive problems; they may eliminate (or control) parasites, candida and other pathogens (without disrupting intestinal flora). Coffee enemas are frequently used in natural cancer protocols such as the Gerson Therapy (www.gerson.org). Coffee enemas were outlined as a treatment in the revered “Merck Manual,” a thick book that physicians used as their primary reference for decades, until the mid 1970s.
It’s not the enema as much as it is the coffee that helps. You are exposed to a barrage of toxic compounds in your life, you can easily become overloaded. Some of you cannot detoxify properly. Coffee enemas help you make glutathione, an antioxidant and that sends poisons packing. More on that momentarily.
Coffee enemas can be done at home inexpensively. You just need a comfortable spot on the floor of your bathroom, or bathtub. As the coffee is retained in your bowel, the fluid goes through your intestinal wall, through the portal vein to your liver. The stimulating effects and healing compounds of coffee jumpstart your liver and gallbladder. Bile flows. There are compounds in coffee like kahweol and cafestol which spark production of glutathione, and that is a strong cleansing compound in your body, one that consumers pay good money for when they buy glutathione as a dietary supplement, or get IV injections of it. To make more glutathione naturally (by using a coffee enema) is awesome.
These enemas may allow for relaxation, a better mood, more energy, refreshing sleep and greater mental clarity. If you do too many enemas per week, you may experience electrolyte imbalances. Restoring your electrolytes is crucial, as coffee is a potent drug mugger of minerals. While the controversial cancer specialist Dr. Max Gerson suggested up to six per day, I think that is way too much for the average person. Doing a coffee enema weekly (even daily for awhile) is probably okay for most, but always follow your doctor’s recommendation. The recipe for a coffee enema is different than the beverage.
I was pretty stunned to see this response, particularly from a health professional. Here’s how I’d answer the same question:
A Science-Based Take on Coffee Enemas
Question: I see a naturopathic doctor for chronic fatigue and fibromyalgia. She recommended coffee enemas. Scott, I’m a faithful reader of Science-Based Medicine, do you think this is safe?
Answer: No. Coffee enemas are considered unsafe and should be avoided. Rare but serious adverse events like septicemia (bacteria in the bloodstream), rectal perforation, proctocolitis, and electrolyte abnormalities have been caused by coffee enemas. Deaths from the administration of coffee enemas have been reported.
A 2020 systematic review noted, “Nine case reports that describe adverse events were identified and included in the analysis. Of these, 7 recent ones reported colitis after self-administration, mentioning that the most plausible cause assumed was the coffee fluid itself, which contained numerous chemical substances. Two others reported more critical adverse events. All 9 case reports with acceptable quality of evidence warned against the self-administration of the procedure. No study that reports the effectiveness of coffee enema was found.” It concluded, “..this systematic review does not recommend coffee enema self-administration as a complementary and alternative medicine modality that can be adopted as a mean of self-care, given the unsolved issues on its safety and insufficient evidence with regard to the effectiveness.”
Coffee enemas are based on a pre-scientific idea called “autointoxication”, the belief we are being poisoned by toxins because we are not digesting and eliminating waste products from our colons. This concept is not new, and has roots as far back as the history of medicine. Autointoxication as a concept was discarded over time, as the scientific basis for disease was discovered. “Humoral medicine” emerged from ancient Egyptian and Roman ideas that the body was composed of four liquids: black bile, yellow bile, phlegm, and blood. “Balance’ in the humors was the goal, and an accumulation of waste in the colon was though to lead to humoral imbalances. The remedy was flushing colon through enemas and purgatives. This philosophy, now discarded from science-based medicine, is still found in alternative medicine practices.
There is no credible evidence to suggest that coffee enemas can help with insomnia and cognitive problems. In fact, caffeine is absorbed by the colon when coffee is administered as an enema, so it is a poor option for insomnia. The idea that you are contaminated with parasites or candida are just that – ideas. While alternative practitioners may state that these conditions are widespread in the population, there is no scientific evidence to suggest this. There is no reason to treat conditions which do not exist.
Coffee enemas have their roots as part of the “Gerson Treatment” for cancer, developed by physician Max Gerson in the 1940s. His regimen included coffee enemas, supplements, juice, and injections of calves’ liver. The approach has been investigated and been shown to be useless for the treatment of cancer.
The Gonzalez regimen, developed by Dr. Nicholas Gonzalez, is an alternative cancer treatment protocol that involves the consumption of pancreatic enzymes, dietary supplements, and twice-daily coffee enemas. This treatment protocol has also been investigated and found to be ineffective and possibly harmful. In one study, patients treated with standard chemotherapy survived a median of 14 months and patients treated with the Gonzalez regimen survived a median of 4.3 months.
Some proponents of coffee enemas believe that the chemical components of coffee stimulate liver and gall bladder function. There is no credible evidence to suggest this occurs, or that it is necessary. Your liver and gallbladder don’t need an enema in order to work effectively. There is no evidence to suggest that you need to boost your liver’s production of glutathione with enemas. You may in fact be boosting your glutathione already, if you’re a coffee drinker.
I’m very sorry to hear about your chronic fatigue and fibromyalgia. Science-based medicine lacks a good understanding of this illness, and there is a lack of effective treatments. Unfortunately, that can make patients with these illnesses targets to those that profess certainty and offer dubious and unproven treatments, like coffee enemas. A decision to undergo any treatment needs to consider the risk and benefits, and treatments need to be investigated to determine if the benefits outweigh the risks. With coffee enemas, the evidence is clear. Given the lack of benefit and potential harms, there is no plausible justification to undergo these treatments. You should ignore any medical advice from anyone that recommends coffee enemas to you.
A trend to ignore
Autointoxication is a belief that has persisted for hundreds of years. These ideas seem almost a part of human nature: Purification rituals are common features of different cultures worldwide. In modern society, and with many alternative medicine providers, detoxification gets wrapped with a “science!” banner, in an attempt to give the treatments (and their purveyors) a veneer of credibility. Autointoxication beliefs are not only wrong, but they are demonstrably dangerous. Practices like coffee enemas have no plausible benefit and a real risk of harm. More broadly, and perhaps most importantly, the continued promotion of these practices distracts people from legitimate science-based advice and better health care decision-making.