Transcript Is there any evidence support effectiveness of coffee enema?

Is there any evidence support
effectiveness of coffee enema?
Truth and Myth
Pisaln Mairiang MD.
Searching strategy
• Pubmed (no limit)
Keywords: Coffee enema,
Colonic hydrotherapy
Colonic irrigation
Searching: coffee enema
Historical aspects of enema therapy
• An ancient theory of autointoxication by
intestinal waste products.
• Had been practicing among ancient
Chinese, Hindu, Egyptian medicine
NJ Taffinder et al Colorectal disease 2004;6:258-60
Indications
asthma,allergies, arthritis,
back pain, headache,
insomnia, hyperlipidemia,
bad breath, hypertension,
mental disorders,
alcoholism, ulcerative
colitis, cancers and liver
insufficiency.
Gerson’s hypothesis
Alteration of
Immune system
intoxication
headache, insomnia,
bad breath, mental disorders,
cancers and liver insufficiency.
Bile flow
asthma
allergies
arthritis
Bile salt enterohepatic recirculation
Gerson’s hypothesis
Repair of Immune
system
detoxication
headache, insomnia,
bad breath, mental disorders,
cancers and liver insufficiency.
Bile flow
asthma
allergies
arthritis
Scientific background of coffee enema
• Anaerobic  decreased energy production andNO
promote cancer
• Coffee stimulate bile formation and flow
NO
• Colestol compounds present in coffee act as
NO
detoxicants by stimulate liver GST
• Cancer cells can be killed by inflammatory
reaction
Yes/No
Coffee enema and cancer
tumor
No.
response
Clinical course
melanoma
9
n/a
Within natural history
Prostate
metastasis
2
1
n/a
cr
Within natural history
Elevation of AP return to normal
Breast
2
n/a
Residue mass post biopsy
Low grade
lymphoma
3
1cr
2n/a
2 with convention treatment
1 regressed
endometrium
3
1cr
1n/a
1pd
1 ca in situ
1 hysterectomy
Ca cervix
1
n/a
1a with conization
astrocytoma
1
pd
Slow progresive disease
gastrinoma
1
pd
Liver met and slow progressive
pancreas
2
2n/a
No tissue prove
Hard palate
1
sd
Positive biopsy
bladder
1
1cr
Excision chemo and cystectomy
Leed A, et al. Lancet 1990;15:677-2
Safety and
complications
Complications of coffee enema
• Sporadic cases of deaths related to coffee enemas :
• Pulmonary enema and septicemia in 46-year-old woman diagnosed as
colitis
• 37-year-old woman with carcinoma of the breast developed
hyponathemia, hyperkalemia and abdominal pain with dyspnea
John W. Eisele, Donald T. Reay. JAMA 1980;244(14):1608-9.
• Perineal gangrene and rectal perforation
Tan MP et al Ann Acad Singapore 1999;28:583-5
• Potassium depletion by enemas
Dumning MF, Plum F. Am J Med 1956;789-92.
• Water intoxication
Ziskind A, Gelis SS. J Dis Child 1958;699-04.
• Polymicrobial enteric septicemia from coffee enemas
Margolin KA, Green MR. West J Med 1984;140(3):460
• Report cases of colonic injury (Burn) from Thai endoscopists
Summary on colonic hydrotherapy
• Colonic hydrotherapy is effective in
treatment constipation and hepatic
encephalopathy
• There is no scientific evidence of its
effectiveness
• To answer for effectiveness of coffee enema
need controlled trail study. possible or
impossible