A high colonic is a procedure that flushes the entire length of the colon with large amounts of water, introduced through a tube inserted into the rectum. You may also hear it called colonic irrigation, colonic hydrotherapy, or simply a “colonic.” Unlike a standard enema, which reaches only the lower portion of the colon, a high colonic pushes water much further through the large intestine, with the goal of washing out accumulated waste. Sessions typically cost between $50 and $121 and are offered at spas, wellness clinics, and some naturopathic practices.
How the Procedure Works
During a high colonic, you lie on a treatment table while a small tube (called a speculum) is inserted into your rectum. Warm, purified water flows into your colon, softening and loosening waste material. The water and waste are then expelled, either around the tube into a basin built into the table or back out through the tube itself, depending on the system used. This fill-and-release cycle repeats multiple times over the course of a session, which generally lasts 30 to 45 minutes. Some practitioners add coffee, herbal solutions, or other substances to the water, though plain filtered water is the most common.
Open System vs. Closed System
Colonic devices come in two main designs, and the experience differs noticeably between them.
An open system uses gravity to move water into the colon rather than mechanical pressure, making it a gentler process. You insert the rectal tube yourself, control the water flow and temperature, and the therapist leaves the room so you can have privacy. Waste exits around the outside of a small tube and drains into a basin beneath you, functioning like a toilet.
A closed system uses a larger tube that the therapist inserts and manages. The practitioner stays in the room for the entire session, controlling both the water pressure going in and the release of waste coming out. Because the waste travels back through the tube into a sealed disposal line, there tends to be less odor and noise. Some people prefer having a therapist guide the process; others find the open system more comfortable because they’re in control.
High Colonic vs. Enema
The key difference is reach. A standard enema uses a relatively small volume of fluid, typically under 500 milliliters, and cleans only the rectum and lower colon. Large-volume enemas use 500 to 1,000 milliliters and push higher, but a colonic goes further still, cycling many liters of water through the entire large intestine over multiple fills. Enemas are also self-administered at home, take just a few minutes, and are routinely prescribed by doctors before certain procedures. A high colonic requires specialized equipment and a trained operator, lasts considerably longer, and is not something you’d do at home.
What Practitioners Claim
Proponents of high colonics say the procedure removes built-up toxins from the colon wall, boosts immune function, increases energy, improves skin clarity, and supports weight loss. These claims are widely promoted by celebrities and social media influencers. However, no rigorous clinical evidence supports any of these benefits. Your colon already has its own efficient waste-removal system: the lining sheds and replaces itself regularly, and beneficial bacteria break down remaining material. The concept of “toxin buildup” in a healthy colon is not recognized in mainstream gastroenterology.
Known Risks and Side Effects
High colonics carry several real medical risks. The most serious is bowel perforation, where the tube or water pressure tears the intestinal wall. This is a surgical emergency. Gastroenterologists at Keck Medicine of USC have reported seeing serious complications from colonics, noting that the procedure is often performed by non-medical personnel.
Flushing large volumes of water through the colon also strips out electrolytes, the minerals your body needs for normal heart, muscle, and nerve function. Potassium and calcium are especially vulnerable. Studies on high-volume bowel cleansing show that low potassium levels occur in roughly 5 to 17 percent of cases, and low calcium in 8 to 16 percent, depending on the method used. For people with heart disease or kidney problems, these shifts can be dangerous.
Other risks include dehydration, infection from improperly sanitized equipment, cramping, nausea, and disruption of the gut’s natural bacterial balance. Repeated sessions may make the colon less responsive to normal signals, potentially worsening constipation over time rather than helping it.
Who Should Avoid Colonics
Certain conditions make high colonics especially risky. The procedure is contraindicated for people with:
- Inflammatory bowel disease (Crohn’s disease or ulcerative colitis in an active flare)
- Acute diverticulitis
- Recent abdominal or bowel surgery
- Severe heart disease, liver cirrhosis, or kidney failure
- Pregnancy
- Active hemorrhoids or anal fissures (which can make tube insertion painful or impossible)
Regulation and Oversight
The FDA classifies colonic irrigation systems as Class 2 medical devices under gastroenterology and urology. That means the machines themselves are regulated, but the people operating them often are not. In many states, no specific license is required to perform colonics. Washington State’s court of appeals ruled in 2008 that colonic irrigation qualifies as a medical practice, placing it within the scope of physicians and naturopathic doctors. The state’s Department of Health has recommended that non-physician operators work under the supervision of a licensed healthcare professional, with proper training, appropriate equipment, and patient safety protocols in place. But this level of oversight is not universal, and standards vary significantly from state to state.
If you’re considering a colonic, verifying the operator’s training, the facility’s sanitation practices, and the type of equipment used are the most practical steps you can take to reduce risk. No major medical organization currently recommends high colonics for general health or detoxification purposes.