Colon Hydrotherapy

R.I.C.T.A.T
Foundation Manual

R.I.C.T.A.T.

24b Lancaster Lane

Clayton le Woods
Leyland, Lancashire
PR25 5SN, UK
www.colonic-association.net
email – [email protected]

© 2017 R.I.C.T.A.T. Ltd

RICTAT Ltd would like to thank

Galina Imrie
Cartoon illustrations: Roy Nixon, Frezia Zarrat

Anatomical Drawings: Maurice Imrie, Frezia Zaraat

All rights reserved

The moral right of the author has been asserted

With the exception of short quotations, used within their express or implied context, for the
purposes of review, education or health promotion, no part of this publication may be reproduced,
taken out of context, published, photocopied, recorded or stored electronically without the author’s
permission that won’t be unreasonably withheld.

The content of this manual is based upon the sources that the author believes to be reliable. It is
current as of August 2018
 Contents

Preface………………………………………………………………………………………….5

Objective of the Manual……………………………………………………….………………7

Introduction……………………………………………………………………………………..8

What is Colon Hydrotherapy.........................................................................................10

History and Present Day Colon Hydrotherapy………………………………………….....13

Review of Functional Anatomy and Physiology…………………………………….……..20

Glossary of Terms……………………………………………………………………………44

The Digestive System – A brief overview………………………………………………….48

The Small Intestine………………………………………………………………………..…68

Digestion, Absorption and Excretion in the Large Intestine……………………………...73

Four Layers of the Gut Wall…………………………………………………………………79

Absorption in the Small Intestine…………………………………………………………...81

The Pancreas: form, functions and secretions…………………………………………….84

Digestive Enzymes……………………………………………………………………...……86

The Liver and Gallbladder………………………………………………………………...…89

Hepatic Portal System…………………………………………………………………….....96

The Nervous System in the Large Intestine……………………………………………...100

The Functions of the Large Intestine…………………………………………………..….105

Absorption and Transport of Nutrients: Overview…………………………………….…108

Intestinal Flora…………………………………………………………………………….…110

Diseases of the colon and conditions affecting the digestive processes……………..116

What are Faeces?......................................................................................................130

Laxatives……………………………………………………………………………………..140

Prescription Medications…………………………………………………………………...143

Effects of Colon Hydrotherapy on Bowel Function………………………………….…..147

 Contraindications to Colon Hydrotherapy………………………………………………..163

Colonic Systems and Equipment…………………………………………………….……167

Generic Operating Procedures………………………………………….…………………169

Blood Pressure……………………………………………………………………………...173

Professional Conducts – Rules, Boundaries and Limitations……………………..……175

Client Confidential Questionnaire and Observation Form……………………………...178

Icebreaker and Interview…………………………………………………..……………….183

Treatment Procedure Guidance………………………………………………………..….184

Client and Therapist Interaction during the treatment…………………………………..186

Abdominal Massage……………………………………………………………………..…189

Post Treatment Advice………………………………………………………………….….192

Frequently Asked Questions by Clients……………………………..……………………196

Starting your own Colon Hydrotherapy Business…………………………………….….206

Appendix 1 – Colon Hydrotherapy and Other Holistic Modalities…………………..….209

Appendix 2 – Diet and Nutrition……………………………………………………………213

Appendix 3 – Physical Exercise for Digestive Conditioning……………………………218

Appendix 4 – Speculum Insertion Techniques………………………………………..…224

Appendix 5 – Nervous and Endocrine Systems (Further Reading)………………..….231

Appendix 6 – Emergency Medical Situations…………………………………………….240

Appendix 7 – Suggested Reading List……………………………………………………253

Appendix 8 – Student Study Log, Case Study Template and Guidance………...……256

Appendix 9 – RICTAT Foundation Exam………………………………………………...263

Preface
Our knowledge of the normal and abnormal physiology of the colon and its pathology and
management has not kept pace with that of many organ systems of the body. As long as we continue
to assume “The colon will take care of itself” just that long will we remain in the complete
ignorance of perhaps the most important source of ill health in the whole body?
Dr Wiltsie
The purpose of this manual is to introduce students to colon hydrotherapy as a modern holistic
complementary medicine modality.

Colon hydrotherapy has come for the forefront of alternative, complementary and integrative
medicine in the past ten years. This is due, on the one hand, to our increasingly “toxic” and stressful
lifestyle, and on the other hand to the renaissance of simple but effective, time tested, nature,
nutrition and intuition-driven treatments.

It is a truly exciting time to become a colon hydrotherapist. Colon hydrotherapy or colonic

irrigation, as it is known to the general public, is gaining prominence as a treatment in its own right,
not only in naturopathic clinics, but also in beauty spas that realise the enormous potential of
holistic approaches to beauty, rejuvenation and longevity.

Intensive colon cleansing with the help of colonic irrigation has also become part of treatment
protocols in major holistic medical establishments where naturopathically minded or integrative
physicians treat acute degenerative conditions including cancers, MS and others.

There are fewer and fewer ‘taboo’ subjects in the modern world: we as a human race realise that the
reason for taboos is our internal insecurities and our fear of the unknown.

‘What we eliminate’ has been for a long time such a taboo subject, it was considered to be dirty, not
spiritual and not worthy of our attention. This is not the case anymore. More importantly, medical
science is discovering more and more how much our eliminations reflect the general condition of all
bodily systems.

Colon hydrotherapy is a health promotion tool

In this context, colonic irrigation is becoming a health promotion tool, something that can raise
one’s awareness about the importance of the body’s eliminative function in a very short period of
time, sometimes in the space of one colonic session. Colon Hydrotherapy is an extremely effective
method of health maintenance.

One of the aims of this workbook is to de-mystify this tool, to make it clear, understandable and to
make it available to as many practitioners and clients as possible. As a qualified Colon
Hydrotherapist you are in a unique position to provide health promotion by your knowledge and
example, along with de-mystifying the anatomy and physiology of the human body, and its ability
to maintain homeostasis and balance and consequently optimum health.
Objective of the Manual
This manual is designed to introduce colon hydrotherapy to those willing to practice it as a
complementary health modality. It presents a foundation course suitable both for those
who have decided to change the course of their life and become a colon hydrotherapist, as
well as for those who are already practicing therapists and who want to add colon
hydrotherapy to their toolkit.

This manual is not intended to diagnose or treat any medical condition and is not substitute for
medical advice.
INTRODUCTION

Student eligibility criteria

We recognise that people come to learn colon hydrotherapy from different backgrounds:

Some are already practicing therapists or medical doctors and nurses who have
discovered that the bowel holds the key to a lot of their clients’ problems and have decided
to look deeper into it. This is usually the path that doctors, physiotherapists, nurses, care
workers, naturopaths, nutritionists, massage therapists, hypnotherapists, and reflexologists
take. Colon hydrotherapy will be a valuable addition to your practice and will enable you to
meet your clients’ needs more completely. You will combine colonics with your existing
strengths and create an outstanding practice.

Sometimes people come to practicing colonics through their own life-changing

experiences. This could be the case when someone suffered from a longstanding
degenerative disease and decided to try colonics as a last resort. That person could have
come across an outstanding therapist who changed his/her life by both physically helping
them to recover from the disease and by strengthening their mental state, challenging
them, involving their whole body into survival. It’s not infrequent that people like this
change their lives and start helping others. We hope that this manual will become their first
step on a long and rewarding path of structured learning not only about colon
hydrotherapy, but also about the human body.

Some people engage on a personal development path due to the benefits they have
personally received or observed through colon hydrotherapy we hope that this manual will
deepen your knowledge and intensify your desire to make a difference to the world, by
making a difference to people one-by-one, through training to become a colon
hydrotherapist.

Your employer might have sent you on a colon hydrotherapy course in your spa or your
beauty practice: one day your boss asked you whether you wouldn’t mind learning colon
hydrotherapy. You might not even know too much about it now, but there must be a reason
why you were selected, and there must be a reason why you didn’t say no. So keep your
mind open and engage your previous knowledge, engage your skills; engage your desire
to enhance the business.

Various categories of students can become colon hydrotherapists. The foundation syllabus
places considerable emphasis on the anatomy and physiology of the human body in
relation to colon hydrotherapy, and carrying out colonic treatments.
Practice is everything
This manual is primarily designed to be taught, as the base of a foundation colon
hydrotherapy course. However it can also be used as a standalone guide to learning or a
reference book for a colon hydrotherapy practitioner.

We have endeavoured to make the style of this manual as interactive as possible. This is
why, after you learn virtually every piece of information, you will be encouraged to answer
some challenging questions or even ask some challenging questions. We encourage you
to engage in all the intellectual and emotional activities suggested in the manual. Do the
exercises, get involved in drawing, or work with other members of your group in
completing team exercises, if appropriate.

However, the main practical thing is to perform a number of treatments during your course.
You must be involved in a minimum of 25 treatments, and this is an absolute must for
becoming a successful beginner. Although the theory is very important (you cannot
become a successful therapist without knowing all the theory behind the practice), it’s only
the practice that, as the saying goes, ‘makes perfect’:

• It’s only the practice that brings you into contact with people;
• It’s only the practice that enables you to develop your own style;
• It’s only the practice that is an ultimate test of what you have learnt
and what you have experienced.

Practice is everything. Take part in treatments, keep a journal of what you felt you’ve
succeeded in and what you felt was your weakest link. Come back on your steps; don’t
hesitate to ask the questions. There is no such a thing as a stupid question. Those who
ask questions learn faster. Make sure that you get the full benefit of the hours that you are
going to spend with your lecturers and trainers on the course.

Develop good habits from the start

Make sure that you develop good habits from the start. Remember how you learnt to drive
and what your driving teacher told you: Don’t cut corners. Look to the front, look to the
right, look to the left. And then again to the right, then only move. If you do this again, and
again, and again, it becomes a habit. And it is only when it becomes a habit that you
become a good driver.

Colon hydrotherapy is very similar to driving in this respect. It’s not only a bodywork
treatment but it is also an emotional release treatment. It’s a treatment that engages your
physical, emotional and intellectual skills. You must remember that you are dealing with a
human being as a whole, and not only with the anatomical part to which the pipe is
attached!

Develop the habits of working with the equipment, observing the rules of hygiene, the rules
of confidentiality, the boundaries of your knowledge and internationally acknowledged
good practices. The more you practice, the more good habits become a second nature,
and the more success you will have as a practitioner. Don’t cut corners at the start, and
you will reap rewards very soon.
What is colon hydrotherapy?
You might try to answer this question in several different ways and realise that no one
answer can cover the whole scope of what colon hydrotherapy can achieve.

For example, you can say that colon hydrotherapy is about introducing large amounts of
water into the anus, and removing wastes from the large intestine with the intention of
cleansing it. You will be absolutely correct: this is indeed the definition of the procedure of
colon hydrotherapy.

If you say that, just as an individual experience of a massage reflects how well people look
after their muscles and posture, an individual experience of colon hydrotherapy reflects
how well people look after their digestive system, you will also be right, because you will
answer the question on how colon hydrotherapy can play a part in people’s health
awareness.

If you say colon hydrotherapy is one of the ways of cleansing the person from the inside,
and helping the person to remove toxins from the body, you will also be right, because you
will identify one of the reasons why colon hydrotherapy is so popular.
You can even go further and say that colon hydrotherapy is about health promotion:
helping people to lose weight, engage in more exercise, start looking after themselves,
eating healthier, managing stress and so on. Here you will describe the mission of colon
hydrotherapy, which is to help people reconnect with their bodies and achieve better
health.

What makes a good colon hydrotherapist?

What kind of person do you need to be able to help people in this powerful way?

First of all you need to be a person of integrity. There is more to colon hydrotherapy
therapy than ‘just a job’, although it can become a very well paid occupation. You should
want to get up in the morning and go into your practice, open the door, pull up the blinds,
switch the computer on and look at the phone, and know that there are messages from
people whom you have already helped or new people who have been referred to you by
the people you have helped.

How do you get that far?

You study, you read, you practice, you are critical towards yourself, you look for new
information, and you ask the right questions. Also, you walk your talk.

You always listen to what people have to say. You help people to let go of their insecurities,
of their fears, of their inhibitions, of their destructive behaviour, just by being there and
helping them to cleanse. Remember, as a colonic therapist you are with your clients in a
crucial and intimate moment of their lives, when they have entrusted their bodies to you as
someone who can help them to get healthier and stronger.

You have to respect clients’ confidentiality. Any information that they entrust to you has to
stay between you and your client. Confidentiality is of utmost importance. You can only
divulge personal information if this is a legal requirement: there are no other excuses. Do
not talk to your friends or colleagues about what the client told you, unless you need to ask
for advice. One mistake, one temptation can cost you hundreds of lost clients.
Your practice must be clean at all times. People coming to you must be confident that you
will look after their health. There is nothing worse than an untidy therapy room. Remember,
“People mistrust the doctor whose house plants have died”. Make sure that between
treatments you freshen up the room and sterilise every single surface that the client’s body
fluids may have touched.

Whatever colonic system you choose to use, you MUST use disposable equipment: the
speculum, the inlet and outlet pipe, the Inco-pad that you put under the client, the sheets,
the paper, the underpants and the robe. Nothing that you use on a client and that is
exposed to the clients’ body fluids should ever be reused on anyone else.

If you adopt this practice and budget the cost of disposables into the price of the treatment,
it will become your strongest selling point, even before the people know you and know how
much else you can contribute to their wellbeing. They will be safe in coming to you.

During any treatment it is extremely important to remember that you only have one mouth
and two ears. Use them in proportion. When people let go of their fears, when people let
go of the things that are holding them back, they also let go of the waste in their bowels. If
you listen and don’t prejudge, if you help people to release their hidden emotions, they will
come to you again and again and again. A lot of people come to therapists to talk,
remember this and give them an opportunity.

Respect your boundaries

If you have chosen to learn colon hydrotherapy from a medical background, then no doubt
you already understand and know a lot about human anatomy, physiology and function.

This knowledge will be a great foundation for you. It means that you can not only perform
the treatment but also be able to point your client in the direction of specific changes.
However, remember that you do this as a doctor or nurse, on the basis of your existing
qualifications and your interaction with the client, and not as a colon hydrotherapy
practitioner.

The same applies to naturopaths and nutritionists, as well as sports or massage

therapists: any recommendations you give must be rooted in your existing insured
qualifications rather than in the training you receive as a foundation level colon
hydrotherapist.

If you have come to colon hydrotherapy as a layperson and you don’t have any
qualifications that enable you to understand deeper certain aspects of human health and
disease, work within your knowledge base and re-direct clients to the appropriate health
care practitioners, or seek guidance from a medical Doctor.

The training that you will receive during your course will enable you to become a colon
hydrotherapist. You will learn the basics of anatomy and physiology, and acquire
knowledge of how to administer a colon hydrotherapy treatment.

Please do remember: as a colon hydrotherapist, you

don’t diagnose and you don’t prescribe.
.
Managing clients’ expectations
Clients come to colon hydrotherapy practitioners with high expectations. These
expectations may be based on successful colon hydrotherapy treatments that that their
friends have had, or a story they read in the press, or a book they came across that
praised colon hydrotherapy and made some (frequently unsubstantiated) health claims.

It is your duty as a practitioner to manage this expectation tactfully. No one knows

everything that there is to know. When you just start practicing any complementary
modality, whether it is colon hydrotherapy, massage, reflexology or anything else, make
sure that you only assert what you know. You need to take responsibility for what you say.
If you don’t know something, don’t guess admit you don’t know, but if possible you will
endeavour to find out.

Don’t make any claims that you can’t back up one hundred per cent, and even then,
think twice!
HISTORY OF COLON HYDROTHERAPY AND PRESENT DAY
This section is based on the following sources:
“Always Look After Number Two” – A Guide to Better Health through Colonic Irrigation and
Bowel Care, by Galina Imrie March 2006 ISBN 0955246202
I-ACT Colon Hydrotherapy Manual First Edition June 2005;
Colonic Irrigations: A Review Of The Historical Controversy and the Potential For Adverse
Effects: Douglas G. Richards, Ph.D. Meridian Institute (Paper presented at the 9 th Annual
Cayce Health Professionals Symposium, September 2004)
Various manufacturer instructions

History of Colon Hydrotherapy

Colon hydrotherapy is not a new procedure. Enemas and rituals involving the washing of
the colon with water have been used since pagan times. The first record mentioning colon
cleansing is an Egyptian medical papyrus dated as early as 1500 B.C., which shows that
the Egyptians employed purgatives, enemas, diuretics, heat, steam and blood-letting to
treat diverse diseases.
Ancient and modern tribes in the Amazon, Central Africa and remote parts of Asia have
used river water for bowel cleansing, usually as part of magic-medical rites of passage
performed by priests or shamans. Colon cleansing therapies was an important part of
Taoist training regimens. These therapies still form one of the fundamental practices of the
yoga teaching.

Hippocrates, Galen and Paracelsus, who are recognized as the founding fathers of
Western medicine, described, practised and prescribed the use of enemas for colon
cleansing.

Both in Europe and in the USA, the popularity of colon cleansing treatments was remarkable in the
early decades of the twentieth century, when colon irrigation equipment was commonly used by
doctors practising in sanatoria (health spas) and hospitals. From the 1920s to the 1960s, the regular
use of enemas was standard practice among most medical practitioners and they were implemented
as common treatment in most hospitals.

With the rapid advancement of pharmaceutical approaches to treating various conditions,

natural forms of healing, including colon cleansing, had suffered a temporary setback.
However, the pharmaceuticals have failed to deliver a neatly packaged ‘pop and go’
solution to annoying and tiring digestive complaints, such as malabsorption caused by
underlying stress, constipation, bloating, recurrent yeast infections, dysbiosis, intestinal
discomfort etc.

So, having travelled the full circle, we are back to natural healing. Now, having moved to
the fringes of mainstream medical practice, colon hydrotherapy is fast becoming, yet
again, one of the most popular holistic treatments.

How colonics are different from an enema?

Enemas have been used through history for the relief of constipation, gasses and intestinal
discomfort. They are different from colonics, though, in that:

Enemas are self-administered;

The purpose of enemas is to clear out the lower part of the large intestine;
One has to hold water for a long time, then go and sit on the toilet
One needs to repeat the enema a few times to achieve the desired effect.

Colonics:
Are administered by a person with professional training;
Their purpose is to clear out the entire colon;
There is no need to hold or be uncomfortable;
It is a 45-minute procedure that uses a type of device to control the water flow.

Holistic approach to colon hydrotherapy - overview

Colon hydrotherapy is a fast developing complementary health practice. Reportedly, at
least six million colon therapy procedures have been performed in the USA, It is estimated
in the UK, at least 5,000 to 10,000 colon hydrotherapy procedures are performed monthly.
There are at least 450 trained colon hydrotherapy professionals in the UK.

Many clients perceive colon hydrotherapy, as a bodywork therapy alongside massages,

reflexology, body wraps, or as a detox and health maintenance treatment. It is also being
recognised as a detoxing and cleansing therapy, which promotes rejuvenation resulting in
a more youthful appearance of the skin, which was traditionally associated with beauty
treatments and products. Clients are releasing that inner cleansing is the essence of
optimum health.

Two approaches to colon hydrotherapy practice

In today’s unhealthy and stressful world very few people doubt the benefits that can be
brought by complementary health approaches, such as nutritional medicine, naturopathy,
bodywork and spiritual and emotional healing.

In many countries, such as Germany, the medical establishment relies more and more on
complementary healing. In many instances, doctors even recommend complementary
medicine that mobilises the body’s natural healing mechanisms and defences as the
preferred approach, rather than using medicinal drugs and procedures.

In this context it is important to understand what part colon hydrotherapy plays in the
complementary medical field and what role we as colon hydrotherapy professionals can
and should play in helping the individuals to reach their optimum health.

There are two distinct approaches in different countries to the study and practice of colon
hydrotherapy.

United States
In the United States, where colon hydrotherapy is a technically procedure that must be
prescribed by a medical professional, colon hydrotherapists are trained as technicians,
who assist the client during the procedure and should rely in their pre-care or aftercare on
the recommendations of the client’s physician. The exception to this is Florida where colon
hydrotherapy is part of the wider massage practice and colon hydrotherapists are
regulated by the same rules as massage therapists.

Eastern Europe
In Eastern Europe, colon hydrotherapy used to be part of the mainstream medical practice.
The name of colon hydrotherapy in Eastern Europe is “subaqual washout”. Subaqual
washouts were traditionally used in sanatoria and health spas using mineralised water,
mainly in instances prescribed by physicians for liver, bowel, and kidney or blood
detoxification protocols.

One would normally receive a series of those procedures in a short amount of time and
blood, urine and stool tests would be performed on a regular basis to observe the
development in the functioning of the visceral internal organs.

Colon hydrotherapy would be combined with medical massages, alpine walks and drinking large
amounts of mineral water as well as eating prescribed foods. These were very effective
interventions and many people in Eastern Europe used to undergo these cleanses annually, or even
twice a year at the change of seasons in Spring and Autumn so as to prepare the body for Winter or
Summer.

Emotional issues of the individual were not specifically addressed in the course of the
treatments, and were assumed to benefit from the general boost that the body received.

United Kingdom
In the United Kingdom colon hydrotherapy has been taught in the herbalist and
naturopathic tradition with the emphasis being put on the use of herbs, coffee enemas and
pro-biotic implants (rather than the water itself) to increase the effect of the cleansing.
Again emotional issues were not at the forefront of training to become a colon
hydrotherapy practitioner. However due to the work of individuals like Louise Hay and
others who promote the notion that physical illness and disease has its roots in emotional
trauma, has resulted in a change of attitude of many complimentary therapists.

Holistic influence
However with the development of the holistic approach to complementary healthcare,
colon hydrotherapy has acquired a larger meaning.

Something that was originally designed to hydrate the large intestine is now being
perceived by the paying public as the treatment (rather than a clinical procedure) that may
bring a much wider variety of collateral benefits that in theory were hard to explain by the
narrow approach to colon hydrotherapy which limited its value to the large intestine.

These are the advantages people often cite when asked why they choose to use colon
hydrotherapy:

To cleanse the body

Higher levels of energy
Relieve Constipation
Help with IBS
Reduction of gas and bloating
Food intolerances such as Gluten
Improvement in various skin conditions
Relief upper gastric problems
Recolonizing the gut. Candida Albicans
Reduction in stress levels
Eradicating parasite infestation
Weight issues
Pain relief arthritic pain and headaches

It is possible that clients may also experience though colon hydrotherapy

Better quality sleep

Better ability to cope with stress
A greater awareness of the anatomy of the digestive system
Opportunity to discuss emotional issues
A much higher degree of “connectedness” and understanding how the body works.
Is colon hydrotherapy a procedure or a therapy?

Terminology
A difference between a procedure and a therapy can be described as follows.
A procedure is a series of actions conducted in a certain order with a predictable outcome.
A technician performs a procedure.

Colonic irrigation using approved equipment along with disposable speculums and tubing,
is a procedure of introducing purified filtered water into the anus and removing the wastes.
The predictable outcome of this procedure is increased hydration in the colon and relief of
stagnation in the large intestine.

Unlike a procedure a therapy, which involves overall healing as its main outcome, with
sometimes-unpredictable consequences. Therefore performing a Colon Hydrotherapy
treatment is both a therapy and within a structured procedure.

Healing can be defined as restoration of wellbeing. Therapy can be defined as a healing or

curative system of procedures that provide a structure for beneficial change in the client
and support for achieving and maintaining an optimum state of health.

If we accept this definition and we also agree that colon hydrotherapy is a client-led
treatment, then we will realise that this is what the public requires from us.

Three Main Aims of Colon Hydrotherapy

The Client requires three main things:

A procedure that ensures rehydration and removal of stagnation in the large intestine;
Education about how to maintain the higher state of health that has been achieved after
the procedure;
Restoration of physical, mental and emotional wellbeing.

Need for good education

Colon hydrotherapy has just recently acquired wide recognition and is still fighting for an
appropriate public image. The better the therapists are trained and the wider range of
therapies they are aware of, the higher will be the public respect of colon hydrotherapy and
the more satisfied clients will be spreading the word.

At the moment colon hydrotherapy is taught by a very few institutions. Some of them have
achieved a high standard of training, where as some lure future colon hydrotherapy
technicians with the promises of a quick path to high earnings and a fast track to riches.

It is envisaged that the professionalism of Colon Hydrotherapy will be achieved through

high standard standards of training with recognition of National Occupation (NOS) and
collaboration of Government agencies GRCCT regulatory body ensuring that the credibility
of the Colon Hydrotherapy continues to gain momentum in both the public domain and
Government approval.

On the successful completion of your training it is expected that you will join RICTAT or
another approved Colon Hydrotherapy Association. This will differentiate between
therapists who have received a high standard of training as opposed to inferior training
programs who produce technicians and not competent therapists.
Text and exercises in this section are based on the following sources:
• William Arnold-Taylor: A Textbook of Anatomy and Physiology Third
Edition ISBN 0748736344
• The ABC of Common Disorders Affecting Bowel Movements: A reference
guide and workbook for colon hydrotherapy students and practitioners, Wellbeing Now,
Fotherby Press 2006
• Human Body. An Illustrated Guide to Every Part of the Human Body and
How it Works ISBN 978 0 751335149
• Anatomy Colouring Workbook I. Edward Alcamo, Ph.D ISBN 0-375-76342-
2
• The Second Brain; Michael D. Gershon, MD ISBN 0060182520
• First Principles of Gastroenterology: The Basis of Disease & an Approach to
Management: Thomson, A B R & E A Shaffer www.digitalbookindex.org
• I-ACT Colon Hydrotherapy Manual, 1st Edition
• I-ACT Study Guides (Tiller Mind-Body Institute)
• Information contained in this workbook
• Colorado State University Anatomy Online
• University of Hong Kong Anatomy and Physiology Online
• Encyclopaedia Britannica 16th Edition
• Wellsprings training manual
Review of Functional Anatomy and Physiology
The text books recommended by RICTAT for this Section are:

For review: William Arnold-Taylor: A Textbook of Anatomy and Physiology Third Edition
ISBN 0748736344

For beginners:
• Tina Parsons: An Holistic Guide to Anatomy and Physiology
• Helen McGuinness: Anatomy and Physiology. Therapy Basics.
• Ross and Wilson Anatomy and Physiology in Health and Illness

Colon hydrotherapy is a form of bodywork. You need to realize, especially at the start of your
practice that colon hydrotherapy as interaction between you, as a therapist, and your clients happens
at the level of engaging the client’s whole body, and often mind, soul and emotions, into the process
of holistic colon cleansing.

That is why the more you know and understand the human body, the better you will be able to
perform the treatment and help the client relax and cleanse, as well as inspire the client to work
towards better physical, emotional and mental health.

Anatomy
Anatomy means in Greek “cutting up the body”. It is a science that researches body parts.
Functional anatomy focuses on relationships between body parts, which result in a
function.

Physiology
Physiology is the word that derives from two Greek words, meaning “nature” and “wording”
or “logic”. Broadly speaking, human physiology looks at the nature of processes happening
in the body, researches connections between them and describes them in words.

Body systems in relation to their function

Body systems consist of several organs of the body working together in order to perform a
specific function that supports life. No system can exist in isolation.
In a healthy body, all systems work in unison to maintain homeostasis.

Homeostasis is the constant or almost constant internal environment in the human body,
such as temperature, composition of fluids and positive-negative charges that enable life.

If one system gets severely damaged, such as respiratory system, we will die in a matter
of minutes, even with all other systems trying to compensate for the loss of oxygen. That is
just one example showing that no system can exist in isolation from others.
Knowledge Review and Research
• Body temperature
•
• What is normal body temperature?

• What does a high temperature suggest?

• What is known as ‘rigors’?

• What is a febrile convulsion?

• Blood pressure (BP)

•
• Identify symptoms of a raised BP?

• What is the medical term for a raised BP?

• What is the medical term for a low BP?

 • Liquid contents of blood
•
• What are the constituent parts of blood?

• Oxygen contents in tissues

•
• If there was insufficient oxygen in the body the person lips and
finger nails would be what colour?
Brief systems overview
There are 12 separate systems in the body. Please name an organ associated with each
of the systems listed below:

• Cells and Tissues

• Skin, Hair and Nails
• Skeletal System
• Muscular System
• Cardiovascular System
• Lymphatic System
• Respiratory System
• Nervous System
• Endocrine System
• Reproductive System
• Urinary System
• Digestive System
The integumentary system and the accessory organs (eyes, ears and
breasts)
The human integumentary system consisting of skin, the hair, nails and a variety of glands,
serves the following main functions in the human body:

Serving as a barrier against infection and injury;

Protecting against ultra-violet radiation;
Helping to regulate body temperature;
Removing waste products from the body;
Providing protection against ultraviolet radiation from the sun;
Producing vitamin D;
‘Advising’ the nervous system, through the skin’s sensory receptors, of sensations such as
pressure, heat, cold, and pain.
Knowledge Review and Research

• List four factors which are harmful to the skin?

• Why is it important to that skin is exposed to sunlight?

• How does a bad diet affect the condition of skin, hair and nails?
The Skeletal System
The human skeletal system consists of 206 bones and cartilage. Some of its most
important roles are:

• Providing a structural support for the body;

• Supporting the body against the pull of gravity;
• Protecting the sensitive organs, for example the brain, the tongue and
the eyes;
• Enabling movement and action through the lever action of each joint;
• Providing a storage facility for minerals, such as, for example, calcium
and phosphates;
• Generating blood cells;
• Producing cellular constituents for the immune system
• In order for us to move, the skeletal system needs the support of the
muscular system.
Knowledge Review and Research
RESEARCH:

Some clients who come to you will tell you during the consultation that they suffer
from, or are worried about suffering from or developing the following conditions:

• Arthritis, rheumatoid arthritis and osteoarthritis

• Osteoporosis

Do research using the available materials and answer the following questions:

• What is arthritis?

• What are the symptoms of arthritis?

• What is osteoporosis?

• What populations are in danger of developing

osteoporosis?

• What steps can be taken to avoid or reduce the effects of

osteoporosis?
The Muscular System
There are about 640 main muscles in the body that are labelled and named. In addition to
named muscles, there are hundreds of tiny unnamed muscles (for example, those just
under the skin surface that give us goose pimples)

The human muscular system comprises muscles of three types: skeletal muscles, smooth
muscles and the cardiac muscle that account, in total, for about a third of our body weight.
The muscular system plays the following main roles in the human body:

• Skeletal muscles are attached to the bones. They are mostly

controlled by our Central Nervous System and are responsible for our voluntary
(conscious) movements, such as running, swimming, walking, or, on the opposite,
for being still;
• Smooth muscles, that line up our internal organs (the intestines, the
stomach, the pupils of our eyes) and blood vessels are directly related to the
autonomic nervous system. Through their contractions, they help deliver oxygen
and nutrients to all body cells and remove wastes.
• The cardiac muscle is the heart that pushes blood around the body.

The illustration below shows layers of the smooth muscle of the large intestine.
Knowledge Review and Research
RESEARCH:

Some clients who come to you will tell you during the consultation that they suffer
from, or are worried about suffering from or developing the following conditions:

• Fibromyalgia and muscle inflammation

• Muscle cramping
• RSI

Do research using the available materials and answer the following questions:

• What is fibromyalgia?

• What are its symptoms?

• What is muscle cramping and what causes it?

•
•
•
•
•
•
•
•
•
• What is RSI and who might be likely to suffer from it?
The Cardiovascular System
The cardiovascular system is composed of the heart, blood and, blood vessels, lymph and
lymph vessels. Its main role is to:

• Be the main transportation system of the body;

• Supply the body with oxygen and nutrients;
• Carry away waste products and toxins.

It is very important for colon hydrotherapists to understand in more detail the functions of
the lymphatic system and the spleen.

The lymphatic (immune) system is part of the vascular system

The lymphatic system comprises lymph, lymphocytes, the lymph nodes, channels and
ducts, as well as tonsils, the thymus gland, the spleen and the appendix. Its main roles in
the body are:
• Eliminating pathogenic organisms, foreign substances or
toxic material that may be damaging the body;
• Intelligently protecting the body and increasing its
resistance to disease;
• Generating first immune responses, such as sneezing,
coughing, crying, sweating, runny nose etc.
Knowledge Review and Research
RESEARCH

The most frequent blood complaints presented at treatments are anaemia, varicose
veins and atherosclerosis.

• What is anaemia? What are the two main types of anaemia?

• What are its symptoms?

• What steps can be taken to avoid or reduce anaemia?

•
•
•
•
•
• Describe varicose veins.

• What four main factors can cause varicose veins?

• What are its symptoms?

• What is atherosclerosis?

• How can the build-up of cholesterol inside arteries be

reduced?

The Lymphatic (Immune) System

The immune and lymphatic systems are two closely related organ systems that share
several organs and physiological functions. The immune system is our body’s defence
system against infectious pathogenic viruses, bacteria, and fungi as well as parasitic
animals and protists. The immune system works to keep these harmful agents out of the
body and attacks those that manage to enter.

The lymphatic system is a system of capillaries, vessels, nodes and other organs that
transport a fluid called lymph from the tissues as it returns to the bloodstream. The
lymphatic tissue of these organs filters and cleans the lymph of any debris, abnormal cells,
or pathogens. The lymphatic system also transports fatty acids from the intestines to the
circulatory system.
Knowledge Review and Research

• Any disease can be caused or aggravated by a weak lymphatic

system. Describe how the lymphatic system fights disease.

• What health and lifestyle measures can make the lymphatic (immune)
system stronger?

• What is an ‘autoimmune disease’? Give examples.

The Respiratory System
The human respiratory system consists of the upper respiratory tract (the mouth, the nose
and the pharynx) and the lower respiratory tract (the trachea, lungs, and the diaphragm).

The primary function of the respiratory system is to supply the blood with
oxygen in order for the blood to deliver oxygen to all parts of the body. The
respiratory system does this through breathing. When we breathe, we inhale
oxygen and exhale carbon dioxide.

Knowledge Review and Research

RESEARCH

• Why do some people have trouble breathing after a large meal?

 • What prevents the food entering the lungs?

• What is the function of the diaphragm?

• What are the symptoms of Asthma?

• Apart from Asthma list another 4 diseases associated with the

respiratory system?

The Neurological (nervous) System

The nervous system is the body’s information gatherer, storage centre and control system.

Its overall function is to collect information about the external conditions in relation to the
body’s external state, to analyse this information, and to initiate appropriate responses to
ensure that certain needs are met. The most powerful of these needs is survival.

The nervous system plays numerous roles in the human body, the most important of them
being:

• Information gathering. The nervous system collects signals from the

outside world and from inside the body, such as temperature, smell, taste, pain etc.
This is its sensory function;
•
• Information storage. The nervous system stores information about
certain responses (for example, reaction to heat or cold) thus protecting the body
• .
• Information transmission. The nervous system transmits the
information from neuron to neuron, up to the processing centres of the brain and
spinal cord or the relevant internal organs.
•
• Information processing. The nervous system processes the
information that is being delivered to the organs of the body to determine the best
response;
•
• Response to information. The nervous system sends the relevant
signals to the muscles and organs so that they could respond correctly.
Knowledge Review and Research
• What are the two main divisions of the nervous system?

• Some clients will tell you during the consultation that they suffer
from neuralgia and sciatica. You should be familiar with these conditions.

Please do research on the causes of neuralgia and sciatica and their

symptoms.

CAUSES, SYMPTOMS AND EFFECTS ON HEALTH OF NEURALGIA AND

SCIATICA

• What neurological disorder causes excessive electrical brain

activity?
The Endocrine System
The endocrine consists of endocringlands, such as the hypothalamus, the pineal gland,
the pituitary gland, the parathyroid gland, the thyroid gland, thymus and the adrenal glands
that secrete hormones directly into the blood stream or tissues; as well endocrine organs,
such as the kidneys, the pancreas, the hypothalamus, the ovaries and the testes.

Exocrine glands (glands with ducts) such as salivary and sweat glands are also a part of
the endocrine system. It works in, alignment with the nervous system to maintain
homeostasis in the body. Some of its functions include:

• Maintaining electrolyte, water and nutrient balance of the blood.

• Regulating cellular metabolism and energy levels in the body;
• Regulating reproduction, growth and development
• Regulating our mood.

The endocrine system made up of a group of glands that produce the body’s long-
distance messengers, or hormones. Hormones are chemicals that control body
functions, such as metabolism, growth, and sexual development. The glands, which
include the pituitary gland, thyroid glands, parathyroid gland, adrenal glands, thymus
gland, pineal body, pancreas, ovaries, and testes, release hormones directly into the
bloodstream, which transports the hormones to organs and tissues throughout the body.
Knowledge Review and Research

• Clients will come to your clinic who have been prescribed

thyroxine, what is this prescribed for?

• What organ of the endocrine system is responsible for the

production of insulin?

• What are the main differences between a Type 1 and Type 2

Diabetic?
The Reproductive System
• The main role of the reproductive system is in the continuation of the
species;
• In humans, sexual acts are also a source of pleasure and enjoyment.

The reproductive system is most closely linked with the endocrine system.

The Female Reproductive System

The female reproductive system includes the ovaries, fallopian tubes, uterus, vagina, vulva, mammary
glands and breasts. These organs are involved in the production and transportation of gametes and the
production of sex hormones. The female reproductive system also facilitates the fertilization of ova by
sperm and supports the development of offspring during pregnancy and infancy.

The Male Reproductive System

The male reproductive system includes the scrotum, testes, spermatic ducts, sex glands,
and penis. These organs work together to produce sperm, the male gamete, and the other
components of semen. These organs also work together to deliver semen out of the body
and into the vagina where it can fertilize egg cells to produce offspring.
Knowledge Review and Review

• A client may tell you that they are suffering with polycystic ovary
syndrome (PCOS), what symptoms might they display?

• What are the symptoms of menopause?

• What is your understanding of Pre-menstrual Syndrome?

The Urinary System

The urinary system consists of the kidneys, ureters, urinary bladder, and urethra. The
kidneys filter the blood to remove wastes and produce urine. The ureters, urinary bladder,
and urethra together form the urinary tract, which acts as a plumbing system to drain urine
from the kidneys, store it, and then release it during urination. Besides filtering and
eliminating wastes from the body, it plays a number of varied roles in the body, some of
which are:

• Excretion of liquid wastes;

• Maintaining homeostasis of water in the body;
• Contributing to normal blood pressure;
• Maintaining the concentration of electrolytes in the body fluids;
• Regulating blood cell production;
• Controlling blood volume.
Knowledge Review and Review
RESEARCH

• As a colon hydrotherapist, you will hear a lot from your clients,

especially female clients, about cystitis and kidney infections, which are
urinary tract infections and disorders (UTD and UTI). Research the causes
these disorders have and the symptoms associated with each.

Summarize your findings below:

• What gives urine its colour?

• List 3 factors which affect the body’s fluid balance?

Glossary of Terms
This is a short reference list. Every time you are not sure about what a term means, come
back to this list and check your knowledge.

• Absorption – Absorption is the second stage of digestion, after

ingestion. Absorption means that food, already broken down into nutrients, is able
to cross the barrier between the sealed digestive system and the blood stream and
the lymphatic vessels. In order to be absorbed properly, nutrients need to be in a
form that is recognizable to human cells

• Acidophilus (Acid-loving) – “Friendly” bacteria ensuring fermentation

of insoluble fibre in the large intestine. Survives in a slightly acidic environment of
the caecum and the large intestine in general.

• Assimilation – Occurs following absorption, when nutrients enter

human cells and turn into components similar to those that human cells already
possess.

• Autointoxication – A term that is used to describe the re-absorption of gut

toxins back into the blood stream. The term I prefer is leaky gut syndrome.

• Bowel – A term that may mean large or small intestine. In this book it
is used to mean the large intestine. See also ‘Colon’ and ‘Gut’.

• Candida – There are hundreds of forms of Candida, a yeast-like

fungus that is naturally present everywhere on the planet. Candida Albicans, the
best-known version of Candida, is a form of gut dysbiosis (imbalance of gut
bacteria), an excessive fermentation of sugars that can be caused by dietary
imbalances and malnutrition, as well as by low emotional and immune states.

• Colon – Another name for the large intestine or bowel.

• Colon hydrotherapy – Also called colonic irrigation or high colonic,

this is a term used to describe the process of cleansing the large intestine, bowel or
the gut with water, which is introduced into the bowel through the anal opening.

• Colonic irrigation – See Colon hydrotherapy.

• Digestion – The process by which food is dissolved and broken down

so that it can be absorbed by the cells of an organism and used to maintain the vital
bodily functions. It is a general term used to describe the whole process of
digesting, and sometimes also to describe the stage between ingestion and
absorption.

• Digestive system – A system in humans and other animals that

enable digestion to take place. In humans, digestive tract is a long tube, comprising
the mouth, oesophagus, stomach, small intestine, large intestine, rectum and anus.
Digestive system also includes the liver, pancreas, spleen, gall bladder and the
glands of the oral cavity.

• Dysbiosis – An imbalance of microorganisms in the digestive tract.

Virtually every digestive disease has dysbiosis as its underlying cause. Dysbiosis
can cause intolerances, Candida infections, indigestion and bloating, discomfort,
headaches and other digestive health complaints.

• Elimination –The final stage of digestion. It is the clean- up and

removal of wastes and non-nutrients that are incompatible with our living cells and
therefore can’t be assimilated and used by the body.

• Enema –A device used to introduce water through the anal opening

into the rectum and descending colon to clear out the waste from these areas. The
difference between the enema and the colonic is that the enema clears only a small
section of the large intestine, whereas the colon hydrotherapy treatment can clear
most of it.

• Enteric nervous system – Located in the intestines, is the ‘brain’ that

our gut uses to run the whole digestive process.

• Fermentation –Chemical conversion of carbohydrates and fibre into

simpler compounds by the action of enzymes, which are produced by micro-
organisms such as yeasts and bacteria residing in the large intestine (see also Gut
bacteria). Traditionally the term ‘fermentation’ is used, in relation to stools formation,
to denote a bowel-friendly process. See also Putrefaction.

• Gut – A general term, which is used to mean large and small intestine,
or the bowel.

• Gut bacteria – Organisms that live in the large intestine, and to a

lesser extent in the small intestine. Their main functions are to process wastes and
to help the elimination process. Gut bacteria can be divided into several groups.

• Commensals – Commensal (from the Latin for ‘eating at the same

table’) bacteria live in our gut, use it as their home and help some aspects of the
eliminative function of the general health maintenance.

• Pathogenic – Pathogenic bacteria inhibit eliminative function, and

cause dysbiosis.

• Probiotic – Probiotic bacteria actively support the eliminative function.

• Symbiotic – Symbiotic bacteria help some aspects of the eliminative

function. Also see Commensals.
Some bacteria can be commensal, symbiotic or pathogenic depending on our
lifestyle, nutritional choices and the condition of our immune system.

• Gut permeability –A condition characterised by absorption of the

undesirable contents of the intestines into the bloodstream, cause by the weakening
of the bowel wall. When large molecules are absorbed, the body treats them as
toxic, triggering immune reactions including food allergies and intolerances.
Excessive uptake of toxic compounds can overwhelm the livers detoxification
systems as well as lead to an overly sensitive immune system, causing
malabsorption. Also see “Leaky gut”.

• Ingestion – The first stage of taking the food into the body, which
initiates digestion.
 • Intestinal flora – Another term for gut bacteria.

• Large Intestine – The part of the intestine where elimination and

some assimilation take place. Other names for the large intestine are the colon, the
large bowel and the gut.

• Leaky gut syndrome – A combination of symptoms that can include

bloating, indigestion, abdominal pain, constipation, diarrhoea and other digestive
complaints caused by increased gut permeability. This means that the seal between
the bowel and the rest of the body is breached, which enables toxins to penetrate
the gut wall and get reabsorbed into the blood stream. Leaky gut or gut permeability
has a negative effect on all other organs and systems of the body.

• Malabsorption – Occurs when the body is unable to break down food

into nutrients that can be assimilated by cells. It can be caused, among other
factors, by malnutrition, shortage of stomach acid, insufficient activity of digestive
enzymes or the presence of toxins in the body.

• Neurotransmitter – Neurotransmitters and receptors are main

components of the enteric nervous system, the gut’s ‘think tank’. They have a
similar function to the factors that ensure the process of thinking in our brain.

• Parasite – Organisms that live inside the host use the host and
negatively affect the hosts’ function. Humans suffer mostly from single-cell parasites
(micro parasites) and worms. Parasites mainly live in the digestive tract, but
sometimes they can also invade muscles or connective tissue.

• Putrefaction – Decomposition of proteins. In relation to bowel health, this

term is commonly used to denote the decay of protein and fat matter in the gut, which has a
negative impact on health, such as constipation, diarrhoea and bloatedness. See also
Fermentation.

• Serotonin – The neurotransmitter that determines, to a very large

extent, not only our mood, but also the quality of our digestion. It is sometimes
described as the happiness factor. 95% of the serotonin that exists in our body and
brain is produced and stored in the large intestine.

• Small Intestine – A section of the intestines where absorption and

assimilation take place. Small intestine consists of the duodenum, the jejunum, and
the ileum.
The Digestive System – A Brief Overview
The digestive system is essential for maintaining all processes in the body. It is through
digestion that we take in food, break down nutrients, then absorb and assimilate them. The
final part of the digestive system, the large intestine, get rids of indigestible wastes.

Digestive complaints
Unfortunately, most people only start paying attention to their digestive processes when
something goes wrong. It is only too often that we abuse our bodies and push them too far.
When things go wrong, we get worried and try and ‘fix’ things.

That is why a lot of clients come to a colon hydrotherapy session because their digestive
systems do not work properly. The most common digestive complaints are:

• Feeling bloated and uncomfortable after a meal;

• Heaviness and discomfort in the abdominal area;
• Heavy feeling in the chest after a meal;
• Certain foods causing dizzy feeling or light-headedness;
• Gassiness;
• Smelly flatus (gas):
• Constipation;
• Undigested food in the stools;
• Allergies and intolerances;
• Diarrhoea;
• Alternating constipation and diarrhoea;
• Irritable bowel syndrome (IBS);
• Candida and other forms of yeast overgrowth;
• Pain when passing stools;
• Painful bloating without an apparent reason;
• Very dry stools;
• Suspected parasites and so on.

As a therapist, you need to understand how the digestive system works and what can
possibly cause these complaints.

If you are not qualified to give professional advice, you should not. However, you
should be able to tactfully direct your clients to better food and lifestyle choices.
The more you understand about digestion will enable you to support your clients
.
AN OUTLINE OF THE DIGESTIVE SYSTEM
We share our digestive system with the animal kingdom: in fact, there is surprisingly little
difference between human digestive processes and those of a worm.

In humans, the digestive system is a series of hollow organs forming a long, convoluted
tube that starts in the mouth and finishes in the anus.
The organs of the digestive system can be divided into two main groups.

The first group is called the digestive tract, the gastrointestinal tract or the alimentary
canal. In humans, the alimentary canal is a long tube, comprising the mouth, pharynx,
oesophagus, stomach, small intestine, large intestine, rectum and anus. This tube is made
mostly of smooth muscle tissue.

An easy way to remember these organs and their sequence is to use a mnemonic, such
as, for example:

MANY
PET
OWNERS
SEEK
SYMPATHY
LOVE
RELATIONSHIP
AFFECTION

(the first letters stand for: mouth, pharynx, oesophagus, stomach, small intestine, large intestine,
rectum and anus)

MANY PET OWNERS SEEK SYMPATHY, LOVE, RELATIONSHIP, AFFECTION

The length of this ‘long tube’ depends on when and how it is measured. In a dead person, is quite
long – up to 10 meters, when stretched in a line.
However we must remember that muscles of a living person have tone that enables them
to contract and relax, so the living person’s alimentary canal will be much shorter.
The alimentary canal is a sealed system – it does not have any direct contact with other organs in
the body.

It opens to the external environment at the top end, through the mouth, and at the bottom end,
through the anus.

The second group of organs are accessory digestive organs, forming, together with the
alimentary canal, the digestive system. These organs are the teeth, tongue, salivary
glands, liver, gall bladder and the pancreas.

Two Types of Digestion

Digestion involves the mechanical mixing of food and its movement through the digestive
tract, as well as the chemical breakdown of the large molecules of food into smaller
molecules of a different chemical composition.

Peristalsis
The hollow digestive organs are made of smooth muscle that enables their walls to move.
The movement of organ walls can propel food and liquid and also can mix the contents
within each organ.

Typical movement of the oesophagus, stomach, and intestines is called peristalsis. The
action of peristalsis looks like an ocean wave moving through the muscle. The muscle of
the organ produces a contraction (a narrowing) that pumps the narrowed portion slowly
down the length of the organ. These waves of contraction followed by expansion push the
food and fluid through each hollow organ.

Main Stages of Digestion

Digestive begins before we eat!

The alimentary canal is a “complicated tube” that enables the outside world to run through
us, so that we could absorb and assimilate all the elements useful for our sustenance, and
eliminate wastes.

Digestion begins even before we start eating: the thoughts, the smell and the sight of food
engage our nervous system and generate nerve impulses. These impulses stimulate
digestive organs, activating the hollow smooth muscles of the digestive system.

Simultaneously with the engagement of the muscles, nerves impulses help activate the
release into the blood of hormones – chemical messengers that organs use in order to
communicate with one another or influence one another.

Hormones and nerve impulses stimulate the secretion of digestive enzymes.

That is why it is very important not only to eat, but also to enjoy the sight of the food, its
smell, temperature and consistency. If the enjoyment is missing, digestion will be
incomplete!

Before the Stomach

Food gets ingested in the mouth. It spends about 10 to 30 seconds being chewed
(masticated) with the teeth.
The mastication process stimulates the release of saliva containing a digestive enzyme
(ptyalin or salivary amylase: same enzyme, two different names), which begins the
chemical breakdown of carbohydrates.

Saliva also helps condense food into a bolus that can be easily swallowed.

Swallowing means forcing the food bolus into the pharynx (the throat). This process takes
only 2 to 3 seconds.

From the pharynx, the food passed through the oesophagus. The oesophagus is about 18
to 25 cm long. The food is forced towards the stomach by gravity and a rhythmic wave-like
contraction and relaxation movement called peristalsis, which is characteristic of the whole
of the digestive system. It usually takes the food less than a minute to reach the stomach.

The Stomach
The food bolus enters the stomach through the cardiac sphincter. The stomach muscle
thoroughly churns it mixing it with the digestive juices, made up of hydrochloric acid and
other digestive enzymes. The bolus mixed with digestive enzymes in the stomach is called
chyme (pronounced: K-ai-m). Chyme spends two to four hours in the stomach. During this
time it is digested mainly mechanically, but some chemical digestion of proteins and fats
also takes place.

The Small Intestine

The peristaltic movement of the stomach forces the chyme into the small intestine where it
spends from five to six hours. This is where most of the digestive process occurs.

As mentioned earlier, it takes the small intestine around six hours to digest a normal meal.
After this time all the nutrients in the food have been absorbed into the bloodstream
leaving only water and indigestible substances to be passed into the large intestine. At the
connection between the small and large intestine is the ileocaecal (pronounced ILEO—
SEE-KAL) valve, which looks like two liplike folds, which allow liquid chyme to be passed
into the large intestine but stop it from returning.

The Large Intestine

After going through the small intestine, the remaining undigested food, now called wastes,
moves on to the large intestine where it should spend no longer than a day (8 to 20 hours).

The large intestine is about 1.5 m long and it has the following parts: the caecum (the pouch that
forms the T-junction with the small intestine), the ascending colon, the transversal colon, the
descending colon and the sigmoid colon. These are followed by the rectum and the anus.

The large intestine re-absorbs most of the remaining water and compacts the wastes into
faeces. Faeces are stored in the descending colon, and then expelled through the rectum
into the anus and out.
Knowledge Review and Research

1. In your opinion, why do so many organs need to participate in digestion?

• Start filling this table on the organs of the alimentary canal and come
back to it as you gather additional information:

Mnemonic
Organ
Function
Time food spends there
Many

Pet

Owners

Seek

Sympathy

Love

Relationship
Affection
Over the coming pages we will look in more depth at the following:

• Mouth and Tongue

• Stomach
• The Small Intestine
• The Large Intestine (Colon)

DIGESTION IN THE MOUTH

Technically, digestion does begin in the mouth. The mouth is the first section of the
alimentary canal, or digestive tract. The mouth is a moist, neutral or slightly alkaline
environment. The irregular rough ridges or folds on the hard palate (roof of the mouth) that
retain the moisture are called rugae.

The main functions of the mouth are:

Introducing the food into the system;

Mechanical breakdown of non-liquid food by chewing (mastication) in preparation for
swallowing;
Lubrication of food and its preparation for the chemical breakdown;
Beginning of chemical breakdown of carbohydrates by saliva;
Sending information to the brain as to the taste, temperature and contents of the food.

SALIVA
Saliva is a digestive juice. Digestive juices are manufactured by glands of the digestive
system and are released at different stages of digestion into the alimentary canal.

In the animal world, demands on salivary glands are extensive. Many species depend on
saliva for survival. Functions of saliva range from protection or aggression (spitting by
camels and llamas), diluting venom to incapacitate pray (reptilians) or producing 50 litres
to digest a day’s grazing (ruminants).

Other species depend on saliva not for survival, but for improving the quality of life, using
the fluid for functions varying from grooming and cleansing to nest building.
Humans can manage without saliva; its loss is not life threatening in any immediate sense,
but it results in a variety of difficulties and miseries.

Salivary Glands
There are three pairs of salivary glands that release, on the average, 1,500 ml of their
secretions (saliva) daily into the oral cavity.

The largest pair of salivary glands is parotid glands located below the ear and between the
skin of the cheek and the masseter muscle. Their total weight is about 20-30 grams. And
has a total weight of approximately 20-30 grams. The duct of the parotid gland ends in a
small orifice in the cheek opposite the second molar.

The sublingual (under the tongue) glands are the smallest salivary gland. They are
situated on the floor of the mouth covered by readily mobile mucous membrane. Their
multiple ducts release saliva directly into the mucosal layer of the oral cavity.
The submandibular (under the jaw) glands are the size of a small olive. We have two
submandibular glands, which are situated under the lower jaw at the corner on both sides.
The ducts open close to each other behind the lower front teeth under the tongue (you can
see these as raised bumps).

Saliva produced by these glands is 99.5% water; the rest is plasma salts and an enzyme
called amylase (ptyalin).

Functions and properties of saliva

Saliva contains

• mucus, which lubricates the food,

• mineral salts to activate enzymes,
• lysozyme which kills bacteria entering with the food,
• and amylase, an enzyme that breaks down starch into shorter
polysaccharides and then into maltose.
•
Human saliva has antibacterial, antiviral and antifungal properties.

Here is a list of several functions, which have been attributed to saliva:

Lubrication and protection of soft and hard tissues of the mouth against desiccation,
penetration, ulceration, and potential carcinogens by mucin and anti-proteases.
Hydration of food in preparation for mastication;
Saliva is effective in maintaining pH in the oral cavity, contributes to the regulation of
plaque pH, and helps neutralize reflux acids in the oesophagus;
Saliva can encourage soft tissue repair by reducing clotting time and accelerating wound
contraction;
Antibacterial enzymes contained in saliva help prevent serious infection;
The water contents acts as a solvent and helps recognize the taste of food;
Saliva prevents bacterial build-up in the oral cavity;
Salivary amylase or ptyalin initiates the digestion of carbohydrates;
Calcium and phosphates contained in saliva prevent de-mineralization of teeth.

Frenulum
A frenulum (“little bridle,” in Latin, the plural is “frenula”) is a small fold of tissue that
secures or restricts the motion of a mobile organ in the body. Frenula on the human body
include several in the mouth, some in the digestive tract, and some connected to the
external genitalia.

Where in the mouth are they located?

The frenula in the mouth are located inside the upper lip, inside the lower lip and extending
from each tip of the gum (bucchal frena).

The frenulum lingua under the tongue attaches the tongue to the floor of the mouth and is
located midline on the underside of the tongue.

Did you know?

Being “tongue-tied” means virtually having a frenulum, which is too short. If the length of
the frenulum interferes with feeding, digestion and the formation of speech, the frenulum
needs to be clipped, which is a painless operation in babies.

Uvula
The uvula is small piece of soft tissue that hangs down from the soft palate over the back
of the tongue. Its name comes from the Latin word for “grape,” uva.

The uvula has its own little muscle, the musculus uvuae, to help it stiffen and change
shape, so it helps fill in the space at the back of the throat in order to stop food from going
down the wrong way down the windpipe, or trachea, when one swallows. Singers credit
the uvula with letting them produce a vibrato, a wavy up-and-down sound.

Did you know?

The uvula is one of the soft-tissue structures commonly blamed for snoring and for sleep
apnea (a break in breathing during sleep). Some treatments for these conditions involve
removing excess flesh from the uvula and surrounding areas. The surgery, called
uvulopalatopharyngoplasty, is designed to tighten up flabby tissues and enlarge the upper
air passages.
THE TEETH
The teeth are the hardest substances in the body. They are ‘grinding stones’ that perform
the actual process of chewing. They are accessory digestive organs that help mix food
with saliva. The teeth have nerve supply and can feel food temperature, acidity and
alkalinity.

There are different types of teeth in the human mouth. Out of the total of 32 teeth there are

Incisors (8) – thin, sharp teeth best used for cutting;

Canines (4) – conical teeth used for tearing;
Pre-molars (8) – grinding teeth;
Molars (12) – larger grinding teeth.

Baby teeth or milk teeth that we lose in our childhood are called deciduous teeth.

THE TONGUE
The tongue is a gland consisting of striated voluntary muscle. It forces bolus toward the
pharynx, assisting deglutition (swallowing) as well as preventing regurgitation (food re-
entering the mouth). Everyone is born with 10,000 taste buds on the tongue. People lose
some of them, as they grow older, with smokers losing more than non-smokers.

Working taste buds send to the brain information about taste, texture and temperature of
the food that we eat. This information releases digestive juices of the stomach that are
required to process the food further.

THE THREE STAGES OF SWALLOWING

Forcing bolus into the pharynx (the throat starts the three stages of swallowing.

• After the food is swallowed, digestion becomes an involuntary process

that is managed by the autonomic nervous system. The pharynx nerve is stimulated
to close the epiglottis, blocking the trachea and the Eustachian tube, and then
opening the posterior opening of the nasopharynx. The tongue prevents food from
re-entering the mouth.

• Food then passes into the oesophagus and moves toward the
stomach. The two forces controlling this process are gravity and peristalsis.

• The oesophagus is a 20-cm tube that connects the throat above with
the stomach below. At the junction of the oesophagus and stomach, there is a ring
like valve called the cardiac sphincter, which is a muscular valve that prevents the
stomach contents from backing up into the oesophagus. However, as the food
approaches the closed ring, the surrounding muscles relax and allow the food to
pass.
Knowledge Review and Research
• Why do they say that digestion begins in the mouth?

• True or false?

• Saliva prevents teeth from crumbling __________________

• Proteins do not require chewing ____________________

• The only function of the tongue is to sense the temperature

of foods.____________________

• Saliva is a digestive juice.________________________

• Digestion of carbohydrates begins in the mouth in the

presence of amylase. _________________

• What are the three main functions of the mouth?

1.

2.

3.

• What are the three main functions of saliva?

1.

2.

3.

• Why do we have four different types of teeth?

• What do the tongue and the cardiac sphincter of the stomach

have in common?
7. What two forces affect food after swallowing? What are the roles of
these two forces?
THE STOMACH

The stomach’s main functions include being a food reservoir, a site of mechanical and
chemical digestion (mainly) of proteins, and as an absorption site for alcohol, water and
some salts.

Although the stomach is a very important digestive organ, in simple terms it is a digestive
storage sac, serving as a reservoir and a mixing bowl for the chyme before it enters the
duodenum. It can have different shapes depending on constitutional factors, volume of the
contents, or body height.

The main action that takes place in the stomach is the churning of the food with gastric
juices, containing hydrochloric acid and protein digesting enzymes

The stomach is a smooth muscle consisting of three layers. Like other parts of the
alimentary canal, the stomach has a longitudinal layer and a circular layer of smooth
muscles. In addition, the stomach has an internal oblique layer of smooth muscles, to be
able to stretch diagonally.

The folds in the stomach help increase its surface area and retain mucus that protects the
stomach muscle.

This structure enables the stomach to

store food;
churn food,
Break it down mechanically,
Alter it chemically and
Prevent absorption of incompletely broken down nutrients. .

Anatomy of the stomach

The cardia is opening of the stomach that receives bolus from the oesophagus.

The fundus is the temporary storage site for foods and liquids. Sometimes it becomes filled
with gases, causing pain and discomfort.

The body or the corpus is the mid-portion of the stomach, which is its main processing
area.

It leads to the pylorus, or pyloric region, that propels the bolus, now called chyme, through
the pyloric sphincter to the duodenum portion of the small intestine.

The antrum of the stomach (gastric antrum - below) is a portion immediately preceding the
duodenum, which is lined by mucosa, which does not produce acid.
As food enters the stomach, the walls of the stomach can expand dramatically due to the
thick layers of smooth muscle and the numerous folds of the mucosa, called rugae.
Digestive phases in the stomach

There are three phases of gastric secretions (release of enzyme-rich fluids and
hydrochloric acid from the mucosal layer of the stomach):

the cephalic phase;

the gastric phase
the intestinal phase.

The cephalic phase is the shortest phase – it is initiated by the expectation of food (its
sight, smell and taste) and lasts about 30 minutes into the meal. This enables the stomach
to prepare itself to the imminent arrival of food.

The gastric phase is the longest phase, lasting about 2.5 hours from the start of the meal.
It is triggered by the presence of food in the stomach and the distension of the stomach.
The intestinal phase is triggered by the release of the chyme into the duodenum, which
inhibits gastric secretion (stops the release of stomach acid).

Mechanical digestion in the stomach

The stomach has three mechanical tasks to do.

• It serves as storage medium for swallowed food and liquid. The

cardiac sphincter at the top of the stomach can relax and accept large volumes of
swallowed material.

• It is also a blender that mixes the food, liquid, and digestive juice
produced by the stomach. The lower part of the stomach mixes these materials by
its muscle action.

• It produces highly liquefied chyme;

4. The final task of the stomach is to empty its contents slowly into the small intestine
through the pyloric sphincter between the stomach and the small intestine.

Several factors affect emptying of the stomach, including the nature of the food (mainly its
fat and protein content) and the degree of muscle action of the emptying stomach and the
next organ to receive the contents (the small intestine).

Chemical Digestion in the Stomach

Chemical digestion in the stomach requires the action of hormones and nerve stimulation
(remember: thought before action!) This is how it happens:

Nerve stimulation: Well before food makes its way into the stomach, its sight,
smell and taste initiate initiates the cephalic phase, including release of gastric
digestive juices and muscular contractions by stimulating the vagus nerve (that is in
charge of the parasympathetic nervous system).

Hormonal action: When partially digested food makes it to the stomach, the
presence in the blood of gastrin, a hormone of the pyloric mucosa, activates further
release of gastric digestive juices and muscular contractions.

More hormonal action: As the final mass of partially digested food bolus now
called chyme passes from the stomach to the intestine, the intestine produces a
hormone, enterogastrone that stops further secretions of gastrin and stimulates
release of intestinal digestive juices and muscular contractions.
Digestive Juices
Digestive juices in the stomach comprise hydrochloric acid (the HCl), gastrin, pepsinogen
(that is converted into pepsin), rennin, gastric lipase and mucins.

The important role of hydrochloric acid

The hormone gastrin in the blood triggers release of hydrochloric acid (HCl) in the
Stomach. This makes stomach is a very acid environment.

HCl
Activates pepsinogen (see below),
Curdles milk,
liquefies chyme;
Plays a minor role in protein digestion (i.e. swells and softens protein – mechanical
breakdown),
kills almost all of the bacteria present in the food bolus obtained from the oesophagus.
Low pH is lethal to most pathogens.
Low pH is necessary for the enzymes to work efficiently.

Pepsin and other important enzymes required for chemical digestion in

the stomach
The presence of gastrin in the blood also stimulates the secretion of pepsin. Pepsin is the
major enzyme in the stomach that starts chemical breakdown of proteins into polypeptides.
It is secreted in an inactive form, pepsinogen, which is activated in the presence of the
HCl.

Rennin is another enzyme responsible for breaking down casein, a sticky milk protein.
Infants have much higher concentration of rennin in their stomach than adults. That is why
many people find it difficult to digest milk and cheese that contain a lot of casein.
Gastric lipase breaks down fats to triglycerides.

Mucins are secretions from the section of the stomach wall adjacent to the pyloric
sphincter (called the pyloric mucosa) that combine with water to form mucus. This forms a
protective barrier against enzymes on the inner lining of the stomach and prevents self-
ingestion (we need to remember that stomach is also a protein).
Knowledge Review and Research
• Please Label the main sections of the stomach

• List the most important functions of the stomach.

• How can the stomach expand to more than double its size?
 • Fill in the blanks:

• The opening of the stomach that receives the bolus from

the oesophagus is called __________________.

• When the fundus fills up with gasses it may cause the

following
___________________________

___________________________

__________________________

• The main processing area of the stomach is called __________

• A muscle called the ________________ sphincter stops the food

from leaving the stomach too early.

5. Mucosal folds are called the rugae. Where else in the digestive system
are they present?

6. If the person does not produce enough hydrochloric acid, what could
be the consequences for that person’s digestion and absorption?

7. List all the roles of hydrochloric acid.

8. Why some people cannot digest milk and cheese?

9. What are gastrin and enterogasterone? What is their main role?

10. What is the role of the vagus nerve in digestion in the stomach?
THE SMALL INTESTINE
The small intestine extends from the pyloric sphincter (lower aperture of the stomach) to
the ileocecal valve where it merges with the large intestine. The small intestine is the
longest part of the digestive tract: it can be 5 - 7 m long. It is called “small” because it is
quite narrow, unlike the large intestine, which is a lot wider.

The small intestinal wall is made up of a muscle layer, lymph vessels, arteries, veins,
capillaries, epithelial cells, villi, and microvilli. The mucosa of the small intestine is
responsible for the breakdown and absorption of the end products of digestion in the
blood.

Most of the digestion and a majority of the absorption occur in the small intestine. Acid
chyme from the stomach is neutralised in the intestine by pancreatic, liver and intestinal
secretions (juices containing enzymes). This occurs such that the pH of the intestine is
continually increasing as the chyme moves from the duodenum toward the ileocecal valve.

Anatomical structure of the small intestine

The small intestine consists of three parts.

A) The duodenum, approx 20-30cm

B) The jejunum, approx 2m
C) The ileum, approx 3m

It has the shape of a convoluted tube.

Unique Anatomical Features of the Small Intestine

As the main site of absorption, the small intestine has a number of unique anatomical
features that are not present in other sections of the digestive tract.

Surface area
The small intestine is able to absorb nutrients efficiently because of its large surface area.
Although the width of the small intestine is 2.5-3.5 cm it is said to have a total absorptive
area the size of a tennis court.

This enormous absorptive surface is due to the concentric folds in the intestine wall, which
run parallel to each other, which are called “plicae circularis” or Kerckring’s folds. Each
fold is 5-6 cm in length and 3.2 mm thick.

Folds are found along the whole length of the small intestine, most are found in the
duodenum and the upper part of the jejunum. They become less numerous and finally
disappear towards the ileum. There are about 800 folds, which increase the surface area
by 5 to 8 times the outside area of the small intestine.

Villi and Microvilli

Intestinal mucosa contains small absorptive organs called “villi” which consist of a lymph
gland and capillary network. They are found along the walls and are tiny finger-like
projections, which absorb nutrients. They are tiny: 0.5-1 millimetres in height. Microvilli are
located on top of the villi. They are known as brush border cells (that’s how they look under
an electronic microscope) and they also help with absorption.

The villi and microvilli increase the active surface of the small intestine. In order to reach
the same effect without the villi, the small intestine had to be 40m in length.
The villi are mostly found in the duodenum where they look like tiny leaves. In the jejunum
and ileum their appearance and shape is different to that in the duodenum: they get
smaller and gradually disappear altogether.

Once the villi absorb the nutrients they enter the circulatory system though the blood and
lymph vessels found at the base of the villi. Blood, which has absorbed nutrients, is carried
away from the small intestine via the hepatic portal vein and goes to the liver for filtering,
removal of toxins, and nutrient processing.

Between the villi, there are tubular glands in the intestinal surface, called the Crypts of
Lieberkuhn. These crypts secrete various enzymes, including sucrase and maltase.
Malfunction in the in the crypts of Lieberkuhn is thought to lead to colorectal cancer.

Peyer’s patches are secondary lymphoid organs named after the 17th-century Swiss
anatomist Hans Conrad Peyer. They are aggregations of lymphoid tissue that are usually
found in the lowest portion of the small intestine (ileum) in humans; as such, they
differentiate the ileum from the duodenum and jejunum.

Mechanical digestion in the small intestine – propulsion and mixing

The intestinal movements are controlled by the autonomic nervous system.

Propulsion: foodstuffs must be propelled along the length of the digestive tube in order to
be subjected to the sequential series of processing involved in disassembly and
absorption.
The principal type of propulsive motility in the small intestine is peristalsis - a ring of
muscle contraction that and moves toward the anus, propelling the contents of the lumen
in that direction; as the ring moves, the muscle on the other side of the distended area
relaxes, facilitating smooth passage of the chyme.

Mixing: If ingested materials were simply propelled through the digestive tube, digestion
and absorption would not be complete, because the digestive enzymes would not be
adequately mixed with the chyme and the bulk of the ingested material would not come in
contact with the epithelial cells that absorb nutrients.

Segmentation contractions are a common type of mixing motility seen especially in the
small intestine - segmental rings of contraction chop and mix the ingesta. Alternating
contraction and relaxation of the longitudinal muscle in the wall of the gut also provides
effective mixing of its contents.

Digestive Process in the Small Intestine

The Duodenum
The duodenum is the first 20-30 cm of the small intestine and is the thickest section. The
duodenum obtained its name by the fact that its length of about 25 cm equals the breadth
of twelve fingers. It is shorter, wider and less mobile than the other parts of the small
intestine. Between its two ends, it has the shape of a large Roman C embracing the head
of the pancreas.

Duodenum receives chyme from the stomach. There is a specialized muscle at the
junction of the stomach and duodenum called the pyloric sphincter, which prevents chyme
from regurgitating back into the stomach.

When the duodenum becomes filled with chyme, the walls of the duodenum are stretched
and the enterogastric reflex is stimulated in the presence of the hormone enterogasterone.
This reflex initiates action in the small intestines and terminates action in the stomach.

The duodenum is a very active organ, both mechanically as well as metabolically. It tends
to function like a cocktail shaker in that by to-and-fro motion it mixes the chyme with the
enzymes within its lumen.

The cells that line the duodenum secrete hormones - chemical messengers that regulate
the secretion of pancreatic juices and the emptying of the gallbladder and flow of bile into
its lumen.
About 7 cm below the pylorus, common bile duct and the major pancreatic duct merge in
the duodenum. Within the duodenal wall, both are surrounded by the sphincter of Oddi.

Through these ducts, as the sphincter of Oddi relaxes, the duodenum receives secretions
(juices containing salts and enzymes that the body requires for the mechanical and
chemical digestion of food) from the liver, gall bladder and the pancreas.

It also receives enzymes from the numerous glands along its walls.

This lowers the acidity and raises the pH of the chyme and continues to break it down.
Most of the chemical breakdown in the small intestine occurs in the duodenum. The
duodenum is also a very important site of iron absorption.
As the duodenum merges in the jejunum, it forms the duodeno-jejunal flexure.

Jejuno-Ileum
The jejunum is about 1.5 to 3 m long. The ileum is 2.5-3.5 m long. Unlike the duodenum,
the jejunum and the ileum are both attached to the abdominal wall by a thin mucous
membrane and can move about within the body.

The jejunum is about 3-31/2 cm in diameter. It commences at the duodeno-jejunal flexure,

is about 2 m long and merges in the ileum without any line of distinction. The Kerckring’s
folds (plicae circularis) are large and thickly set, its villi are larger and more sparse than
the ones in the ileum. In the upper part of the jejunum, there are almost no Peyer’s
patches, in the lower part; they are still less frequent than in the ileum.

The ileum has numerous coils and convolutions and its diameter is smaller (approx. 2.5
cm) than that of the other two parts of the small intestine. It has only few Kerckring’s folds,
which disappear entirely toward the lower end. The Peyer’s patches, however, are larger
and more numerous. The ileum merges in the large intestine at the ileocaecal valve.

The jejunum plays an important part in the absorption of proteins, sugars and folic acid,
while the ileum is important for absorbing products of fat digestion: fatty acids and glycerol,
bile salts and vitamin B12.

The jejunum and its lining is specialised in the absorption of carbohydrates and proteins.
In fact, the majority of carbohydrates and proteins are absorbed within the first 30% of its
length.

The ileum, the lowermost segment of the small intestine, is specialized in the absorption
of water, fats, and a component of the bile called bile salts.

The ileum enters the large intestine at the ileocecal valve, a structure that is designed to
prevent the backward movement of substances from the large to the small intestine.
These three sections of the small intestine work together to break down the chyme even
further, by absorbing the nutrients from the food into the body.
Knowledge Review and Research
• How does the mechanical digestion in the small intestine take
place?

• How does chemical digestion in the small intestine take place?

• What are the three sections of the small intestine called and how
long is each section?

• Why does the small intestine need villi?

DIGESTION, ABSORPTION AND EXCRETION (ELIMINATION) IN THE
LARGE INTESTINE
Anatomical structure of the large intestine
Human colon (the large intestine) is the final destination the food reaches in the alimentary
canal. It starts from the ileocecal valve and finishes at the anus. It is a muscular organ
measuring approximately 1.2 m long in a living body and 1.6 m in a cadaver (when there is
no muscle tone) and has an average diameter of 5 cm or twice that of the small intestine.

Features of the colon and differences from the small intestine

The wall of the large intestine consists of the four basic layers found in other GI hollow
visceral organs -the mucosa, sub mucosa, circular muscle and longitudinal muscle and
serosa.

However, several important differences exist.

The mucosa lacks the villi and the microvilli found in the small intestine and presents a
smoother surface than in other sections of the alimentary canal. However, numerous
crypts extend from its surface.

As the protective and immune functions of the large intestine are important, cell types
lining the surface and the crypts are composed of significantly greater numbers of goblet
cells than in the small intestine that secrete mucus into the lumen, and as a result mucus
strands can often be seen in stools.

The haustral folds, which help define the colon on barium x-ray, are not a static anatomical
feature of the colon but rather result from circular muscle contractions that remain constant
for several hours at a time.

The outer or longitudinal muscle is organized in three bands, called taeniae coli, which run
from the caecum to the rectum where they fuse together to form a uniform outer muscular
layer.

Sections of the large intestine

The large intestine can be divided into four sections (numbered 1 to 4) and seven parts:
the caecum, ascending (1), transverse (2), descending (3) and sigmoid colon (4). The final
two parts are the rectum and the anus.

It begins just above the right groin where it is known as the caecum and from which grows
the appendix.

The appendix is a gland of the immune system. Its purpose is to fight possible infections in
the incoming chyme. Inflammation of appendix is referred to as appendicitis.

The next section of the large intestine is the ascending colon, which is approximately 20
cm. It starts at the caecum and climbs to a position behind the liver on the right and then
does a sharp left that is known as the hepatic flexure (the bend at the liver).

At this point, it becomes the transverse colon (approximately 35-55 cm), which extends
across the abdomen. This region exhibits a lot more motility (peristaltic movement).
With a second sharp right below the spleen, known as the splenic flexure, the large
intestine turns downwards and is now known as the descending colon (approximately 22-
30 cm)

Finally, the colon makes a curve in a form resembling the letter S known as the sigmoid
flexure (named after the Greek letter sigma or ð) that is around 15 cm before emptying into
to the rectum.

The rectum is 8 to 18 cm long. Three semilunar valves (Valves of Houston) are present in the
mucosal layer of the rectum, which slows faecal movement through this region. It is only designed
to serve as a short-term holding pen and is normally is empty unless defecation is occurring.

Although the word ‘rectum’ means ‘straight’ in Latin, the rectum itself sharply backwards
just before it joins on to the anal canal. It does straighten out, however, while the bowels
are being opened. Its function changes to that of a short-term store to that of a “shipper”.
When straightened out, the muscular tube of the rectum conducts stools from the sigmoid
colon to the outside world.

Generally the descending and sigmoid colon evacuate at the same time.

The last section of the rectum (2 to 6 cm) referred to as the anal canal. Its lining is not of
mucus but squamous epithelium.

Located at the end of the anal canal are two sphincter muscles. The internal sphincter
muscle is a smooth muscle, while the external anal sphincter is a skeletal muscle. The
external sphincter muscle is under voluntary control, while the internal muscle is an
involuntary muscle. Working in conjunction with the external sphincter is the levator ani
muscle, which closes off the anal canal at the end of defecation.

The large intestine contains several ‘pockets’ (haustra) and three longitudinal muscle
bands (taeniae coli). Unlike the small intestine, the large intestine does not have villi.
Some researchers consider that the colon can be functionally divided through the
transverse colon into two parts, the right and left colon. The right colon (caecum and
ascending colon) plays a major role in water and electrolyte absorption and fermentation of
undigested sugars and cellulose (insoluble fibre found in plants), and the left colon
(descending colon, sigmoid colon and rectum) is predominantly involved in storage and
evacuation of stool.
Large Intestinal Motility

Large intestinal motility is a term that describes muscle-assisted contractions occurring in

the colon to facilitate movement of intestinal contents. There are five main types of bowel
motility.

Haustral churning or segmentation contractions - slow, segmented movements that

take place in the haustra (pockets) which chop and mix the chyme, presenting it to
the mucosa where absorption occurs.
Pendular movements – slow swinging motions of the transverse colon;
Peristalsis - slow, wave-like contractions of the longitudinal and circular muscles,
which propel the chyme along the colon;
Anti-peristalsis or reverse peristalsis – a movement that slows down the propulsion
of the chyme, in order to increase absorption of fluids (water and electrolytes) in the
ascending colon and promote better stool formation;
Mass peristalsis constitutes a type of motility that is unique to the large intestine and
does not exist anywhere else in the alimentary canal. Known also as giant migrating
contractions or defecation, this pattern of motility is like a very intense and
prolonged peristaltic contraction, which clears out of contents a whole area of large
intestine.

Bowel motility is the least active at the caecum, where the large intestine has the widest
diameter, and it intensifies when the wastes reach the transversal section of the colon,
which is considered to be the most motile section of the large intestine.
Knowledge Review and Research
• Why do you think the large intestine does not have villi?

• What is the role of mucus in the large intestine?

• On the illustration below, please label the anatomical features of

the large intestine.

• Explain the term ‘motility’. Make a simple drawing to illustrate

bowel motility.

• In your opinion, why does the bowel motility increase in the

transverse section of the large intestine?

• Why do you think physical exercise would be good for promoting

bowel motility?
Four Layers of the Gut Wall
The gut wall consists of four layers that one can compare to four lanes.

The first layer, mucosa, is the inside lane. It acts as a lubricant and protects the blood and
other organs from gut bacteria.

The middle lane is called submucosa. It is made up of connective tissue that contains
blood vessels, nerves and lymphatic vessels. It operates as an immunity barrier between
the sealed eliminative system (the body’s sewer) and the rest of the body. This is also
where the nutrients from the large intestine are absorbed into the blood stream.

The outside lane is called the muscularis consists of the bowel muscles that are
responsible for peristaltic movement – the vertical and horizontal contractions that propel
the faeces towards the exit.

And finally, the hard shoulder - connective tissue called serosa, which gives the gut its
strength and suspends it in the chest and in the abdominal cavity where the gut, in its turn,
supports and massages the other internal organs. Serosa also releases a lubricant that
stops the gut from rubbing the internal organs that it comes in touch with.
Knowledge Review and Research
1. Name the four layers of the gut wall and list their main functions?

2. In your view, what effect would constipation or diarrhoea have on these

for layers?
Absorption in the small intestine
Absorption takes place by diffusion and active transport.

Monosaccharides, amino acids, dipeptides and tripeptides are actively transported

(using a carrier protein) into the epithelial cells lining the wall. It is thought that their
absorption is coupled with the absorption of sodium.

This would mean that the carrier proteins have two receptor sites, one for sodium and one
for glucose. Only when both are filled would they be actively transported from the lumen
side of the epithelium, and into the cells. From here they diffuse into the capillaries.

The fatty acids, glycerol and monoglycerides form complexes with bile salts called
micelles. The micelles come into contact with epithelium cells and the fat-soluble fat
components diffuse into the epithelium cell, leaving behind the fat insoluble bile salts.

In the epithelium, the fatty acids and glycerol are reformed into triglycerides, packaged into
globules with cholesterol and phospholipids and then coated with protein. These
packages, called chylomicrons, are eventually passed out from the epithelial cell into
blood.

Digestion and absorption are almost complete by the time the chyme reaches the caecum
of the large intestine.
Digestive Juices and Enzymes in the small intestine
The digestive juices found in the small intestine are bile from the liver, pancreatic juice
from the pancreas and intestinal juice from the intestine itself. All three secretions are
necessary for digestion to occur.

Chyme passes through the small intestine slowly, therefore the digestive enzymes have
time to act on the food and raise the pH of the acidic chyme.

Hormones of the small intestine – thought before action!

The major hormones that control the functions of the digestive system in the small
intestine are produced and released by cells in the mucosa (the wall) of the small intestine.
These hormones are released into the blood of the digestive tract; travel back to the heart
and through the arteries, and return to the digestive system, where they stimulate the
release of digestive juices containing digestive enzymes. They also engage the accessory
organs of the digestive system into releasing their own juices and enzymes into the small
intestine. The main hormones that control digestion are enterocrinin (this hormone also
has the following names: “enterokrinin” and “enterokinin”), enterogastrone, secretin, and
cholecystokinin (CCK):

Enterogasterone stops gastrin from releasing after the chyme has left the stomach and
activates digestion in the small intestine.
Enterocrinin stimulates the release of digestive juices (enzymes) from the intestinal walls.
CCK stimulates contractions of the gall bladder and common bile duct. This enables
gallbladder to deliver bile required for fat digestion. As a secondary function, it also causes
the pancreas to produce the enzymes of pancreatic juice.
Secretin causes the pancreas to release into the small intestine a digestive juice that is
rich in bicarbonate. Bicarbonate is a very important enzyme that reduces acidity of the
chyme. Secretin also stimulates both the contraction of the gall bladder and the relaxation
of the sphincter of Oddi; this sphincter controls the flow of bile and pancreatic juices from
the common bile duct into the duodenum.

JUICES AND ENZYMES OF THE INTESTINAL TRACT Enzyme:

Released by duodenum:
Released by pancreas:
Action:
Aminopeptidase
Yes
Peptides to amino acids
Enterokinase
Yes
Inactive trypsinogen into trypsin
Maltase
Yes
Maltose to glucose
Sucrase
Yes
Sucrose to glucose and fructose
Exopeptidase
Yes
Peptides into amino acids
Lactase
Yes
Lactose into glucose and galactose
Amylase
Yes
Yes
Starch / glycogen into maltose
Chymotrypsin
Yes
Proteins into amino acids
Trypsin
Yes
Proteins into amino acids Chymotrypsinogen into chymotrypsin
Lipase
Yes
Lipid into fatty acids and glycerol
Carboxypeptidase
Yes
Peptides to amino acids

Endopeptidase
Yes
Proteins into peptides
The Pancreas: Form, Functions and Secretions
One of the two important accessory digestive organs is the pancreas. Pancreatic
secretions are controlled by the parasympathetic nervous system and by hormones.
Secretin that is released in the small intestine in the presence of proteins and fats
stimulates the action of the pancreas.

Pancreas is located between the greater curvature of the stomach and the duodenum, it is
both an endocrine and exocrine gland. It is composed of granular-like epithelial cells
forming two masses:

• The Islets of Langerhans produce endocrine secretions involved with

sugar metabolism. These endocrine secretions are hormones insulin and
glucagons.
• The Acini cells secrete digestive enzymes of exocrine origin that are
released into the small intestine:
• sodium bicarbonate, which neutralises the hydrochloric acid (HCI)
produced in the stomach;
• Amylase to decompose starch into sugars;
• Proteases to digest protein into amino acids;
• Lipase that breaks down fats to fatty acids and glycerol;
• Nucleases that serves to digest nucleic acid in the duodenum.

Since the pancreas is not part of the small intestine it must transfer its digestive enzymes
through the pancreatic duct (Canal of Wirsung) to the common bile duct. The common bile
duct merges with the small intestine.

As chyme floods into the small intestine from the stomach, two things must happen:

Acid must be quickly and efficiently neutralized to prevent damage to the duodenal
mucosa.
Macromolecular nutrients - proteins, fats and starch - must be broken down much further
before their constituents can be absorbed through the mucosa into blood.

The pancreas plays a vital role in accomplishing both of these objectives; so vital in fact
that insufficient exocrine secretion by the pancreas leads to starvation, even if one is
consuming adequate quantities of high quality food.

In addition to its role as an exocrine organ, the pancreas is also an endocrine organ and
the major hormones it secretes - insulin and glucagon - play a vital role in carbohydrate
and lipid metabolism. They are, for example, absolutely necessary for maintaining normal
blood concentrations of glucose.

Pancreatic juice is composed of two liquids critical to proper digestion: digestive

enzymes and bicarbonate. The enzymes are synthesized and secreted from the exocrine
Acini cells, whereas bicarbonate is secreted from the epithelial cells lining small pancreatic
ducts.
Digestive Enzymes
The pancreas secretes powerful enzymes that collectively have the capacity to reduce
virtually all digestible macromolecules into forms that are capable of, or nearly capable of,
being absorbed. Three major groups of enzymes are critical to efficient digestion:

• Proteases
Digestion of proteins is initiated by pepsin in the stomach, but the bulk of protein
digestion is due to the pancreatic proteases. Several proteases are synthesized in
the pancreas and secreted into the lumen of the small intestine. The two major
pancreatic proteases are trypsin and chymotrypsin, which are synthesized and
packaged into secretory vesicles in the inactive forms - as trypsinogen and
chymotrypsinogen.

Because our bodies are mainly protein, fat and water, proteases that break down
proteins are rather dangerous enzymes to have in cells, and packaging them into
an inactive form is a way for the cells to safely handle these enzymes.
The secretory vesicles also contain a trypsin inhibitor, which serves, as an
additional safeguard should some of the trypsinogen be activated to trypsin; once
trypsinogen and chymotrypsinogen are discharged from the cells this inhibitor is
diluted out and becomes ineffective - the pin is out of the grenade.

Once trypsinogen and chymotrypsinogen are released into the lumen of the small
intestine, they must be converted into their active forms in order to digest proteins.
Trypsinogen is activated by the enzyme enterokinase, which is embedded in the
intestinal mucosa.

After trypsinogen turns into trypsin, it activates chymotrypsinogen, as well as

additional molecules of trypsinogen. The net result is a rather explosive appearance
of active protease once the pancreatic secretions reach the small intestine.

Trypsin and chymotrypsin digest proteins into peptides and peptides into smaller
peptides, but they cannot digest proteins and peptides to single amino acids. Some
of the other proteases from the pancreas, for instance carboxypeptidase, have that
ability, but the final digestion of peptides into amino acids is largely the effect of the
enzymes secreted by the small intestine.
• Pancreatic Lipase
A major component of dietary fat is triglyceride. A triglyceride molecule cannot be
directly absorbed across the intestinal mucosa. Rather, it must first be hydrolyzed,
 i.e. broken down into smaller molecules. The enzyme that performs this hydrolysis
is pancreatic lipase, which is a constituent of pancreatic juice.

Sufficient quantities of bile salts must also be present in the intestine in order for
lipase to efficiently digest dietary fats and for the resulting fatty acids and
monoglyceride to be absorbed. This means that normal digestion and absorption of
dietary fat is critically dependent on secretions from both the pancreas and liver.

• Amylase
The major dietary carbohydrate for many species is starch, a storage form of
glucose in plants. Amylase is the enzyme that hydrolyses starch to smaller
molecules that will eventually be broken down to simple sugars. The major source
of amylase is pancreatic juices, although amylase is also present in saliva of some
animals, including humans.

• Nucleases
Pancreatic nuclease enzymes digest nucleic acids (DNA and RNA) to nucleotides in
the duodenum.

Bicarbonate and Water

Epithelial cells in pancreatic ducts are the source of the bicarbonate and water secreted by
the pancreas. Bicarbonate is a base and critical to neutralizing the acid coming into the
small intestine from the stomach. It is secreted into the duodenum with pancreatic juices.

Knowledge Review and Research

1. Explain the meaning of this statement: Pancreas is both an endocrine
and exocrine gland.
 • What enzymes do pancreatic juices contain? What is the role of?

• Pancreatic amylase?

• Proteases?

• Lipase?

3. The Islets of Langerhans produce hormones insulin and glucagons.

What is the role of these hormones?

4. How does the pancreas communicate with the duodenum?

THE LIVER AND THE GALLBLADDER

The liver is the largest gland in the body. It weights around 1.2 to 1.6 kilos or 3 to 4 pounds
(around the same weight as the human brain) and is located in the upper right-hand
portion of the abdominal cavity, beneath the diaphragm, and on top of the stomach, right
kidney, and intestines.

There are two distinct sources that supply blood to the liver, including the following:

Oxygenated blood flows in from the hepatic artery

Nutrient-rich blood flows in from the hepatic portal vein

Did you know?

• The liver holds about one pint (13 percent) of the body’s blood
supply at any given moment.
• The liver can lose three-quarters of its cells before it stops
functioning.
• In addition, the liver is the only organ in the body that can
regenerate itself.

Functions of the Liver

More than 500 vital functions have been identified with the liver.

The liver functions as the blood filter of the body. All blood that leaves the digestive tract
flows through the liver prior to being returned to general circulation. The blood flows from
the inferior mesenteric and superior mesenteric veins to the hepatic portal veins and into
the liver, where the blood is cleaned and filtered. The toxins removed from the blood in the
liver are then returned into the small intestines with the bile.
Some of the liver’s other well-known functions are:

Production of bile which helps carry away waste and break down fats in the small intestine
during digestion;
Delivery of bile through the common bile duct to the small intestine.
The liver consists of two main lobes, both of which are made up of thousands of lobules.
These lobules are connected to small ducts that connect with larger ducts to ultimately
form the hepatic duct. The hepatic duct transports the bile produced by the liver cells to the
gallbladder and duodenum.
Production of heparin which helps prevent blood from clotting in the vessels;
Removal of dead and malfunctioning red blood cells from the circulatory system;
Removal of toxins from the blood;
Storage of absorbed nutrients;
Storage of trace metals (such as copper and iron);
Storage of fat-soluble vitamins A, D, E and K, which are necessary for daily metabolic
activity;
Production of certain proteins for blood plasma;
Production of cholesterol and special proteins to help carry fats through the body;
Conversion of excess glucose into glycogen for storage (glycogen can later be converted
back to glucose for energy)
Regulation of blood levels of amino acids, which form the building blocks of proteins;
Processing of haemoglobin for use of its iron;
Conversion of poisonous ammonia to urea (urea is an end product of protein metabolism
and is excreted in the urine);
Filtering drugs, alcohols and other poisonous substances out of blood;
Resisting infections by producing immune factors and removing bacteria from the
bloodstream.

When the liver has broken down harmful substances, its by-products are excreted into the
bile or blood. Bile by-products enter the intestine and ultimately leave the body in the form
of faeces. Blood by-products are filtered out by the kidneys, and leave the body in the form
of urine.
Kupffer Cells
Kupffer cells or Browicz-Kupffer cells are specialized scavenger cells called macrophages
located in the liver. Karl Wilhelm von Kupffer first observed the cells in 1876. The scientist
called them “sternzellen” (star cells or stellate cells). Over 20 years later, in 1898, after
several years of research, scientist Tadeusz Browicz identified them correctly as
macrophages.

The primary function of Kupffer cells is to recycle old red blood cells that no longer are
functional. The red blood cell is broken down by phagocytic action and the haemoglobin
molecule is split. The globin chains are reutilized while the iron containing portion or heme
is further broken down into iron, which is reutilized, and bilirubin, which is secreted into the
bile and ends up giving faeces their characteristic rusty colour.

Phagocytic action is the action of engulfing and absorbing waste material, harmful
microorganisms, or other foreign bodies in the bloodstream and tissues.

Conditions and Diseases of the Liver

Jaundice comes from the French word jaune, meaning yellow. Jaundice is a yellowing of
the skin, conjunctiva whites of the eyes and mucous membranes, caused by increased
levels of bilirubin in the human body. It typically appears in a ‘top to bottom’ progression
(starting with the face, progressing toward the feet), and heals in a ‘bottom to top’ manner.

Hepatitis is a gastroenterological disease, featuring inflammation of the liver. The clinical

signs and prognosis, as well as the therapy, depend on the cause.

In cirrhosis of the liver, scar tissue replaces normal, healthy tissue, blocking the flow of
blood through the organ and preventing it from working, as it should.

Did you know?

Cirrhosis is the twelfth leading cause of death by disease, killing about 26,000 people each
year. Also, the cost of cirrhosis in terms of human suffering, hospital costs, and lost
productivity is high.

Causes
The common causes of Cirrhosis of the liver include chronic alcoholism and Hepatitis C.

Alcohol seems to injure the liver by blocking the normal metabolism of protein, fats, and
carbohydrates. Alcoholic cirrhosis usually develops after more than a decade of heavy
drinking. The amount of alcohol that can injure the liver varies greatly from person to
person. In women, as few as two to three drinks per day have been linked with cirrhosis
and in men, as few as three to four drinks per day.

Hepatitis A is caused by the hepatitis A virus. It’s usually caught by consuming food or
drink contaminated with the poo of an infected person and is most common in countries
where sanitation is poor. Hepatitis A usually passes within a few months, although it can
occasionally be severe and even life-threatening. There’s no specific treatment for it, other
than to relieve symptoms such as pain, nausea and itching.

Hepatitis B is caused by the hepatitis B virus, which is spread in the blood of an infected
person. It’s common infection worldwide and is usually spread from infected pregnant
women to their babies, or from to child-to-child contact. In rare cases, it can be spread
through unprotected sex and injecting drugs. Most adults infected with the hepatitis B are
able to fight off the virus any fully recover from the infection within a couple of months.

Hepatitis C is caused by the hepatitis C virus and is the most common type of viral
hepatitis. It’s usually spread through blood-to-blood contact with an infected person i.e.
sharing needles used to inject drugs or poor healthcare practices and unsafe medical
injections. Hepatitis C often causes no noticeable symptoms or only flu-like symptoms, so
many people are unaware they’re infected. Around 1 in 4 people will fight off the infection
and be free of the virus. In the remaining cases, it will stay in the body for many years.
This is known as chronic hepatitis C and cause cirrhosis and liver failure.

Hepatitis D is caused by the hepatitis D virus and only affects people who are already
infected with hepatitis B as it needs the hepatitis B virus to survive. Hepatitis D is usually
spread through blood-to-blood contact or sexual contact.

Hepatitis E is caused by the hepatitis E virus, the virus has been mainly associated with
the consumption of raw or undercooked pork or offal but also with wild boar meat, venison
and shellfish.

Functions of bile
Bile, yellow-ish to green-ish in colour and bitter in taste, is produced by hepatic (liver) cells
from cholesterol. It is composed of bile salts, bile acids, lipids (fats), and the pigments
biliverdin and bilirubin.

Biliverdin and bilirubin are products of the decomposition of dead red blood cells. They
must be removed from the circulatory system. If there is a malfunction in the liver and they
stay in the system, the skin and the whites of the eyes develop a yellowish tinge, a
condition known as jaundice.

Besides its excretory (eliminative) properties, bile is responsible for the emulsification of
fats and the partial neutralisation of chyme. Fatty acids and glycerol can only be absorbed
in the presence of bile salts.
THE GALL BLADDER
The gallbladder is a small storage organ located inferior and posterior to the liver. The
gallbladder is a small pear-shaped organ that stores and concentrates bile. It is connected
to the liver (which produces the bile) by the hepatic duct. It is approximately 7.6 to 10.2 cm
long and about 2.5 cm wide. The gallbladder holds bile produced in the liver until it is
needed for digesting fatty foods in the duodenum of the small intestine. Bile in the
gallbladder may crystallize and form gallstones, which can become painful and potentially
life threatening

The Functions of the Gallbladder

Storage

The gallbladder acts as a storage vessel for bile produced by the liver. Bile is produced by
hepatocytes cells in the liver and passes through the bile ducts to the cystic duct. From the
cystic duct, bile is pushed into the gallbladder by peristalsis (muscle contractions that
occur in orderly waves). Bile is then slowly concentrated by absorption of water through
the walls of the gallbladder. The gallbladder stores this concentrated bile until it is needed
to digest the next meal.

Stimulation

Foods rich in proteins or fats are more difficult for the body to digest when compared to
carbohydrate-rich foods. The walls of the duodenum contain sensory receptors that
monitor the chemical makeup of chyme (partially digested food) that passes through the
pyloric sphincter into the duodenum. When these cells detect proteins or fats, they
respond by producing the hormone cholecystokinin (CCK). CCK enters the bloodstream
and travels to the gallbladder where it stimulates the smooth muscle tissue in the walls of
the gallbladder.

Secretion

When CCK reaches the gallbladder, it triggers the smooth muscle tissue in the muscularis
layer of the gallbladder to contract. The contraction of smooth muscle forces bile out of the
gallbladder and into the cystic duct. From the cystic duct, bile enters the common bile duct
and flows into the ampulla of Vater, where the bile ducts merge with the pancreatic duct.
Bile then flows from the ampulla of Vater into the duodenum where it breaks the fats into
smaller masses for easier digestion by the enzyme pancreatic lipase.

Gallstones

Gallstones are hard masses of bile salts, pigments, and cholesterol that develop within the
gallbladder. These solid masses form when the components of bile crystallize. Growing
slowly over many years as more crystallization occurs, gallstones may reach up to an inch
in diameter.

Most gallstones remain in the gallbladder and are harmless, but they can be pushed out of
the gallbladder along with bile and potentially block the neck of the gallbladder or one of
the bile ducts. Blockage of the gallbladder or cystic duct may result in cholecystitis, a
painful inflammation of the gallbladder. Even worse, blockage of the common bile duct
may result in jaundice and liver damage, while blockage of the ampulla of Vater can lead
to pancreatitis. Both liver damage and pancreatitis are potentially life-threatening
conditions.

Gallstones are most often treated by a cholecystectomy, the surgical removal of the
gallbladder.
Knowledge Review and Research
• What happens to the blood filtered by the liver?

• What happens to the toxins removed by the liver?

• List five most important functions of the bile:

1.

2.

3.

4.

5.

• Cirrhosis of the liver is associated with which strain of

hepatitis?

• What causes Gallstones?

The liver’s very important role is that of a detoxifier. It breaks down or makes less harmful
substances like ammonia, metabolic waste, drugs, alcohol and chemicals, and then makes sure they
are excreted from the system. Under a microscope, liver cells appear like a filter or sieve, through
which the blood stream flows.

The liver filter is designed to clean up the blood, by removing toxic matter such as dead
cells, microorganisms, chemicals, drugs and particulate debris from the blood stream. The
specialized cells known as Kupffer cells located in the liver ingest and break down toxins
and metabolic wastes.

The liver detoxification pathways

Phase One- conversion of toxic substances into components that can be excreted by the
body

There are a few main lines of defence the body puts up to protect itself from harm caused
by the ingested food:

• The mildly antiseptic environment of the mouth;

• The lymphatic system in the mucosal layer of the digestive tract;
• The acidic environment of the stomach;
• The liver filter and chemical reactions that take place in the liver.

External toxins that have not been neutralised by the mouth, the mucosa of the
oesophagus and the stomach acid, such as some harmful bacteria, parasites and
indigestible substances (chemicals and pesticides in food, for example) as well as
digestive end products that can be harmful (such as ammonia) can naturally enter the liver
and have to be removed from the body.
Putting it very simply, Phase One detoxification consists in turning a toxic component that
the body cannot excrete or eliminate into something that the body can work with and
eliminate during the second phase of liver detoxification. This is achieved by various
chemical reactions: oxidation, reduction and hydrolysis, for example.
Enzymes, that are catalysis of the digestive process, play a very active part in these
reactions.

The resulting compounds can sometimes be less harmful than the original substances, but
sometimes they are even more harmful and aggressive. If they cannot be excreted and
eliminated, they continue their travels around the blood system and poison internal organs.

That is why the Phase Two of liver detoxification is extremely important.

Phase Two – excretion from the body

The purpose of Phase Two liver detoxification is to make the harmful substances less
active and aggressive and excrete them from the body.

In a healthy body, both these objectives are achieved through a process called conjugation
(a kind of combination), whereby liver cells add another substance (e.g. cysteine, glycine
or a sulphur molecule) to a toxic chemical or drug, to render it less harmful. This also
makes the toxin or drug water-soluble, so it can then be excreted from the body through
the lymphatic system, urine, large intestine, respiration or perspiration.

Toxic Overload
If Phase Two of liver detoxification does not work properly, often as a result of poor diet
and inactivity, as well as stress, the body starts suffering from a condition that is often
described as toxic overload.

If the toxins stay in the system, they can become absorbed into organs where they can
stay for years. For example, fat-soluble toxins can penetrate the fatty organs and glands
such as the brain or the thyroid and other endocrine glands that have high fat contents.
This may cause:

Brain dysfunction an fuzziness;

Hormonal imbalances, such as infertility, breast pain, painful periods and early menopause
adrenal gland exhaustion, leading to dehydration and constipation;
Many types of cancer.

Temporary increases in the toxic load of the portal vein can be caused by poor diet and
airborne infections, such as the flu.

Dietary Guidelines for Promoting Daily Liver Detoxification

The nutritional regime that supports the liver should include:

Unrefined, unprocessed foods, as fresh as possible and in their natural state. Fresh
vegetables, fruits, whole grains and unrefined carbohydrates should make up the majority
of the diet;
Drink plenty of bottled water or diluted juice, at least two litres per day;
Red meats, animal fats, sugars and refined foods should be used in moderation;
Caffeine, other stimulants and alcohol should be also used in moderation.

Cleansing, including liver cleansing, gives many positive health benefits: higher levels of
energy, clear skin, vitality and a general feeling of well-being.
Knowledge Review and Research
1. Why is the liver called the great detoxifier?

2. Why do we need to support the liver?

3. How can colon hydrotherapy help detoxify the liver?

4. Why can the clients sometimes feel the toxic overload during the
colonic treatment?
THE NERVOUS SYSTEM IN THE LARGE INTESTINE
The gut is a sophisticated piece of equipment. You choose what to eat or drink and when
to do it. You chew (may be not as much as you should), and then you swallow the food.

Once you have swallowed the food, you have no idea at all what will happen to it over the
next 24 hours at least, until what used to be the food invites you to open your bowel some
9 m or so later. What you release has no resemblance to what you have taken in.

The substances that the gut decides to keep ends up being you: not only your face, hair,
nails, internal organs, but also your energy level, body weight and moods.
All this ambitious undertaking is run by the digestive system more or less on its own. To be
able to manage this complex operation, there must be a sophisticated nervous system in
the gut. And indeed, there is one.

Sympathetic and Parasympathetic Stimulation of the Digestive System

The ANS innervation (stimulation and relaxation) of the small and large intestines come
from the vagus nerve, which is more or less in charge of the parasympathetic nervous
system. The vagus nerve which meanders (“vagus” means “meandering” in Latin)
following the oesophagus down into the abdominal cavity, innervates the stomach, the
liver, the gall bladder, the small intestines, the kidneys, the pancreas and over half of the
large intestine (excluding some of the transverse, the descending colon, the sigmoid colon,
the rectum and the anus).

The final section of the transverse colon and the descending, sigmoid, rectum and anus
are stimulated by the pelvic splanchnic nerve.

The stimuli associated with the entry of food into the stomach are conveyed by afferent
fibres of the vagus nerve to the command station or nucleus of the vagus in the brain.
From there, messages are automatically conveyed through efferent fibres of the vagus
back to the stomach.

These stimulate the secretion of gastric juices and peristaltic contractions of the stomach
to mix the food with the secreted digestive juices and gradually to convey the gastric
contents into the intestines where a similar process is initiated through essentially the
same parasympathetic nerve pathways.

Fortunately, emptying of the rectum and of the urinary bladder is not entirely automatic but
is subject to parasympathetic impulses that are voluntarily controlled. Thus, filling of the
urinary bladder with urine stimulates stretch-sensitive receptors in the wall of the bladder
whence the message is conveyed to the midbrain where the stimulus to bladder
contraction and opening of the sphincters is voluntarily initiated to allow the discharge of
the contained urine.

In general, sympathetic stimulation causes inhibition of gastrointestinal secretion and

motor activity, and contraction of gastrointestinal sphincters and blood vessels. In other
words, when the rest of the body is in a “fight” mode, the gut is struggling.

That is why many people suffer from diarrhoea before an important meeting or an exam.
When the brain triggers the body’s fight or flight response, adrenaline is released, and the
body experiences a heightened awareness of surroundings. There are several changes in
the body, such as rapid respiration and increased muscle tension.
Systems that are not deemed essential for survival, such as the bowels, slow right down
and get a limited blood supply. In this situation, the bowel does what a good pilot would do
to save the passengers if the aircraft was in trouble: dump all fuel except for what is
required to try and get to base safely. In the context of saving a life, fuel is immaterial. This
is an example of how the brain can send signals to the digestive system, and the digestive
system will respond.

Conversely, parasympathetic stimuli typically encourage digestive activities. That is why

university students who suffer constipation or diarrhoea instantly get better when they go
back home even for a short break: they relax, it is their room, their toilet, and they can get
to the toilet when they want rather than when they can. Consequently stress has a direct
effect on digestive health.

The Enteric Nervous System – the Brain that Runs the Gut
However, people who have had vagus nerve surgically compromised still have a functional
digestive system. Formation of faeces continues in dead people even when the vagus
nerve is unable to send any signals to the digestive system from the brain because they
are both dead.

The digestive system is endowed with its own, local nervous system referred to as the
enteric or intrinsic nervous system. The magnitude and complexity of the enteric nervous
system is immense - it is said to contain as many neurons as the spinal cord.
The enteric nervous system, along with the sympathetic and parasympathetic nervous
systems, makes up the autonomic nervous system.

The principal components of the enteric nervous system are two networks or plexuses of
neurons, both of which are embedded in the wall of the digestive tract (previously covered)
and extend from oesophagus to anus:

The myenteric plexus is located between the longitudinal and circular layers of muscle in
the muscularis layer and, appropriately, exerts control primarily over digestive tract motility.
The submucous plexus, as its name implies, is buried in the submucosa. Its principal role
is in sensing the environment within the lumen, regulating gastrointestinal blood flow and
controlling epithelial cell function. In regions where these functions are minimal, such as
the oesophagus, the submucous plexus is sparse and may actually be missing in sections.

Within enteric plexuses are three types of neurons:

• Sensory neurons receive information from sensory receptors in the mucosa and
muscle. At least five different sensory receptors have been identified in the mucosa, which
respond to mechanical, thermal, osmotic and chemical stimuli. Chemoreceptors sensitive to
acid, glucose and amino acids enable the gut to “taste” the chyme that it is supplied and start
treating it correctly by “ordering” a take-away of the appropriate hormones and enzymes.
Sensory receptors in muscle respond to stretch and tension. Collectively, enteric sensory
neurons compile a comprehensive battery of information on gut contents and the state of the
gastrointestinal wall.
Motor neurons within the enteric plexuses control gastrointestinal motility and
secretion, and possibly absorption. In performing these functions, motor neurons
act directly on a large number of cells, including smooth muscle, secretory cells
(chief, parietal, mucous, enterocytes, pancreatic exocrine cells) and gastrointestinal
endocrine cells that release hormones in the blood. Collectively, motor neurons take
charge of bowel motility and the negotiations between the endocrine, the immune
and the digestive systems.
Interneurons are largely responsible for integrating information from sensory
neurons and providing it to (“programming”) enteric motor neurons.

Communication between the ENS and the brain

The enteric nervous system can and does function autonomously, but normal digestive function
requires communication links between this intrinsic system and the central nervous system. These
links take the form of parasympathetic and sympathetic fibres that connect either
The central and enteric nervous systems or connect the central nervous system directly with the
digestive tract. Through these cross connections, the gut can provide sensory information to the
CNS, and the CNS can affect gastrointestinal function.
So, what is the main purpose of communications between the ENS and the brain? In order
for the GI tract to function correctly, it still needs to receive communications from the brain:
for example, if you see your favourite food, your gut may react by suddenly making you
feels hungry. It is also easy to understand that historically this has been a very important
survival function.

The messages that the gut sends to the brain are also a part of survival: for example
letting the brain know through pain or a need to vomit, that poisons have been ingested, or
there has been an infection. The relationship of the brain and the ENS is very close during
the state of alert, and is virtually non-existent when crisis passes..
The ENS is, therefore, the brain of the digestive system, our “second brain”. May be, that
is why there are so many similarities, for example, between depression, stress, and IBS or
between emotional blockages and constipation.

The nervous system uses electrical impulses, which travel along the length of the cells.
The cell processes information from the sensory nerves and initiates an action within
milliseconds. These impulses travel at up to 250 miles per hour, while other systems such
as the endocrines may take many hours to respond with hormones.
Knowledge Review and Research
• Please explain the effects of sympathetic and parasympathetic
stimulation on the function of the large intestine.

• What is the enteric nervous system and where is it located?

• We say “butterflies in the stomach”, “gut feeling”, “and my

stomach turns when I think about ….” And so on. How can you explain the
origin of these sayings?

• Why is the bowel often described as ‘the second brain’?

The Functions of the Large Intestine
The major functions of the large intestine are:

Supporting and massaging the organs of the abdominal cavity;

Recycling water, electrolytes and nutrients back into circulation;
Producing serotonin, our mood-regulating neurotransmitter that also plays an important
role in digestion and absorption;
Producing vitamin K and some vitamins of the B group;
Producing stool-fermenting enzymes and fermenting wastes;
Storing and eliminating wastes;
Supporting the body’s immune system and organizing protection against pathogens by
hosting the bacterial population.

Gut bacteria and stools

The unique thing about the gastro-intestinal tract in general and the large intestine in
particular is that it serves as a host to numerous colonies of bacteria – there are between
200 and 500 species in total – and each colony plays an important part in absorption,
vitamin and enzyme production, stools formation and elimination.

Here are some pretty amazing facts that can be found on the website of the Society for
General Microbiology, www.microbiologyonline.org

‘There are more microbial cells in our bodies than there are human cells.

In fact 95% of all the cells in the body are bacteria, mainly living in the digestive tract.
There are more bacteria in the colon than the total number of people who have ever lived.

Everyone has about 1 kg in weight of bacteria in their gut. Each gram of faeces contains
100,000,000,000 microbes. Human adults excrete their own weight in faecal bacteria
every year.’

Our cooperation with the beneficial bacteria in our gut appears to be a result of billions of
years of evolution.

There is a lot of research on gut bacteria, showing that the lawful inhabitants of the large
intestine not only help eliminate wastes, but also act as the most effective immune barrier
for the whole body, destroy invading pathogens, manufacture vitamins, and provide the
body with other services that are only now coming to light.

Did you know?

Greater numbers of bacteria are found within the colonic lumen than elsewhere in the GI
tract. As many as 95% of these bacteria are anaerobes or facultative anaerobes (i.e. not
needing oxygen for survival). They digest a number of undigested food products normally
found in the water and nutrient mix delivered to the colon, such as complex sugars and
cellulose contained in dietary fibre.
The fermentation of these by bacteria results in:

Formation of short-chain fatty acids (SCFAs) butyrate, propionate and acetate. These
SCFAs are essential nutrient sources for colonic epithelium.
The process of fermentation in the caecum can provide, in addition, up to 500 cal/day of
overall nutritional needs. The SCFAs are passively and actively transported into the cell
where they become an important energy source for the cell through the ß-oxidation
pathway.
Fermentation of sugars by colonic bacteria is also an important source of colonic gases
such as hydrogen, methane and carbon dioxide. These gases, particularly methane,
largely account for the tendency of some stools to float in the toilet. Nitrogen gas, which
diffuses into the colon from the plasma, is the predominant gas.
Overdose of undigested complex carbohydrates containing insoluble fibres, such as
beans, or inability of the body to digest simple sugars such as lactose may cause
overproduction of colonic gases, abdominal bloating and increased flatus.
When bile salts in long-chain fatty acids are malabsorbed in sufficient quantities, their
digestion by colonic bacteria generates potent hormones and other agents stimulating
secretion from cells (secretagogues) causing diarrhoea.

What’s in the stools?

As colon bacteria ferment starches, this process releases gases such as hydrogen, carbon
dioxide and methane. They also help to convert any protein leftovers into amino acids
through the process known as roptein putrefaction. These products are then converted to
indoles and hydrogen sulphide, which give the faeces its odour. Bilirubin, which entered
the intestine in the bile, is broken down into other pigments by bacteria and is responsible
for the rusty-brown colour of the stools.

Toxins (indol, skatol, cresol, phenol and others) that are released in the process of stool
formation are treated by the liver and excreted by the kidneys. Hydrogen and methane
gases absorbed in the colon are excreted through the lungs.

That is why bad breath can be a very clear indication of the poor works of the digestive
system.
Knowledge Review and Research
1. What are the major functions of the large intestine?

2. Is having bacteria in the gut a good thing? What role do they play?

3. What toxins are released in the process of stool formation? What

should happen to them afterwards?

4. What gives the stools their smell and colour?

5. In what way does bad breath relate to bad digestion?

ABSORPTION AND TRANSPORT OF NUTRIENTS: OVERVIEW
Digested molecules of food, as well as water and minerals from the diet, are absorbed
from the cavity of the upper small intestine. Most absorbed materials cross the mucosa
into the blood and are carried off in the bloodstream to other parts of the body for storage
or further chemical change. As you would have already noted, this part of the process
varies with different types of nutrients.

Carbohydrates. It is recommended that about 55 to 60 percent of total daily

calories be from carbohydrates. Some of our most common foods contain mostly
carbohydrates. Examples are bread, potatoes, legumes, rice, spaghetti, fruits, and
vegetables. Many of these foods contain both starch and fibre.

The digestible carbohydrates are broken into simpler molecules by enzymes in the
saliva, in juice produced by the pancreas, and in the lining of the small intestine. Starch is
digested in two steps: First, amylase, an enzyme in the saliva and pancreatic juice breaks the
starch into molecules called maltose; then an enzyme in the lining of the small intestine
(maltase) splits the maltose into glucose molecules that can be absorbed into the blood.
Glucose is carried through the bloodstream to the liver, where it is stored or used to provide
energy for the work of the body.

Table sugar is another carbohydrate that must be digested to be useful.

Sucrase, an enzyme in the lining of the small intestine digests table sugar into
glucose and fructose, each of which can be absorbed from the intestinal cavity into
the blood. Milk contains yet another type of sugar, lactose, which is changed into
absorbable molecules by an enzyme called lactase, also found in the intestinal
lining.

Protein. Foods such as meat, eggs, and beans consist of giant molecules of protein
that must be digested by enzymes before they can be used to build and repair body
tissues. Pepsin, an enzyme in the juice of the stomach starts the digestion of
swallowed protein. Further digestion of the protein is completed in the small
intestine. Here, several enzymes from the pancreatic juice and the lining of the
intestine carry out the breakdown of huge protein molecules into small molecules
called amino acids. These small molecules can be absorbed from the hollow of the
small intestine into the blood and then be carried to all parts of the body to build the
walls and other parts of cells.

Fats. Fat molecules are a rich source of energy for the body. The first step in
digestion of a fat such as butter is to dissolve it into the watery content of the
intestinal cavity. The bile acids produced by the liver act as natural detergents to
dissolve fat in water and allow the enzymes to break the large fat molecules into
smaller molecules, some of which are fatty acids and cholesterol. The bile acids
combine with the fatty acids and cholesterol and help these molecules to move into
the cells of the mucosa. In these cells the small molecules are formed back into
large molecules, most of which pass into vessels (called lymphatic’s) near the
intestine. These small vessels carry the reformed fat to the veins of the chest, and
the blood carries the fat to storage depots in different parts of the body.
Vitamins. Another vital part of our food that is absorbed from the small intestine is
the class of chemicals we call vitamins. The two different types of vitamins are
classified by the fluid in which they can be dissolved: water-soluble vitamins (all the
B vitamins and vitamin C) and fat-soluble vitamins (vitamins A, D, and K).
Water and salt. Most of the material absorbed from the cavity of the small intestine
is water in which salt is dissolved. The salt and water come from the food and liquid
we swallow and the juices secreted by the many digestive glands.
INTESTINAL FLORA

The gastro intestinal tract contains 500 different species of bacteria, which are essential
for a strong immune system.

There needs to be a balance of both good and bad bacteria, the ratio of 80% good and
20% bad is considered to be healthy.

When this balance is disrupted a condition called Dysbosis can manifest.

Causes of Dysbosis

The major factors of dysbosis are

• Stress
• Chemical exposure
• Anti-biotics
• Contraceptive Pill

To correct dysbosis:

• To rectify an imbalance of intestinal flora

• Avoid were possible the use of anti-biotics, steroids, antacids,
immunosuppressive and oral contraceptives
• Kill the yeast/fungus with diet
• Kill Parasites
• Establish good bacteria in the body
• Support the immune system with nutrients

The pro-biotic originates from a Greek word meaning ‘For Life’ they are beneficial and
necessary for life. They consist of a spectrum of bacteria made up of:

• Resident Strains – found in the human tract ie. Lactobacillus,

acidophilus, Bifidobacterium
• Transient Strains – consumed in foods such as bio yoghurts –
Lactobacillus casei, Lactobacillus, bulgarius or streptococcus thermophillus.

These strains do not flourish in the gastrointestinal tract but are beneficial as they pass
through.

Pro-Biotic

Is a living micro-organism that promotes health and intestinal function.

Pro-Biotic Dietary

A non-digestible food ingredient that stimulates the host to activate and produce bacteria in
the colon, it reaches the colon in an intact form where it metabolises beneficial bacteria not
harmful bacteria.

The majority of companies that market pro-biotics do not in fact manufacture them, they
obtrain their individual formulas from a few independent suppliers who cultivate and
package the pro-biotic.

Companies select formulas which meet their own individual markets.

The majority of studies which have been published, concentrate on cultures from the
Lactobacillus or bifidobaceria groups. This is due to them having no pathogenic specifics,
which makes them the safest.

The majority of pro-biotics consist of multiple species form either the Lactobaclli or
bifidobacteria families. In the Lactobaclli species are both resident and transient (L-Casei).
Whilst both are beneficial resident species offer the greater benefits of establishing in the
digestive tract whilst working with and being less antagonistic to other resident strains.

Using a product that has a multiple strain of resident Lactobacilli and bifidobacteria species
to rebuild and maintain the intestinal of need.

Pro-biotics are measured in either the number of organisms per capsule, per tablet or per
gram. High potencies contain 2-4 billion. It is important to check the expiry date.

Storage

The majority of pro-biotics especially Lactobacillus acidophilus and bifid bacterium does
not survive long periods at room temperature, however, some can ie. Streptocuccus
faecium. The problem is that manufacturers mix the species in the same formula.

If pro-biotics that require refridgeration are placed on shelves for months they will loose
their potency. All pro-biotics are better kept in the fridge, ideally non-refrigerated should be
formulated with other non-refrigerated species.

Pre-biotics

Research claims that the use of pre-biotics promotes the level of beneficial bacterica,
Fructo-oligosaccharide (FOS) are added to many pro-biotics formulas which are
significantly shown to enhance the intestinal levels of beneficial pro-biotics. A formula that
contains a multiple resident pro-biotic (Lactobacillus and Bifid bacterium) along with a pre-
biotic FOS is most beneficial.

Whilst some practitioners advocate taking the pro-biotic with meals to aid digestion it is
also recommended by others that taking a pro-biotic between meals is more beneficial as
the stomach acid is at its lowest.

Pro-biotics taken once or twice a day with a large glass of water between meals ensure
that it is delivered faster and in higher concentrates. As a maintenance dose two to four
billion is recommended, for more specific health problems ten to fifteen cultures once or
twice a day may be required.

A balanced intestinal environment is a vital component in achieving optimal health by

ensuring that all body systems work in harmony with each other. Pre-biotics, pro-biotics,
enzymes and amino acid compounds can all promote and enhance a healthy intestinal
eco-system and extend longevity.

Lactobacillus Acidophilus

This bacteria inhabits the small intestine, colon, mouth and vagina. It is a natural bacteria
found also in animals. It grows in the presence and absence of air (anaerobic). It
produces lactic acid from carbohydrates and flourishes at 95-100 degrees.

Major Functions:

Produces lactase which is needed to digest milk, sugar (Lactose), also aids in the
digestion of nutrients.

• Suppresses harmful micro-organisms due to the latic acid and other

inhibitory substances along with producing natural anti-biotic substances.
• Some strains lower the level of blood cholesterol
• Actively reduces hostile yeast ie. Candida Albicans
• Reverses the negative effects of anti-biotics, which disturb the natural
flora of the gastro-intestinal tract.
• Regular use is an active measure in ensuring against an imbalance of
the intestinal flora.

Bifidobacterium Bifidum

It is found in large numbers in the colon and human vagina, a natural inhabitant it is the
major component in adolescences and adults. Bifidobacterium accounts for 99% of the
organisms in breast-fed babies.

The level of Bifidobacterium declines with age and in cases of chronic illnesses. The
bacteria produces both acetic acid and lactic acid from fermentable carbohydrates, the
anaerobic bacteria thrives at temperatures of 98-105 degrees.

Major Functions:

Prevents yeast and pathogenic bacteria from multiplying, they compete for nutrients and
attachment sites.

• Produces acetic and latic acid, it lowers PH of the intestines, which

creates an environment hostile to invading bacteria.
• Promotes nitrogen retention and weight gain in infants.
• Promotes the production of B Vitamins
• Reduces bacteria, which alter the nitrates in the intestines into
potentially harmful nitrates.
• Promotes dietary management of liver conditions. When the intestinal
micro flora is disturbed resulting in a decline in Bifidobacterium as a result of oral
anti-biotics, irritations of the abdomen, reduced gastic acidity, poor intestinal motility
and stress.
Taking Bifidobacterium can help restore the intestinal flora.

Lactobacillus Salivarius

It is a natural resident bacteria found in the human intestines and mouth. They are
facultative anaerobic lactobacilli that produce lactic acid from carbohydrates creating a
more acidic environment which less desirable micro-organisms are inhibited.

Bifidobacterium Infantis

They a natural inhabitant of the intestines of human infants, with small numbers in the
human vagina. Anaerobic bacteria, which produces acetic and lactic acid plus a small
amount of formic acid. Major benefits are similar to those of Bifidobacteriu Bifdidum.

In infants when the micro-flora is disturbed due to changes in nutrition, anti-biotics,

vaccinations or sudden weather changes, the administration of Bifid bacterium
supplements or bifid bacterium in food products can help restore the impaired intestinal
micro flora.

Bifid bacterium Longum

A natural inhabitant of human intestines found in the faeces of human children and
adults along with bacterium bifidus and bacterium longum they are predominant
bacteria in the infant colon. A biotype of Bifido longum is located in adolescence and
adults.

Anaerobic in nature producing acetic acid, lactic acid and fromic acid from
carbohydrates fermenting a wide range of carbohydrates compared with B Bidi. Main
functions are similar to Bifido bacterium bifidum.

A pro-biotic formula should contain the resident strains of lactobacillus acidophilus,

Bifid bacterium and bifid bacterium infantis.

Once bad bacteria have been eliminated good bacteria must be replaced. They should
be taken in supplement form with at least four to six billion cultures or capsule essential
during the healing process and following anti-biotic therapy.

Friendly Bacteria is needed to help the following:

• Reduce cholesterol in the blood

• Produce certain digestive enzymes that help to digest proteins,
carbohydrates and fats.
• Help control the acid – alkaline levels (pH) in the intestines
• Reduce unhealthy bacteria and yeast in the intestinal tract
• Reduce high blood pressure
• Detoxify poisonous material in the diet
• Assist the immune system
• Help with elimination of ailments such as colon irritation, constipation,
diarrhoea, irritable bowel syndrome and acne.
• Manufacture as assimilate B-complex vitamins, especially B-12
• Produce natural anti-bacterial agents (anti-biotics) which inhibits 23
known pathogens
• Produce cancer suppressing compounds
• Detoxify hazardous chemicals added to food and drugs
• Help calcium assimilation
• Help eliminate bad bread and gas
 Knowledge Review and Research
1. What is the main mechanism of carbohydrate absorption?

2. Why do we need to eat fibre?

3. What is the process of breaking down foods called?

DISEASES OF THE COLON AND CONDITIONS AFFECTING THE
DIGESTIVE PROCESSES

Diseases and disorders of the large intestine can be divided into several main groups:

structural diseases, meaning that one or more layers of the bowel are damaged
(inflamed, have abnormal tissue growth, perforated and so on);
structural disorders, meaning that a section of the bowel is misplaced in some way or
the structure of the bowel tissue is damaged (for example adhesions);
functional disorders or syndromes that are characterized by negative developments in
the bowel function resulting in constipation, diarrhoea and IBS symptoms.

These are very broad categories, and sometimes the borders between them are not easily
defined.

Points to remember:

ANYTHING THAT ENDS IN “OSIS” IS A CHRONIC CONDITION AND IN THE

MAJORITY OF CASES IS NOT A CONTRAINDICATION FOR COLONICS;

ANYTHING THAT ENDS IN “ITIS” IS AN ACUTE INFLAMMATION (DISEASE) AND IS

IN THE MAJORITY OF CASES IS A CONTRAINDICATION FOR ANY BODYWORK
INCLUDING COLONICS;

IF IN DOUBT, ASK FOR HELP OR LEAVE IT OUT.

Discussion of the Diseases, Disorders, Conditions and Syndromes

of the Colon
When reviewing the information below, ask yourself: Is it a disease, disorder, or a
syndrome? What could help – a colonic session? bodywork therapy?, a visit to a doctor?,
a book on health?, a change in diet, exercise, energy work? herbs or supplements? a
complete change in lifestyle?

Remember, there is always more than one way to help our clients improve their
wellbeing. COLON HYDROTHERAPY IS NOT A CURE ALL TREATMENT

Are these conditions affected by colon hydrotherapy, and if they are, in what way? How
does the presence of these conditions affect our ability to administer colon hydrotherapy
and treatment protocols?

• Adhesions - Adhesions are fibrous bands of scar tissue, which

can loop over a portion of bowel or attach two sections of the bowel to each
other and mechanically obstruct the lumen of the bowel. They are very
common and can be caused by surgeries (appendectomies, Caesareans etc.).
Can cause constipation and weaken the immune system of the bowel.
 • Anorectal Abscess - Rectal abscesses form in several positions.
Many of the abscesses begin as Cryptitis, with the formation of cysts and
extend into the sub-mucosal spaces.

• Appendicitis

Inflammation of the appendix is usually acute and requires appendectomy –

removal of the appendix. Several causes for appendicitis have been noted. A ball of
stool (fecolith) may obstruct the lumen of the appendix causing its inflammation.
The presence of adhesions (fibrous bands of tissue – see above) may also cause
appendicitis. Appendectomies, usually performed as emergency interventions, may
result in more adhesions, impaired bowel motility, slowing down or transit time and
constipation.

• Atonic Colon - This condition is commonly known as Lazy Bowel.

It is characterized by abnormally low muscle tone or strength in the colon. It
may be caused by the overuse of laxatives, dietary imbalances or by
Hirschsprung’s disease. It usually results in chronic atonic constipation.

• Cancers and Benign Tumours - Both benign and malignant tumours

may occur in all portions of the bowel. However malignant tumours (cancers)
are more common in the large intestine than in the small intestine.

In both men and women cancer of the colon and rectum is the second most
frequent cause of death from cancer. There has been a 30% drop over the past 20
years due to better treatment of the disease along with earlier detection.

Males and females are affected in equal numbers. However, statistically cancer of
the colon is more common in women whereas cancer of the rectum is more
common in men.

Risk factors for the cancers of the colon and rectum are high-fat and high-protein
diets; high alcohol intake; smoking: diets high in processed foods; constipation,
heredity factors, sedentary lifestyle, and obesity.

• Candidiasis - Candidiasis is an infection caused by Candida fungi,

especially Candida albicans. These fungi are found almost everywhere in the
environment. Some may live harmlessly along with the abundant “native”
species of bacteria that normally colonize the mouth, gastrointestinal tract
and vagina.

Usually, Candida is kept under control by the native bacteria and by the body’s
immune defences. If the native bacteria are decreased by antibiotics or if the
person’s immune system is weakened by illness (especially AIDS or diabetes),
malnutrition, or certain medications (corticosteroids or anticancer drugs), Candida
fungi can multiply to cause symptoms that include:

• Tiredness
• Irritability
• Digestive pain
• Gas
• Thrush
• Headaches
• Cravings and many others

Candida infections can cause occasional symptoms in healthy people. Candidiasis

can affect many parts of the body, causing localized infections or larger illness,
depending on the person and his or her general health.

• Coeliac Disease - Coeliac disease is a digestive disease that

damages the small intestine and interferes with absorption of nutrients from
food. People who have coeliac disease cannot tolerate a protein called gluten,
found in wheat, rye, and barley. Gluten is found mainly in foods, but is also
found in products we use every day, such as stamp and envelope adhesive,
medicines, and vitamins.

When people with coeliac disease eat foods or use products containing gluten, their
immune system responds by damaging the small intestine. The tiny, fingerlike villi -
protrusions lining the small intestine - are damaged or destroyed. Normally, villi
would allow nutrients from food to be absorbed into the bloodstream. Without
healthy villi, a person becomes malnourished, regardless of the quantity or quality
of food eaten. Therefore sometimes food, even though digested, is not properly
absorbed.

Because the body’s own immune system causes the damage, coeliac disease is
considered an autoimmune disorder. However, it is also classified as a disease of
malabsorption because nutrients are not absorbed. Coeliac disease is also known
as coeliac sprue, nontropical sprue, and gluten-sensitive enteropathy.

Coeliac disease is a genetic disease, meaning it runs in families. Sometimes the

disease is triggered or becomes active for the first time-after surgery, pregnancy,
childbirth, viral infection, or severe emotional stress

• Constipation - Constipation is defined as the difficult or infrequent

passage of faeces and is associated with the presence of dry, hardened
stools. The condition of constipation may lead to increased toxicity of blood
and deposits of toxins in internal organs, sometimes described as intestinal
toxaemia. It is caused by the absorption of bacteria or their toxins,
respectively, through the intestinal wall.

It is well known that chronic constipation also creates conditions for the
development of cancer. Many digestive problems are usually accompanied by
constipation.

Constipation may be causes by a number of factors: heredity; aversion to public

toilets; low-fibre diet; high-protein diet; dehydration; malnutrition, enzyme deficiency,
lack of exercise, and irregular eating patterns.

Constipation is one of the first signs indicating to us that our bowels are not
functioning properly. When a person is constipated, the walls of the colon are often
impacted with accumulated faecal matter. The inner diameter of the colon is
reduced like a water pipe with a build-up of mineral deposits. Eventually the
opening becomes narrower making it more difficult for wastes to pass.

Since the encrusted faeces line the colon wall, the colon is unable to absorb
nutrients from our food. Wastes from the blood, which should normally be drawn
into the colon through the colon walls, are reabsorbed by the body along with other
toxins resulting from the fermentation and putrefaction of incompletely digested
food.

Subsequently, intestinal stasis often follows which occurs when the muscular
contractions know, as peristalsis can no longer sweep the hardened faeces along
the digestive canal.

• Constricted Colon - Constricted colon or bowel is the bowel that is

partially blocked, thus restricting the movement of wastes through it. A lot of
the time it is caused by constipation.

A person can have several bowel movements a day and still be constipated. This is
because movements are usually smaller and occur more frequently when the inner
diameter of the colon is smaller than it should be.

The body’s reaction to such constricted bowel is a stepping up of the frequency of

peristalsis (wave action) to allow the waste to exit the body. Taken to its limit, the
effect can be diarrhoea, which occurs when the large intestine hastens evacuation
to the point where the bowel doesn’t have time to remove the water and consolidate
the waste into solid stool.

• Crohn’s Disease (Regional Enteritis) - An inflammatory disease,

which usually affects the lower ileum but may involve other parts of the
gastrointestinal tract. In 50% of cases – disease begins between ages 20-30.
The cause is unknown and incidence is equal in males and females, but the
disease is more common in Jews. The administration of oxygen by
prescription may be helpful as an anti-inflammatory and healing agent.

• Сryptitis - When particles of stool become lodged in one of the

anal crypts and decay, they cause a pocket of infection known as Cryptitis.
 • Diarrhoea - Diarrhoea is the passing of increased amounts (more
than 300g in 24 hours) of loose stools. It can be acute (short term) or chronic
(long term) - lasting more than two to three weeks.

Globally, seven children die of diarrhoea every minute, mainly due to poor quality
drinking water and malnutrition, which still affects the majority of the world
population. Diarrhoea is mainly caused by bacterial and viral infections and food
poisoning.

Diarrhoea can also be caused by bacteria or viruses that have been transmitted
from person to person. It occurs when the micro-organisms irritate the mucous
membrane of the small or large intestine resulting in an abnormally large quantity of
water in the motions. The irritated gut becomes very active, contracting excessively
and irregularly (colic). This can be accompanied by nausea, vomiting, and cold
sweats. In some cases the motions may include some blood.

• Diverticulosis / Diverticulitis - A diverticulum is an out-pouching of

the mucosa and may or may not be covered by muscular tissue. Diverticula
can occur at any point in the gastrointestinal tract, but are most common in
the sigmoid region of the colon. Most colon diverticula are acquired and
caused by increased pressure inside the bowel, which causes its tissue to
bulge out between the muscle fibres.
The presence of diverticula is referred to as diverticulosis. A diverticulum is no
problem to the patient unless complications develop. Complications are
perforations, haemorrhage, and inflammation, which are referred to as diverticulitis.

It is generally accepted that problems associated with diverticulosis and diverticulitis

are rooted in today’s common diet. Most diets consist of highly refined and
processed foods, which have a tendency to “slow the flow.” For our bodies to mimic
a gently flowing stream, a crucial factor is transit time—the time that lapses
between eating a food and the elimination of its waste products. If transit time is
prolonged, harmful toxins will form. Faecal matter is not successfully evacuated and
remnants collect and hardened on the walls of the colon.

Over a period of time the inside diameter of the colon becomes smaller. Greater effort is
now required by the colon’s circular muscles to move this compacted waste material. This
internal pressure causes small pockets, called diverticula, to develop along the colon.
Eventually these pockets become infected so that diverticulitis is present. This condition
includes possible internal bleeding and tissue breakdown, and is very serious indeed.

Dysbiosis - Dysbiosis is a state of imbalance of intestinal flora that is harmful to the

host. It usually means that there is an overgrowth in the intestinal tract of
pathogenic organisms, such as

Yeasts
harmful bacteria
viruses
fungi
parasites.

Dysbiosis causes tiredness; it also alters the immune system and upsets the
hormonal balance. Dysbiosis can even make it difficult to think clearly. Dysbiosis is
known to cause anxiety, depression or mood swings. Dysbiosis can affect almost
every aspect of health. If you have dysbiosis, then you are likely to suffer from
fatigue, headaches, intestinal upsets, and many of the symptoms normally
attributed to Candida.

Haemorrhoids - Haemorrhoids are a common affliction of mankind and a result of

our upright position and the pressure it causes on the anorectal veins. According to
some authorities, one third, if not more, of all adults have haemorrhoids in one form
or another. They are most common during the active years of adulthood from 20-50
years.

Haemorrhoids are swellings or dilatation of the veins in the anus; actually varicose
veins at the lower end of the large bowel or rectum. Basically, there are two kinds -
internal and external haemorrhoids. When complications arise, they may be quite
painful and may rupture, causing bleeding.

In many cases, however, the person is not aware of having them if they are not
exhibiting any symptoms. It’s long been known that constipation causes, and makes
worse, haemorrhoids. In most cases the mechanism for the haemorrhoid problem is
the same as that for varicosities.

A dry, hard, compacted stool causes considerable strain for evacuation. This strain
causes increased pressure in the veins, resulting in a ballooning out and breakdown
of the vein wall. An acute case of diarrhoea can bring on an attack of complicated
haemorrhoids. Inability to relax the muscles in the anus may also bring them on,
and this, in turn, may well be caused by poor eating habits.

Herniations - The definition of a hernia is a protrusion of an internal organ from its

normal cavity through an opening in a different organ or muscle that may cause an
obstruction. Hernias may penetrate through any defect in the abdominal wall,
through the diaphragm, or some internal structure within the abdominal cavity. The
potential for obstruction is always present in any hernia. A strangulated hernia is a
compromise of the blood supply to the bowel.

Intestinal Dysenteries - These conditions are manifested by intense diarrhoea and

abdominal cramping. Varying amounts of blood may be present in the stool and the
patient may have a mild to severe temperature elevation. Most dysentery is caused
by amoebic and bacterial organisms such as entamoeba histolytica and shigella
bacilli. Cholera also causes dysentery-like symptoms

Intestinal Obstruction - Intestinal obstruction is any obstacle to the forward flow of

the intestinal content, whether by partial or complete blockage or by a reversal of
flow. It can be caused by mechanical, vascular or nervous disorders.

Intestinal Parasitic Infections - According to the World Health Organization, 3.5

billion people suffer from some type of parasitic infection. Not all of these people
live in third world countries; many in the developed world have any number of
parasitic infections, some of which are so highly contagious that extremely casual
contact with something that has been handled by an infected person can infect
another person.

A variety of species of parasitic worms may invade the intestinal tract. The
most common are the ascaris (round worms), the enterobius (pin worms), the
trichinella spiralis (causes trichinosis) and various species of tapeworms. These
parasites are found in all parts of the world.

Acute parasite infection is usually characterized by greater or lesser

abdominal distress and diarrhoea, often urgent and attended by burning sensations
and tremendous fluid loss.

Once a condition has moved from acute to chronic, there may be alternating
periods of constipation and diarrhoea, abdominal distention and bloating, intestinal
cramping followed by burning sensations and the sudden urge to eliminate.
Generally, there is malabsorption of nutrients, especially fatty foods. Irritable bowel
syndrome, blood sugar fluctuations, sudden food cravings, and extreme emaciation
or being overweight are all possible symptoms of a possible parasitic infection.

Intussusception - This is a telescoping of the bowel upon itself and is most

common in infants, occurring at the ileo-caecal junction, with the small bowel
telescoping inside the large bowel.

Irritable Bowel Syndrome (IBS) - An irritable colon is a chronic non-infectious

irritation that is thought to be caused by increased spasticity of the colon. It can be
manifested in frequent liquid stools, small hard stools and abdominal cramps. The
condition often occurs in people who are under stress, tense, anxious and
emotionally unstable.

IBS is not a disease. It’s a functional disorder, which means that the bowel doesn’t
work, as it should.

With IBS, the nerves and muscles in the bowel are extra-sensitive. For example, the
muscles may contract too much when you eat. These contractions can cause
cramping and diarrhoea during or shortly after a meal. Or the nerves can be overly
sensitive to the stretching of the bowel (because of gas, for example). Cramping or
pain can result.

Foods that tend to cause symptoms include milk products, chocolate, alcohol,
caffeine, carbonated drinks, and fatty foods. In some cases, simply eating a large
meal will trigger symptoms.

Women with IBS often have more symptoms during their menstrual periods.

Megacolon - Megacolon is an abnormal dilatation of the colon (a part of the large

intestines) that is not caused by mechanical obstruction. The dilatation is often
accompanied by a paralysis of the peristaltic movements of the bowel, resulting in
chronic constipation. In more extreme cases, the faeces consolidate into hard
masses inside the colon, called faecalomas (literally, faeces tumour), which require
surgery to be removed.

A human colon is considered abnormally enlarged if it has a diameter greater than

12 cm in the cecum, greater than 6.5 cm in the rectosigmoid region and greater
than 8 cm for the ascending colon.

Peritonitis - The peritoneum lines the organs in the abdominal cavity. The
peritoneum is able to produce an inflammatory reaction and wall off a localized
 infection. However, a gastric ulcer that continues to drain into the abdominal cavity
will overcome the ability of the peritoneum to ward off the infection. Generalized
abdominal inflammation and pain will develop as a result. Peritonitis can sometimes
accompany appendicitis and can be fatal.

Pilonidal Cyst - A pilonidal cyst (from Latin meaning ‘hair nest’) is a blanket term for
any type of skin infection near the tailbone. These are normally quite painful, occur
somewhat more often in men than in women, and normally happen in early
adulthood. Although usually found near the tailbone, this painful condition can be
found in several places, including the navel or the armpit.

It usually happens in young people, up to their thirties in age. Conditions in which it

commonly occurs include obesity, body hair around the area in question, and a
sedentary lifestyle. While a traumatic event is not believed to cause a pilonidal cyst,
such an event has been known to inflame existing cysts.

Prolapsed Colon
Rectal Fissure

This is an ulceration of the skin of the anal canal that is actually a longitudinal crack
in the skin. An acute fissure occurs as a result of stretching of the tissue and
possibly from the trauma of a hard or large stool passing through the area.

Rectal Fistula - A fistula is a sinus tract (link) that develops between two body
cavities or between a body cavity and the outside. A rectal fistula is a tract that goes
from the anal canal to the skin outside the anus or from an abscess to either the
anal canal or the perianal area.

Spastic Colon - Spastic colon is another term often used as a term for irritable
bowel syndrome (IBS), a common disorder in which the bowel doesn’t work, as it
should. It is often associated with an increase in spontaneous movement or
contractions (motility) of muscles in the small and large intestines. Signs and
symptoms include:

Abdominal pain
Abdominal cramping
Changes in bowel function, such as diarrhoea or constipation
 Ulcerative Colitis

Ulcerative colitis is an inflammatory disease of unknown cause characterized by

passage of blood and mucous stools. Disease may occur at any age but most
frequently attacks young adults 20 – 40. The administration of oxygen by
prescription may be helpful as an anti-inflammatory and healing agent.

Ulcerative colitis involves the mucosa and submucosa of the colon and consists of
congestion, oedema, and ulcerations, which may develop into abscesses. The
oedema may lead to extreme dryness and fragility of the mucosa. The general
manifestations of this disease are frequent stools that contain pus, blood, and
mucus and may present liquid faeces, weight loss, anorexia, and an intermittent
mild fever.

Volvulus

A Volvulus is a twisting of the bowel about a focus in the abdominal cavity. It can
occur in either the large or small bowel and sometimes is spontaneously relieved.
Normal and Abnormal Colons

Ballooned Sigmoid

Ballooning of the colon occurs as a consequence of backup faeces. For various reasons,
faeces can accumulate and stretch the bowel wall to enormous proportions. This often
occurs in the sigmoid colon as a result a narrowing of the bowel lumen below the
ballooning. This narrowing can be caused by adhesions, spasm or colic conditions. When
this occurs, constipation can become quiet severe and painful and has damaging effects
upon the bowel structure.

Prolapsus of the Colon and with pressure on the organs

All organs above and below the transverse colon will be effected. Pressure on the
Fallopian tubes or ovaries can lead to infertility. Pressure is put on the uterus or prostate
gland which can cause urination difficulties and fluid retention, urine can be re-absorbed
back into the body instigating arthritic and joint problems. Problems with constipation will
be experienced due to the flexions of the colon doubling over the bowel and haemorrhoids
are also linked to the prolapse of the transverse colon.
Spasm of the Colon

A spastic bowel is often associated with colitis. Like any muscle, when the bowel muscle
is overworked tense, and not given an opportunity to rest, it will go into spasm. Muscle
spasm is a chronic tightening of the fibres due to hyperactivity in the nerve impulses
controlling the muscle action. The symptoms frequently manifest as constipation,
alternating with diarrhoea. Mental and emotional stress are high on list of contributing
factors, coupled with chronic toxaemia and poor diet.

Stricture of the Colon

A stricture of the colon normally occurs after an inflammatory disease such as colitis has
damaged the tissue. It is a chronic narrowing of the passage way that results in a backup
of faeces that are unable to pass through. The faeces accumulate in front of the stricture
causing ballooning while the segment just past the stricture collapses.

Diverticular

Diverticular disease of the colon is occurring at an ever increasing rate. It is a serious

bowel disturbance leading to many difficulties and must be avoided. When the diet is
lacking in bulk or fibre, the colonic muscle must work extremely hard to force faeces
through the organ. When there is a weakness in muscle fibres, a small pouch of sac-like
protrudence in the tissue is produced in the colon wall. It looks like a blister on side of tyre
where the air is forcing its way to the surface through a weak spot in the tyre wall.

Colitis

Colitis is an irritable bowel condition that is highly associated with psychological distress.
Few people truly realise the benefits of a calm and peaceful lifestyle. They are often
unaware of the minds ability to sink into the body’s functioning ability and upset normal
tissue activities. Fear, anger, depression, tension, worries and obsessions can all upset
delicate process’s in the body and in particular those of our digestion and elimination.

Pictures reproduced with permission of Bernard Jensen DC, PdD from his book Tissue Cleansing through
Bowel Management 1981
Knowledge Review and Research
• What is the difference between a fistula and a fissure?

• What are the two types of haemorrhoids? Is it always safe to treat

a patient with them?

• What is the difference between diverticulosis and diverticulitis?

• What is IBS? How is stress related to IBS?

• What are the most common parasites found in humans?

What are Faeces?

How much should we eliminate?

Bowel eliminations have been subject of debate and confusion for many years.
The mainstream medicine camp says that you go when you go; if you don’t go; don’t worry
too much about it. The alternative view is that you need to go after every meal.

One extreme
On the one hand, Encyclopaedia Britannica states in one of its articles that there is nothing
wrong with constipation and that faeces have been proven to stay in the bowel for over a
year without any harmful effects on the bowel’s owner:

‘Faeces are normally removed from the body one or two times daily. They may become
impacted as a result of growths in the rectum, obstructions in the colon, deficiencies in
diet, or constipation. Autointoxication, or poisoning by toxins produced by stored faecal
material, is a myth. Several cases have been reported in which faecal material has been
retained in the intestine for a year or more without suffering any bad effects other than
extra burden of carrying 25 to 45 kilograms of faecal material’ (15th Edition, Volume 4,
Page 710).

The other extreme

On the other hand we know the opinion of famous 20th century naturopaths Dr Jensen
and Dr Kellogg, who spent decades of their professional careers saying that if you don’t
eliminate your wastes daily and preferably 2 or 3 times a day, you are in danger of
suffering from major degenerative diseases.

They have said that health is virtually stored in the colon, and, consequently, disease also
begins in the colon. Dr Bernard Jensen, in his ‘Guide to better bowel care’ stated that:

‘Constipation is often referred to by those who have studied it as ‘the modern plague’.
Indeed, I consider it the greatest present-day internal danger to health. Intestinal
toxaemia and autointoxication are direct result of intestinal constipation. Constipation
contributes to the lowering of the body’s resistance, predisposing the body to many
acute illnesses and the initiation of many degenerative and chronic processes.
Constipation indirectly cripples and kills more people in our country than almost any
other single disease condition having to do with deficient function’. (Avery, 1999, p.46)

What’s in the faeces?

Faeces are comprised of:

• Soluble and all of the insoluble fibre, which serves as a cleansing

agent for the body;
• Indigestible components of proteins and fats that the body is unable to
use for any reason;
• the agents that one is intolerant of, or allergic to;
• Dead stomach cells that are renewed every 4 days;
• Cells of the small intestine that are also renewed every 4 days;
• Cells of the large intestine that are replaced every 5 to 7 days;
 • Decommissioned red blood cells that have a life span of 120 days.
After they die, they are converted into bilirubin (the main component of bile that
breaks up fats) and then eventually into stercobilinogen, which gives the faeces
their characteristic rusty-brown colour;
• Dead bowel flora, parasites and other gut buddies that make their
home in the large intestine.

So it would not be unreasonable to eliminate somewhere in the region of 200 g of faeces a

day, if our food intake is about 2 kg, less if we eat less and more if we eat more.

Factors affecting the size and volume of bowel eliminations

The factor that will have the biggest effect on the volume of eliminations is the amount of
fibre and water in our diet. Someone who eats grains and vegetables and drinks a
sufficient amount of water will eliminate more than someone who is on a high-protein and
low-carbohydrate diet.

It is also worth remembering that elimination of stored wastes, both food and non-food in
origin, will continue even if the food intake is minimal, for example during periods of
cleansing or detoxification.

People who don’t eat enough fibre, both soluble and insoluble, or whose diet is too dry, as
well as those who ‘bottle up’ emotions and stress, won’t eliminate as much.

However, just because these people don’t eliminate a certain amount of stools, doesn’t
mean that they don’t produce as much composted waste. All it means is that the body’s
waste removal plant does not get enough fibre-based fuel, and therefore it does not have
enough power to be able to get rid of it.

Routine of a properly working bowel

‘Natural’ bowel movements all have this in common:

• You are aware of the call of nature

• There is a reasonably established pattern of your bowel evacuations
• The feeling that you need to open your bowels is strong, but not
overwhelming
• When you sit on the toilet, the release is easy, and you do not need to
‘help it out’
• The smell is faint rather than overpowering
• Straining is minimal
• There is no feeling of ‘unfinished business’
• There is a feeling of physical and emotional relief.

Signs of bowel mismanagement

• Bloated, heavy feeling after a meal;
• Excessive belching, burping, acid reflux;
• Feeling hardness in the bowels;
• Despite going to the toilet every so often, there is always a feeling of
unfinished business;
• Poos ‘don’t look right’;
 • One has to strain;
• When one responds to ‘the call of nature’, nothing comes out despite
the desire to evacuate.

Healthy and unhealthy faeces

Healthy faeces

• Look like a soft sausage;

• The colour should be light to medium brown, slightly golden and shiny;
• The texture should be that of peanut butter;
• Being slightly acidic, the faeces should float first and sink soon
afterwards without leaving ‘skid marks’ when you flush ‘it’.

Obviously there are variations. If one eats a lot of grains, the faeces will be slightly looser
and the sausage will break in the middle, leaving a rough edge. If one eats lots of leafy
green vegetables, the stools will look quite dark.

Beetroot will make the stools a kind of crimson red, while charcoal will make it dark. Iron
supplements can make one’s stools harder and darker.

The transit time

The size and shape of one’s stools indicate how long the food has spent in the digestive
tract. This is called the ‘transit time’. The transit time in a healthy large bowel should be at
least 12 and at most 48 hours from the moment the food is eaten, to the moment the
waste is eliminated.

In the UK, the average transit time is a lot longer – 54 to 72 hours. Longer transit times
may be associated with low energy levels, bad skin, congested blood, decreased immunity
and degenerative diseases, including colon cancer.
The Bristol Stool Form Scale
To help you identify how one’s digestive system works, and whether it gets rid of the
wastes in an efficient manner, the official Bristol Stool Form Scale divides stools into seven
distinct types in terms of size, shape and colour.

• Dry with hard lumps or clumps - CONSTIPATION.

• Like lumpy sausage - CONSTIPATION.
• Like sausage with surface cracks - HEALTHY, VERY SLIGHTLY
DEHYDRATED.
• Long smooth surface. Normal, good colour, quick exit, and easy to
clean: - HEALTHY.
• In blobs with well-defined margins - HEALTHY.
• Fluffy with ragged edges - BORDERING ON DIARRHOEA.
• Watery with no solids - DIARRHOEA.
•
The size and shape of the stools indicate the transit time through the digestive tract. The
colour can tell you how good your digestion is and alert you to other changes concerning
your wellness.

Indications of potential bowel problems

• Very yeasty stools throughout the treatments or just in one section of
the bowel. A small amount of yeasts will be almost always present, but too much
yeast may be a symptom of dysbiosis.
• Foreign objects in the stool such as numerous unprocessed bits of
foods. You should make allowances for such foods as seeds, nuts and sweet corn
that very few people chew properly. However, if you see a lot more than that, it may
benefit from further investigation.
• Too much mucus and stringy mucus
• Different colour variations: stool comes in different colours, often
compacted in one tight ball.
• The stool is too dry and dehydrated throughout despite the client
asserting you that they drink enough water.
• Dark blood in stools
• Fresh blood in stools (other than minimal amounts)

Basically, if you see that the stool seriously deviates from what could be described as a
healthy elimination, and the client has complaints, such as alternating constipation and
diarrhoea, bloatedness, irregular periods, infertility, intolerances and allergies, headaches,
mood swings and so on, then you might suggest to the client to get their stools
investigated.

Learning to reads the signs of health from stools

Skid marks
Skid marks are often present after a night on the town, and they appear when passing soft
stools that leave a slightly burning sensation after being released.

Alcoholic drinks contain salts, and are often accompanied by meals high in salt, proteins and fat.
This draws excessive amounts of water from outside the bowel wall into the bowel itself, making
the stools heavier and reducing the transit time.

Shorter transit time may cause malabsorption, often wasting valuable nutrients.

Skid marks combined with sticky, foul smelling and greasy stools can be a sign of fat
malabsorption in the small intestine, due to poor bile action, or stomach acid deficiency
that affects the digestion of proteins in the stomach.

Greasy stools
If stools are fatty and hard to flush, it means that fats are not being properly broken down –
due either to bile insufficiency or to excessive consumption of fats, especially of animal
origin.

If, trying to lose weight, your client takes fat-blocking tablets; they will see that the toilet
water, once they have had a bowel movement, is full of orange-slick puddles, which are
reminiscent of an oil slick in the sea.

This is unfortunately what these fat blockers do – they pass the fat straight into your bowel.
Despite the appearance of soft evacuations, because the fat is a great lubricant, these
supplements do wreak havoc with the bowel flora.

It takes quite some time for the bowel ecosystem to recover from the effects of fat
blockers.

Anal itching
Most adults experience anal itching, the soreness around the anus and the irresistible
desire to scratch at some point in their life.

The itching itself is a sign of something going wrong somewhere in the body.

Sometimes the cause is simple and local: wearing clothes that are too tight; dry skin or, on
the contrary, too much moisture on the skin, sweating or using shower gels that can cause
a skin allergy.

Occasionally the causes are found in overusing laxative preparations, taking some
antibiotics (especially if they cause diarrhoea); or being prone to psoriasis or eczema.
Itching could also be caused by dysbiosis, which results in excessive yeast production in
the bowel (the best known manifestation of this condition is Candida albicans), or by
infections, especially by worms or other parasites.

Finally, the dietary ‘culprits’ that cause dysbiosis and itching often are coffee and other
drinks containing caffeine, nuts, popcorn, tomatoes, chocolates and sometimes fruit.

Light-coloured greyish stools

Light-coloured and greyish stools can be indicative of anaemia (shortage of iron in red
blood cells), gallstones or other blockages in the bile duct, as well as of insufficient
production of bile by the body.

White chalk-like stools

White chalk-like stools normally result from a combination of factors: low-fibre diet high in
fat and processed foods, anaemia and severe dysbiosis that is often caused by excessive
or long-term use of prescription drugs, appetite suppressants, street narcotics and
laxatives. All this virtually brings the colon to a standstill.

Gassy (smelly) stools

Often gassy, smelly stools are the evidence of lactose intolerance (lactose is found
primarily in milk). This means that the body is deficient in rennin and lactase, the enzymes
that speeds up the breakdown of casein and lactose.

These stools can also be caused by a bacterial infection or dysbiosis.

Sometimes gassy smelly stools are caused by overdoing one type of food, especially high-
fibre vegetables, such as onions or artichokes, or beans and pulses.

On the other hand, gas can also be caused by the excessive consumption of fatty animal
foods combined with stomach acid or bile deficiency.

Mucus in stools
If one has mucus in your stools, this can also mean several things. There might be an
agent that your body is intolerant to, and the bowel lining has secreted more mucus to try
to eliminate it.

On the other hand, it might mean that you are eating a disproportionate amount of proteins
and fats, especially of animal origin, including meat, milk, yoghurts, fromage frais and
cheeses.

Some people process milk products, animal proteins and fats better than others. If you
regularly consume high amounts of proteins and you don’t find any mucus in your stools,
then your body seems to be coping.

It is worth remembering though, that most people are historically and biologically
conditioned to eat fewer proteins and more unprocessed grains, vegetables and pulses.
The bowel will produce excessive mucus mostly for its own protection, or in order to increase the
lubrication of the bowel wall, and to wrap up and help eliminate undesirable wastes. It could be
caused by dysbiosis, bacterial infections, and obstructions in the bowel, parasites, haemorrhoids and
a multitude of other things.

Blood-containing mucus in the stools is a good reason to have stools checked

professionally.

Goat Pellets
Goat Pellets (also known as ‘rabbit droppings’) are normally a sign of constipation caused
by dehydration.

If one does not eat enough fibre, which serves as a bulking agent, and does not drink
enough liquid, which helps increase the weight of the waste, then stools can be small in
size and very compacted.

Sometimes people have a good diet, but still produce goat pellets. This could be a sign of
adrenal exhaustion, of an emotional blockage or of high levels of suppressed stress and
anxiety that increase acidity in the body.

Bits of undigested food

If you have discernible bits of food in your stools, it might mean that you are not chewing
your food properly.

It may also mean the bacterial colonies that live in your gut are not doing a very good job.
Or it may be that you are not producing enough enzymes in the small intestine, the
stomach or the pancreas and this causes inadequate food assimilation by the body.

Some foods are notoriously harder to digest than others. A lot of people do not digest
tomato, potato and apple skins, seeds or nuts, sweet corn and popcorn.

Peeling your fruit and vegetables and not eating the skins, making sure that sweet corn or
popcorn are chewed properly and grinding your seeds and nuts before eating should help
your digestive system and assist in nutrient absorption and assimilation.

Straining and constipation

Straining is a sign of constipation.

If you have a bowel movement less often than every day with an occasional day off, then
you are almost certainly suffering from habitual constipation. It means, in simple terms that
dead stuff is not getting out through the bowel.

Straining means that the stool is too dry or dehydrated to come out on its own. It irritates
the nerve endings in the lower bowel enough to create an urge, but there is insufficient
moisture and bulk in the stool to build momentum for an easy evacuation.
Nutritional and lifestyle advice contained in the last two parts of this book should help you
alleviate the problem of straining and constipation.
Ribbon stools, painful to pass
If your bowel movements look ribbon-like, your bowel is spastic, and that the mucous
coating of your bowel is inflamed or has dried out. Almost certainly, some sections of your
bowel are swollen. As the stools can’t pass out easily, they come out as a ribbon, trying to
make its way through the sections of the bowel that are suffering from inflammation.

A ‘sore bowel’ is very much like a sore throat. If you think how difficult it can be to swallow
when your throat is inflamed, imagine that the bowel lining is very similar to the throat
lining.

However, it has fewer nerve endings that are part of the central nervous system, so it
takes a while for the condition to build up and for you to take notice.

You can deal with this problem nutritionally. Try to eliminate spicy foods, carbonated
drinks, alcohol and coffee from your diet.

Have ‘warm, wet, boring meals’: runny porridge, vegetable soups and stews with some
grains, such as brown rice or barley, warm fruit compotes and jelly. Keep your meals small
and do not sit down or bend down for about 20 minutes after each meal. Avoid anything
that is too hot or too cold.
Diarrhoea
If you have diarrhoea, it means that you have consumed something that the bowel is trying
to eliminate or that you have caught a bug.
Diarrhoea is a defence mechanism. The bowel is trying to do what it can to stimulate the
healing powers of the body.

In order to help trigger the defecation process as quickly as possible, the bowel will not
extract as much fluids out of the stools as it would do under healthy circumstances. This
will enable the body to get rid of the offending substance and start the healing process.

If diarrhoea stops of its own accord after a day or two and gradually gets better, it means
that the body has mobilized its immune defence potential.

Diarrhoea should not be ignored

Diarrhoea is one way of the bowel telling the brain that the body needs support. These
signs should not be ignored.

Constipation and diarrhoea could also be consequences of stress, taking antibiotics, going
on holiday, increasing or decreasing your level of physical activity, and of any sudden or
drastic changes that the body and the mind are not prepared for.

Blood in the stools

If there is fresh blood in the bowels this may mean that the stools are too dry and they
have scratched the bowel wall, causing it to bleed. A haemorrhoid can also bleed causing
discomfort and pain. If fresh blood continues to appear in the stools a consultation with the
doctor is advised
.
Dark blood in the stools means that there is haemorrhage higher up – in the small intestine
and the stomach. Dark blood is a sign of danger, and needs to be investigated. Definitely
do not put off seeing the doctor.

The third type of blood in the stools is occult blood – the blood one cannot see. Laboratory
testing can only reveal occult blood.

Improving the quality of bowel eliminations

One of the reasons why people have unsatisfactory bowel eliminations is their
psychological attitude to the whole ‘down below’ business.

Childhood and parents’ attitude and training; schooling and cleanliness of school toilets; as
well as university and having to share accommodation with strangers, - all these factors,
among many others, affect the workings of the excretory mechanism of the digestive
system.

Without going into further details, there are a few things you should be able to advise to
your clients in order to help them eliminate better.

• First of all, everyone needs to understand and accept that bowel

cleansing is a natural process for us humans. It is a private thing, but it is not a dirty
or shameful thing. It is important to always find an opportunity to open the bowels
when they ask for it.
 • It is very important to be comfortable when sitting on the toilet, and to
relax skeletal muscles of the abdominal cavity. In many countries, disposable toilet
seat covers are now provided or can be bought in a pharmacy.
• Historically, we are conditioned to squat over a hole. There are not
many holes to squat over in the modern world. However, what does work very well
is having a footstool under one’s feet when sitting on the toilet. This tilts the pelvis
backwards and makes the whole evacuation process much easier.
• One needs to give the bowel time to evacuate and release fully.
• Those who suffer from digestive complaints can be recommended a
series of exercise promoting bowel eliminations that can be found further in this
manual.
• Generally, it is worth remembering that the bowel is our second brain. I
should be treated in the same way as the brain – kept active for a while, and then
given some rest.
LAXATIVES.
Many clients who come for a colonic treatment will be using laxatives. They will confess
that without taking laxatives they are unable to evacuate the bowel. Whilst there can be
many reasons why this happens, life style factors such as poor diet, stress, prescribed
medication, dehydration along with emotional and psychological reasons. it is important
that you are familiar with the different categories of laxatives and how they activate the
bowel.

Which Laxative?

Laxatives fall into broad categories

• Stimulants.
• Bulking agents
• Carminitives
• Osmotics
• Mucilages
• Anti-Spasmodics

Stimulants

Stimulants work by stimulating the bowel to want to empty itself, often by irritating it.
The bowel contracts to rid itself of the irritant.
This is the most common perception of why laxatives are believed to make the bowel lazy,
and often this is true.

But mixing stimulants with other products can temper the effect and produce a gentle, non-
irritating stimulation of peristaltic movement. Senna is an example of a stimulant.

Bulking Agents

Bulking agents work by increasing the amount of fibre in the gut and can help to tone the
bowel as the bulk puts it under pressure to stimulate peristalsis.

Must be accompanied by increased fluid

Be careful if someone is impacted, can make things worse.

Psyllium Husk and Fybogel are examples of bulking agents.

Carminitives

Emotional bowel spasticity is common.

Carminatives have a calming effect on the client & bowel.

They aid expulsion of gas pockets.

Calming the nervous system has the effect of calming the bowel.

Chamomile is an example of a carminative

Osmotics
Osmosis is the action of water moving from a high concentration to a lower concentration
via a permeable membrane.

It means osmotic laxatives draw water into the bowel to keep things soft.

Examples of Osmotic Laxatives

• Sugar Based: Lactulose, Glycerin

• Epsom Salts: Relaxes smooth Muscle promotes relaxation and
vasodilation
• PEG (Polyethylene glycol 3350) contains Hydrophilic molecules.
Works by keeping more water in the stool. Doesn’t affect nerves or muscles so
doesn’t cause dependency.
• Laxido and Movicol are examples of PEG osmotic laxatives.

Mucilages

Mucilages work by adding mucous to the wall of the gut and bowel, effectively making it
more slippery.

They soothe the delicate gut membrane, reduce cramping and spasticity, and help improve
the symptoms of constipation.

Slippery Elm & Marshmallow Root are examples of mucilages.

Anti-Spasmodics

This may sound contrary, that an antispasmodic can have a laxative effect.

But to relax a tight tense bowel, allows peristalsis to function properly, and then allow the
bowel to expel the contents properly.

Peppermint, liquorice and fennel are examples of anti-spasmodics.

Oral Herbal Laxatives.

There are several key herbs that are used to stimulate the bowel they include senna,
cascara, agrimony, raspberry leaf. They are available in a variety of patented herbal
products and are formulated using a synergy of herbs.

Oral Nervines

Oral nerviness help to relax and soothe the nervous system, allowing the bowel to
function.

Valerian, Scullcap, Black Cohosh, Jamaican Dogwood, Cayenne, Cramp bark and Wild
yam

Neurology

Peristeen and Anal irrigation systems are useful to recommend for people suffering spinal
injuries, neurological damage, including

Multiple Sclerosis
• Motor Neurone
• Back injury damage
• People on strong pain killing drugs,
• Opiates, Co-Codamol, Gabapentin.

Laxatives are covered in more depth in the advanced practitioners course and CPD
modules.
Prescription Medications
Here are the twelve most frequently prescribed medications currently in the UK

• Simvastatin, Sold as: Ranzolont, Simvador

Used for: lowering cholesterol and other fats in the blood.

• Aspirin, Sold as: Aspro-clear, Flamasacard

Used for: preventing unwanted blood clots and as a non-opioid treatment for pain,
inflammation and fever.

• Levothyroxine Sodium Sold as: Thyrax, Evotrox

Used as a hormone replacement that regulates the metabolism.

• Ramipril Sold as: Tritace

Used for: high blood pressure, prevention of heart attack and stroke and kidney
problems associated with diabetes.

• Bendroflumethiazide Sold as: Aprinox

Used for: high blood pressure, fluid retention and heart failure.

• Paracetamol Sold as: Calpol, Disprol

Used for: pain and high temperature

• Salbutamol Sold as: Airomir, Asmasal Clickhaler

Used for: opening up the air passages to the lungs to help air flow, used for
asthma , bronchitis and other lung-related problems

• Omeprazole Sold as: Losec, Zanprol

Used to: reduce the amount of acid produced in the stomach, relieving pain, ulcers
and heartburn.

• Amlodipine Sold as: Amlostin, Istin

Used for: high blood pressure and to prevent chest pain

• Lansoprazole Sold as: Zoton, Zoton FasTab

Used for: excessive acid production in the stomach, causing pain, ulcers and
heartburn.

• Mitalopram Sold as: Celexa

Used for: treating depression

• Metformin
Used for: Metformin is used to improve blood sugar control in people with type 2
diabetes. It is sometimes used in combination with insulin or other medications
These drugs clearly all have an impact on liver health and a significant number have a
direct impact on colon health. Although we as therapists cannot advise clients to stop
taking their prescribed medications there are effective methods we can use to offer advice
to clients who maybe on any of the above medications.

Prescription medications are covered in more depth in the advanced practitioners course
and CPD modules.
Knowledge Review and Research
1. What are the stools comprised of?

2. How can you describe a healthy bowel movement?

3. What is the transit time? What’s “normal” transit time? What are the
negative effects of the transit time being too short or too long?

4. A client comes to you complaining that she has dry, small stools. What
questions are you going to ask her to see if you could make suggestions
about how she can improve the quality of her stools?

5. What’s worse, constipation or diarrhoea?

6. Design a stools interpretation template that you could use in working

with your clients using the example below:
Sign
Possible reason
Possible underlying cause
Possible measures
Ribbon-like stools
Bowel inflammation
Too much spicy food or intolerance of some kind
Eat bland, plain diet, steamed veg, soup, yoghurt etc. Exclude pasta, bread, cow’s milk
7. How can one make bowel eliminations more comfortable?
Effects of colon hydrotherapy on bowel functions

Benefits of colon hydrotherapy

Colon hydrotherapy is a great restorative treatment that gives a systemic boost to the
body. The benefits of colon hydrotherapy all originate from removing stored wastes from
the large intestine. Irrigating the gut with large amounts of water has many goals, including
those listed below:

SEVEN R’S OF COLON HYDROTHERAPY

• Relieve stagnation – remove the wastes, irritants and allergy triggers

• Rehydrate the bowel
• Repair the gut wall
• Replace digestants and rebalance the bowel flora
• Rebuild the gut-brain connection
• Restore the bowel function
• Re-educate the owner of the bowel

All these goals are interrelated, but it is only by looking at them more closely that we can
get a truly three-dimensional picture of the physical, emotional and energetic changes that
colonic irrigation achieves in an individual.

Relieve stagnation: remove the wastes, irritants and allergy triggers

In the process of colon hydrotherapy, wastes are removed from the bowel. The wastes are
comprised of insoluble fibre, the red blood cells that have been used up by the body, cells
of the stomach and the bowel lining, and indigestible materials including irritants and
allergy triggers.

The pigment in red blood cells gives the stools their typical rusty-brown colour.

Food intolerances
Every one of us is aware, to a greater or lesser extent, that in the modern world we eat a
lot of ‘non-nutrients’ that weren’t designed to be eaten. These are pesticides that are used
in the farming of grains and in the growing of fruit and vegetables, chemicals that are used
to preserve our food and increase its shelf life, E numbers, colorants and taste enhancers
that are utilized in the manufacture of processed foods.

Also, a significant number of people have poor tolerance of gluten, wheat, cows’ milk, and
even of such foods as tomatoes, onions and oranges.

When we say that the body has poor tolerance of something, what does this actually
mean? It means that it can’t break that material down into useable components, absorb it,
assimilate it and reuse it. So the body has no option but to try to eliminate the offending
substances.

Our most patient channel of elimination is the bowel that is designed for storage and
elimination of wastes. That is why sometimes-digestive irregularities build up for a while,
and when the person finally notices them they are already quite serious
.
When we try to eliminate excessive amounts of toxins through the skin, the skin breaks out
and we develop skin eruptions. Elimination through our breath gives us bad breath, acid
reflux and other symptoms that we notice immediately. The bowel, which is designed to
store wastes for longer, is sometimes able to cope with irritants and allergy triggers for
quite a while before reaching the critical point when we start suffering from bloatedness,
constipation, diarrhoea, pain and discomfort.

Overeating

General overeating, that a lot of people in the West suffer from, puts a huge pressure on
the digestive system, also contributing to the need to eliminate indigestible materials.

How colon hydrotherapy helps

One session of colon hydrotherapy probably won’t eliminate everything that has been
building up in the bowel over time. It can, nevertheless, start the process of further
cleansing.

Those people, who undertake colon hydrotherapy with a specific purpose of getting rid of
certain allergic reactions or intolerances, would probably need more colon hydrotherapy
treatments, and take probiotic supplements between the treatments to promote bowel cell
renewal. They will also need to be on elimination diet and follow the supplementation
routine recommended by a nutritionist or naturopath.

Knowledge Review and Research

1. How can colon hydrotherapy help reduce food intolerances?
 2. How do intolerances build up? What organ needs to be supported in order to reduce
intolerances? How does colon hydrotherapy support this organ?

Rehydrate the bowel

Reasons for dehydration

There are several reasons why people today are could be more dehydrated than even one
or two generations ago.

• Not drinking enough water. One needs to drink around 2 L of water a

day, which can be difficult with our hectic lifestyles.
• Change in our nutritional habits. People rely a lot more on processed
foods, such as pizzas, pastas, breads, potatoes, takeaways that are a concentrated
source of calories and nutrients.
• At the same time, meal times have become shorter. People are busier,
 have more things to attend to, and often they cannot afford the luxury of sitting and
enjoying their meals. The result is that a lot of concentrated calories are consumed
in a very short space of time without adequate hydration.
• Unprocessed foods such as soaked grains that retain a lot of liquid, as
well as vegetables and fruit, seeds and nuts are not a part of an average person’s
diet.
• Modern foods are chemically enhanced, and very few people eat hard
foods that require chewing to ‘unlock’ their taste to the brain. That is why most
people do not chew foods enough. Chewing, however, contributes to the hydration
of foods. ‘Fast chewers’ are very often dehydrated.
• The other factors contributing to dehydration are stress, adrenal
fatigue, air conditioning and dry air in offices, sedentary jobs, sedentary lifestyles,
inhaling petrol fumes, generally breathing bad air and so on.
• Excessive exercise also contributes to dehydration.
• Dehydration is also caused by drinking sweet and fizzy drinks instead
of water, drinking vast amounts of alcohol on a regular basis rather than on special
occasions, and regularly rather than occasionally eating substantial amounts of
animal proteins.

In the meantime, our bodies are 70% water. They need to use water all the time. That is
why, if there is a shortage of water coming in with food, the body will have to look for an
alternative source.

Water re-absorption from the bowel

There are only two storage media in the body where water is not mission-critical: fat and
the stools. In order to obtain water from fat, the body needs to be involved in physical
exercise over a period of time, so that the fat-burning process can release some water. It is
a complicated way of “manufacturing” water in the body.

Re-absorbing liquid from the stools is a lot less complicated: as the large intestine receives the
digested wet wastes from the small intestine to convert them further into stools, it should absorb
most of the water from the bowel anyway, leaving some water in the faeces for a smooth
evacuation. This means that a re-absorption mechanism is already in place.

It also means that in the situation of dehydration the body will re-absorb water from the
bowel. This is one of the reasons for dry, difficult-to-pass, goat-pellet-type stools.
This applies especially to people who don’t regularly eat beans and pulses, natural grains,
vegetables and fruits. The bowels of these people don’t get much fibre, which helps bulk
up the wastes, and consequently retain the water in the stools and stay hydrated.

Dehydration and colonics

It is not unusual to observe during a client’s first colonic irrigation that no wastes are
coming out in the first 10, 20 or even sometimes 30 minutes of the treatment! All the
symptoms of the body trying to get rid of the wastes are present – the cramping, the
discomfort, the urge to release – but the wastes are not coming out or coming out in fits
and starts.

Often the reason for this is dehydration. The bowel needs to absorb water before starting
to release the wastes by making the wastes heavier and moister, so that eventually they
will become bulky and wet enough to go through the evacuation channels.
In a situation of severe dehydration, it is recommended to have a couple of treatments in
close succession, with the changes and diet and supplementation, in order to promote
bowel hydration and cell renewal.

Replace digestants and rebalance the bowel flora

One of the concerns voiced most often is that colonic irrigation could upset the intestinal
balance. Colonic therapists hear this sometimes not only from clients but also from
naturopaths and nutritionists. That is why this issue deserves particular attention.

The bowel’s ecosystem

Generally, the bowel is a host to numerous colonies of bacteria – there are between 200
and 500 species in total – and each colony plays an important part in absorption, vitamin
and enzyme production, stools formation and elimination.

Some of these bacteria are designed to process carbohydrate waste and insoluble fibre,
while others ‘mop up’ protein and fat residue that has not been fully broken down and
absorbed from the small intestine.

The correct balance between these organisms is one of the important factors that
determine how successful and comfortable bowel evacuations are. Some of these
organisms are weaker, and some of them are stronger. Some of them historically, in the
course of human development, have played a more important role; some of them are on
standby and only come into their own at times of crisis, such as in food poisoning or when
there are hormonal changes.
It is also worth mentioning that everyone is unique, and every nation’s bowel bacterial make-up
tends to be influenced, to an extent, by dietary traditions formed over centuries. Northern
Europeans, who for centuries have had a high proportion of muscle and organ meat, milk and milk
products in their diets, could well be different in their bacterial make-up from South Americans,
who eat mainly grains and root vegetables, or Eskimos, who eat a lot of fish or Mongols who don’t
eat vegetables at all!

The basics of good stools

Nevertheless, there are commonalities amongst all people. One of the things that
everyone has in common is that their stools consist of dead blood cells, stomach and
intestinal cells, fibre and indigestible wastes. Also everyone’s stools need to be fermented
in order to be eliminated.

The ‘backbone’ of good stools is fermented fibre. Fibre, both soluble and insoluble, is a
carbohydrate, so everyone needs plenty of bacteria that are able to assist in the
fermentation of carbohydrate wastes.

If one’s diet does not comprise enough grains, pulses, fruit or vegetables containing good,
strong fibre, in all likelihood there will not have enough bacteria in one’s bowel to be able
to process fibre into good quality stools, because there is no call for these bacteria to be
present.

With a diet high in processed foods or in proteins, it is more likely that bacteria facilitating
the putrefaction of proteins and removal of undigested fat will be present in quantities high
enough to cope with the supply. In small quantities, these bacteria would do absolutely no
harm, but if you have an imbalanced diet you will also have an imbalanced bacterial make-
up.

Colonic irrigation and gut bacteria

It is said sometimes that colonic irrigation ‘washes out good bacteria’
.
Logically, if one’s bowel were colonized with a balanced mix of beneficial bacteria that
created good-quality stools, that is the majority of fibre-fermenting bacteria and a small
number of bacteria that speed up the protein putrefaction process, they would be removed
in equal ratios during the colonic treatment.

After the colonic treatment, following a diet rich in natural yoghurt, fresh fruit and
vegetables and sprouted grains would encourage the preservation and proliferation of
beneficial bacteria.

In any case, a colonic treatment could help restore the equilibrium of bacteria by giving the
client an opportunity to restart good nutrition and promote the growth of fibre-fermenting
bacteria.

After the colonic treatment, probiotic supplements and live yoghurts help maintain an
acidic environment in the large intestine, which encourages the growth of the bacteria that
digest carbohydrates and fibre, and that help in their fermentation and in the creation of
good, soft stools, as well as in the retention of moisture in the stools. This would also give
stool-forming bacteria a good start.
Knowledge Review and Research
1. Why is it important to have a balance of bacteria in the gut?

2. Sometimes you hear the statements that ‘colonic irrigation depletes the gut’. What
would you argue?

3. Why people on high protein diet often have bad breath?

4. How does fibre help keep the body clean?

5. What is the serious thought behind this cartoon?

Restore the bowel function
Restoration of bowel function and bowel regularity is one of the most important goals of
colon hydrotherapy treatments.

Very often those who embark on a good diet and lifestyle without a bowel cleanse find it
very difficult to notice any obvious changes in their wellbeing and in the activity of their
bowel.

There might be quite a few reasons for this, but one of the most obvious reasons is that
they have still got too much old faecal matter in their bowels. So whatever they do, their
bowels are not working at 100% efficiency – the mucosa can’t self-lubricate and the gut
muscles can’t contract and relax properly because the gut is still too full.

Colon hydrotherapy gives the gut a workout

Removing the faecal matter enables the bowel muscle to work better. This, in turn, will
help with the absorption of nutrients and the production of the B and K vitamins that the
bowel requires for its optimal functioning.

As better-fermented, heavier and moister stools are created, they give a better workout to
the bowel muscle. A properly exercised muscle, in its turn, is more aware of the signals
sent by the nerve endings, and delivers the stools through the rectum and the anal canal
for regular elimination.

With a more satisfactory release, the muscle remains in good shape, no plaque develops
on the bowel walls, and the effective digestion, absorption, assimilation and elimination
continue.

One of the functions of the bowel that is often taken for granted is the support and
massage it provides to other internal organs in the thoracic and the abdominal cavities.
The regular peristaltic action massages the stomach, the spleen and the liver above the
transverse colon, and provides support and a frame to the small intestine and the organs
of the abdominal cavity. An oversized gut stifles the organs rather than supporting them.

A prolapsed transverse colon would put the whole of the abdominal cavity under pressure,
as well as the kidneys and the abdomen, which rely on the transverse colon for support.

Getting rid of the excess baggage that constipated people often carry around in their
bowels has been known to relieve back and chest pain, help with the constant urge to
urinate by reducing the pressure on the bladder, stop heavy bleeding during periods, and
increase the chances of pregnancy.

Knowledge Review and Research

1. How can chest pains, frequent urination, heavy periods and shortness of breath be
related to constipation?
 2. Sometimes people go on a cleanse and fail to achieve any improvements in their
health. Give possible reasons for this.

3. How does colonic irrigation exercise the bowel?

Rebuild the brain-gut connection

The brain-gut connection is something everyone is aware of, albeit not consciously: every
time we need to make an important phone call, or make a decision that involves risk, we
have a feeling of ‘butterflies in the stomach’.

The expression ‘gut feeling’ is used to describe a premonition that exists on the visceral
level and is not supported by any facts that the head could rely on to make a decision.
Shocking news may leave us doubled up with abdominal pain or gasping for breath.
Diarrhoea on the night before an important exam is quite common.
Many languages have the word ‘gutted’ in their vocabulary, meaning that one feels
distraught, angry and upset.

This is all the part of ‘fight or flight’ mechanism that regulates our response to danger. We
are programmed to respond like this.

Intestinal programming
The intestine is also programmed to tell us when we are hungry, when we have had
enough food and when we need to open our bowels to eliminate the wastes.

About 95% of the available serotonin, the neurotransmitter better known as the mood
regulator is stored in the gut. The bowel and the head constantly exchange messages,
although in most people this is a one-way street: apparently, 9 out of 10 messages are
sent upwards. So in a way, our gut determines our mood.

The second brain

That is why our bowel is often called ‘the second brain’.

The second brain, or the enteric nervous system, i.e. the nervous system that operates the
digestive system, can and should work independently from the head.

Once a portion of food has been swallowed, the next time any conscious control is
exercised over it is when one consciously opens the bowel. The whole process of
transformation of food into nutrients, and of nutrients into our cells, happens virtually
without involving the ‘head brain’.

Precisely because of this, ‘listening to your body’ makes so much sense.

However, in real life there are a lot of factors that shut down communication between the
bowel and the bran:

• Eating for pleasure, consolation or greed rather than to satisfy our

hunger;
• Not opening the bowels due to bad timing, shyness or dirty toilets;
• Ignoring the signs of satiety;
• Not chewing;
• Not hydrating and so on.
So it is hardly surprising that the gut sends upwards plenty of messages saying that it is
bloated, irritated, constipated, spastic and full of indigestible materials that even bacteria
refuse to deal with!

Serotonin overflows, causing diarrhoea, which in turn shuts off the serotonin receptors in
the gut, causing constipation. This is how the IBS cycle works, creating spasms and
irritation of the bowel wall.

As a result, the head brain receives a lot of unhappy messages.

Colonics rebuilds fundamental links

Colonic irrigation helps restore the healthy brain-gut connection in several ways.
When the water flow causes the bowel to evacuate the wastes, it rebuilds the fundamental
link that is compromised in so many people – the urge to open the bowel followed by
immediate evacuation. Both the head and the gut brains remember it; it feels natural, it
feels good and it feels right. Colonics begin to re-establish this very important neural
pathway.

This basic reflex is part of the programming that we are born with. It should be our default
mode, and many people who follow the post-colonic dietary recommendations and hydrate
themselves notice after the first couple of colonics that they ‘know better’ when to go, and
that they are much more aware of the need to give themselves time to evacuate wastes.

Relieving bowel spasms

A lot of the unhappiness and moodiness of people who suffer from the symptoms of
irritable bowel is caused by the bowel going into spasm day after day, virtually after every
meal. This is often caused by the bacterial imbalance, mucosal wall irritation and
inflammation and the presence of allergy triggers.

Colonics done with very warm water help relieve the bowel spasm by mechanically
relaxing the muscularis (muscle) layer of the bowel. Relaxation of the muscles gives a
positive message to the nerves that regulate serotonin production. As a temporary
measure, this often helps reduce considerably the symptoms of IBS, giving the body and
mind a welcome break from its niggling symptoms.

This, in combination with proper chewing, small, warm meals and more specific dietary
measures, brings relief from IBS much faster than dietary measures alone.

Mechanical removal of allergy triggers from the bowel helps calm down the inflamed nerve
endings, regulating the serotonin production and relieving the symptoms of chronic
diarrhoea.
Resolving negativity
Colon hydrotherapy also helps many people who ‘bottle up’ their emotions to start the
process of emotional clear-out. Emotions are, on a very basic level, electric charges.
Storing a lot of negativity in the gut does not do much good to its balance.

Getting rid of this negativity may cause emotional upset in some people. Sometimes you
will see women being quite tearful during the colonic treatment.

In many more people, whose ‘negative charge’ was not excessive, the clear-out causes a
great feeling of the ‘incredible lightness of being’ at every level: physical, emotional,
intellectual and spiritual.

That is why quite a few of creative people have colonics to get rid of writer’s block and to
obtain a surge of fresh adrenalin.
Knowledge Review and Research
1. Explain the meaning of the phrase ‘brain-gut connection’.

2. How does colonic irrigation help restore the brain-gut connection?

3. What happens when we overload our head brain? What happens when we overload
our bowel? Can you see any similarities?

4. How can colonics help one feel less bloated and reduce spasms after a
meal?

Re-educate the owner of the bowel

For many people, opting for colonic irrigation is a great step towards taking control of their
own health. The first step is never easy. Most people, with very few exceptions, feel very
proprietary about ‘down there’, and allowing a foreign mechanical device to enter a very
private space requires courage and determination.

Once everything is in place and the treatment starts, a lot of people feel like they are on a
personal growth rollercoaster ride.

The visual impact

The treatment often has an amazing impact, especially when the wastes can be observed.

Many people, seeing how much waste their bodies are able to store, are awed. They
decide, there and then, to change their diet for the better, to exercise more and never
again to let their body amass so much rubbish!

Sometimes your clients will undergo a great transformation in a heartbeat: all the things
they have read about the need to exercise their bodies, about eating fresh vegetables and
fruit, chewing food and drinking water suddenly come together in a great visual splash.

Emotional release
The emotional release during colonics can be quite amazing. Often, for those who find it
difficult to let go, nothing happens at the start of the treatment. Then – just one word from
the therapist, one question, and one look – will open a floodgate, and tears and wastes
leave the body together, creating a space for new, positive emotions in the soul and for
better absorption and assimilation in the body.

The learning process

With each treatment clients will learn more and more about the way their bodies work.
They will be asking more and more questions, and their questions will become more and
more sophisticated.

That is why it is important for a colonic therapist to never, never, never stop
learning.

Generally, after a good colonic, people are determined to live a much healthier lifestyle
and this makes a great difference for their quality of life at every day level.

Knowledge Review and Research

• Have you noticed during your practice how people change?
Record your three most important observations below:
• What is the serious thought behind this cartoon?
CONTRAINDICATIONS TO COLONIC IRRIGATION
Complementary health centres, beauty clinics and spas are mainly engaged in health
promotion, preventative healthcare, and rejuvenation and health maintenance. You will be
performing colonics as a health promotion tool rather than a disease management tool.

That is why, the list of contraindications below is designed to exclude from your remit those
people who would require medical supervision if they could have colonic.

ABSOLUTE CONTRA-INDICATIONS
• Abdominal Hernia
• Autonomic dysreflexia (occurs in spinal injuries at or above T6)
• Carcinoma of the colon or rectum
• Children under 16 years without a GP’s/medical specialist written
referral and a guardian present at all times
• Colitis
• Congestive heart disease
• Diverticulitis
• Fistula
• Hirschsprung’s disease
• Hypertension –severe or uncontrolled
• Ileus (paralytic)
• Active Inflammatory Bowel Disorders - Ulcerative Colitis, Crohn's,
Colitis and Diverticulitis Inflamed haemorrhoids
• Pregnancy
• Rectal bleeding
• Radiotherapy of abdominal area not discharged from medical care
• Severe Anaemia - Risk of fainting
• Renal insufficiency
• Severe persistent diarrhoea

The following timelines given post-surgery are deliberately conservative and could
be less with the written support of a Medical Specialist

• Recent surgery of colon or rectum (less than 26 weeks)

• Recent bowel biopsy (Less than 12 weeks)
• Recent prostate biopsy made through the bowel (less than 12 weeks)
• Recent abdominal surgery e.g. hysterectomy (less than 26 weeks)
• Recent Laparoscopy (less than 6 weeks)
RELATIVE CONTRA-INDICATIONS
The following are industry agreed relative contra-indications. The suitability of the
treatment remains specific to the individual and must be assessed by a professional
Colonic Hydrotherapist

• Anal tear and haemorrhoid(s) if Digital Rectal Examination reveals

potential intolerance to speculum
• Chemo-therapy and cancer treatments known to cause inflammation,
infections, anaemia and general weakness – Colon Hydrotherapists should work
with the medical team
• Controlled hypertension and a prescription for diuretics
• Debilitating heart, liver and kidney diseases manifesting pain and
weakness
• Diabetes - Risk of Hypoglycaemia; client advice should be given in
preparation for treatment Diverticulosis within 3 months of episode of diverticulitis
• Highly anxious, stressed or emotional
• Hypotension
• Fissure
• Inflammatory Bowel Disorders in remission for a minimum of 6 months
• Inguinal Hernia
• Long term Oral or Rectal Steroid - Risk of reduced bowel integrity
• Recent (within 6 months) hip/knee joint surgery will need to establish
mobility and if client can lie on their left side.
• Severe underweight or Eating Disorders
• Tight Sphincter

INDICATIONS TO COLONIC HYDROTHERAPY

Primary indications:
Hydration of the large intestine
Relieving stagnation by removing wastes from the colon;
Helping to decrease gut permeability;
Improving bowel motility;
Encouraging peristaltic action;
Improving nutrient absorption;
Rebalancing gut bacteria.
Contributing to liver, blood and kidney cleansing;

Other advantages often perceived by individuals:

As prevention against degenerative diseases;
Management of IBS, bloating and alternating constipation and diarrhoea;
Helping to clear up the skin, symptoms of acne and to remove dark circles from under the
eyes;
Increasing the energy levels, stamina, and reducing the need for long sleeps;
Encouraging weight loss and long-term weight management;
Helping to manage food, alcohol and cigarette cravings;
Helping with the release of emotional wastes stored in the large bowel;
Helping to manage intolerances, such as gluten, processed wheat etc;
As a kick-start of healthy living;
As a visual reinforcement of the need to eat healthily and hydrate the body;
As a contribution to knowledge about the body and establishing connections between
one’s physical, intellectual and emotional being.
Knowledge Review and Research
• Please list and explain six contraindications to colon
hydrotherapy

• If you are not sure whether you can administer a colonic

treatment to a client, what would you do?

• If you were a client coming for a colonic treatment, what would be

your reasons?
 Colonic Systems and Equipment
There are two main types of colon hydrotherapy systems used by qualified therapists.

The open system

The first type is usually described as ‘an open system’. In an open system, which is based
on the use of gravity, there is one thin rectal tube that allows water into the rectum, while
the waste matter is released directly from the rectum into an opening in a special colonic
chair and straight into a waste tube.
This type of equipment is popular mainly in the USA and Australia. It is also gaining
popularity in the UK.

The closed system

The other system is ‘a closed system’ originally designed by Dr. Robert A. Wood, which
combines cool and warm water flush with the use of gravity. Dr. Wood began his career in
Australia, his native land, in 1914. As his research into human health and disease
progressed, he found that this method of bowel cleansing was the most effective and safe
way to clean the entire large intestine.
His simple apparatus won him recognition for his work in colon hydrotherapy, which is still
being taught today at Wood Hygienic Institute in Florida.
The pressure system
A variation of the closed system is a pressure system, the water administered during the
treatment is regulated by slight pressure from the machine as opposed to gravity.

The portable system

The portable system is based on the pressurised supply of water; however it delivers the
water into the client under the force of gravity through the flow meter that regulates the
incoming water flow. No electricity is used in the operation. This portable system is
manufactured in the UK.
Generic operating procedures
Equipment
Always use the equipment that is recommended by your national colon hydrotherapy
organisations and meets relevant legislation.
Use the equipment that meets the local water authority’s standards.
Make sure your equipment is installed and tested by a qualified installer.
Always follow equipment manufacturer’s instructions in performing the cleansing
procedure.
Always use the cleansing solution recommended by the manufacturer.
Maintain your equipment and change all necessary parts as per the instructions contained
in your equipment manual.

Disposables
No part of your disposable kits (speculum, obturator, inlet or outlet pipe, disposable
underpants or robe) must ever be re-used.
It is recommended to use paper towels in your washroom.

The Room
The floors must be fully washable. Carpet floor are not allowed.
The room must have its own toilet and washing facilities.
The room must have an extraction system.
UK regulations establish that there must be a separate sink for the therapist’s use only.

Water filtration
Water filters must be replaced in accordance with the manufacturer’s instructions and a
record of water filter replacement must be kept.

Customer Care
Customer records must be kept in a lockable cabinet.
All client’s details must be kept confidential and must not be divulged to anyone without
the client’s prior permission, unless stated otherwise in law.
The therapist MUST be immediately available to the client at any time during the
administration of the treatment.
Pre-care and aftercare advice must be provided to every client.
 Hygiene
All surfaces touched by the client: the toilet, the door handles, the bed must be sanitised
with a disinfectant solution between all treatments.
It is recommended that disposable gloves must be worn at all times during the treatment
and the cleaning process. Any gloves smeared with bodily fluids must be immediately
discarded and replaced.
All disposables, paper etc. must be stored and removed in accordance with local by-laws.

Water Temperature
Always follow manufacturers’ instructions. Generally water temperature must be close to
body temperature.

Water Pressure
Always follow manufacturer’s instructions.

Treatment Duration
The average treatment duration is around 45 minutes and must never exceed 60 minutes.

Lubricant
When using your preferred lubricant, avoid cross-contamination. Any contaminated
lubricant MUST be discarded immediately.

Personal Appearance
Professional appearance must be maintained at all times.
Modest, understated clothing must be worn.
No heavily scented perfumes must be used.

Treatment Procedure
In closed systems, insertion is carried out when the client is lying on the side. Always
explain your actions to the client and make sure the client is comfortable with them. Slight
discomfort maybe experienced, but PAIN IS A SIGNAL TO STOP.
In open systems, the client self-inserts the rectal tube under the therapist’s guidance
Always check the contraindications and if in doubt do not treat the client.
Check that the questionnaire and the disclaimer has been signed and dated by the client.
It is good practice to have a digital wrist blood pressure monitor in your room and
encourage clients to check their blood pressure as they come into the treatment area.
Keep a copy of the diagram below in your treatment room. Treatment is only allowed within
the normal or moderately abnormal range. DO NOT TREAT CLIENTS WITH SEVERE
HYPER – OR HYPOTENSION.
Never treat anyone who appears to be under the influence of alcohol or drugs or behaves
erratically.
Knowledge Review
1. What is an enema? How are colonics different from an enema?

2. Why is it important to follow equipment manufacturer’s instructions?

3. What are the main hygiene requirements?

4. Why must all clients’ records be kept confidential?

5. What two main types of colonic devices exist? What are the differences
between them?

6. Why should not we treat clients whose blood pressure is too high or
too low?
Blood Pressure

The Hypertension Debate.

Hypertension is the medical term for high blood pressure.

Whilst hypotension is low blood pressure.

Whilst you would not treat a client with uncontrolled high blood pressure or extreme low
pressure the dilemma is there are lots of individuals who are unaware of having high or
low blood pressure.

Whilst we could routinely advocate that a new client BP is taken prior to the first treatment,
it would not necessarily be beneficial at giving an accurate reading due to the ‘white coat
syndrome’ plus the stressed associated with receiving a treatment for the first time.

It is up to you as a responsible therapist to decide if you want to embark on taking BP’s of

all new clients, but RICTAT does not enforce this procedure.

Clients with known elevated BP will be taking prescribed medication.

If clients report severe headaches you could suggest that they have it checked out by their
GP.
Professional Conduct – Rules, Boundaries and Limitations

Touch
At the beginning of a colon hydrotherapy treatment we use touch for therapeutic purposes,
to insert the speculum into the client’s anal passage. That’s why the therapeutic touch is
special and we need to focus on its value to the client, its limitations and the burden of
respecting boundaries.

The therapist will not visually inspect, examine, touch or in any way make contact, directly
or indirectly, with the primary or secondary sexual organs of the patient/client.

A very important part of the therapeutic touch is to keep the client informed of what we are
doing; so that at every stage the client understands what our intentions are, and there is
no doubt in the client’s mind that our intentions are therapeutic and serve to benefit the
clients health.

Sometimes what we perceive as a therapeutic touch is misinterpreted by our clients as

personal or sympathy touch. This is caution is needed as this can happen due to the
client’s previous life experiences. The main cause of the inadequate reaction to
therapeutic touch is the inability to observe and respect boundaries.

How do we know if our touch causes an inappropriate reaction in our

client?
It is sometimes difficult to know if the client misreads our therapeutic touch. However, there
are signs:

• The client is always asking for more time

• The client often changes appointment times and asks for a special
treatment as regards cancellation fees
• The client asks for appointments out of hours or wonders of you could
open your practice on your day off
• The client wants contact outside work

The client starts sharing personal information that transgresses the boundaries of a
therapeutic relationship and/or has the intention of eliciting similar personal information
from you.
Importance of the client’s questionnaire and observation form
A well-structured client questionnaire allows the therapist to identify the following, which
ensures a safe and productive treatment

• Contraindications,
• What supplements or medications the client takes,
• What surgeries they have had recently,
• Lifestyle issues
•
These questions are crucial for assessing the client’s suitability for the treatment and for
making assumptions about how the treatment would go and what its
Your verbal questions should elicit the following information from your client:

• The reasons why the clients have decided to have the treatment,
• The symptoms that they have observed,
• Their lifestyle and nutrition,
• Any possible contraindications that they might have,
• Their expectations from the treatment,
• any supplements or medications that they take.
•
The RICTAT questionnaire constitutes a consent form which is a legally binding document
that is required by your insurance company. The questionnaire, consent form and client
observation form must be retained on file for a period of five years for insurance purposes
as there is a three year period of limitation in which a claim can be brought. If the client is
a minor then the five years start at their 18th birthday.

Consent form is a document that constitutes the client’s agreement to have the treatment,
and states that the client has been informed about the procedure and is willing to have the
treatment.

Observation Form
During the treatment you will be observing:

• The physical behaviour of the client,

• The physical behaviour of the client’s digestive system,
• The quality of the client’s eliminations,
• The ease of the client’s eliminations,
• Peristalsis,
• bowel tone,
• Mucus, gas, yeasts and parasites.

As you observe, you mentally take notes about what recommendations you are going to
give to the client and record on your observation sheet.

This form must be completed by the therapist for every treatment undertaken. It is
recommended that the treatment is documentation as soon as possible following the
treatment to ensure an accurate record. The forms must be kept with the clients
questionnaire and consent form for future reference in a secure location.

Data Protection
If you hold your clients treatment records electronically you must comply with current Data
Protection applicable in your country.
CONFIDENTIAL CLIENT HISTORY FORM
TITLE ____________ NAME ________________________________________________________

ADDRESS __________________________________________________________________________

__________________________________________________________________________________

______________________________________________ POST CODE _________________________

DATE OF BIRTH _______________________________ OCCUPATION __________________________

Please give the following contact details and tick your preferred method of contact

________________________________________________________________________________
__

________________________________________________________________________________
__

Where did you hear about us? ________________________________________________________

GP’s Name and Address ______________________________________________________________

__________________________________________________________________________________

Please answer the following as accurately as possible:

Are you seeing your Doctor at present? YES/NO (If Yes, please give details)

__________________________________________________________________________________

List any medications, supplements you are taking: ________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

List any medical conditions you have ___________________________________________________

__________________________________________________________________________________

List any surgical procedures you have had and the dates ___________________________________

__________________________________________________________________________________

List any allergies you may have ________________________________________________________

__________________________________________________________________________________

Do you suffer from any of the following – please tick

• Hernia
• Cancer of the colon or rectum
• Colitis
• Congestive heart disease
• Diverticulitis
• Fistula
• Hirschsprung’s disease
• High Blood Pressure
 • Ileus (paralytic)
• Ulcerative Colitis
• Crohn's
• Inflamed haemorrhoids
• Rectal bleeding
• Radiotherapy of abdominal area not discharged from medical care
• Severe Anaemia
• Renal insufficiency
Severe persistent diarrhoea
• Controlled high blood pressure
• Diabetic
• Low Blood Pressure
• Fissure
• Haemorrhoids

Have you ever had surgery of colon or rectum? YES/NO If yes, when_____________

Have you ever had a bowel biopsy YES / NO If yes, when_____________

Have you a prostate biopsy made through the bowel YES / NO If, yes when _____________

Have you had abdominal surgery e.g. hysterectomy YES / NO If, yes when_____________

Recent Laparoscopy YES / NO If, yes when_____________

Are you undergoing chemo-therapy and cancer treatments? YES / NO

Do you take oral or rectal steroids? YES / NO

Have you undergone recent (within 6 months) hip/knee joint surgery? YES / NO

Are you pregnant? YES / NO

Are you breastfeeding? YES / NO

Do you smoke? YES / NO If yes, how any a day?

_________________

Do you drink alcohol? YES / NO If yes, how much a week? ______________

Do you drink water? YES / NO

Do you have any special diet? YES / NO Please describe _______________________

General Bowel Movements

Do you require laxatives? YES / NO If yes, what do you take? __________________________

How would you describe your bowel movements? Please tick where appropriate

• Less than once a week

• Once a day

• After eating
 • Occasional

• Twice a day

• Require straining

• Every ______ days

Do you suffer from any of the following? Please tick where appropriate

• Diarrhoea

• Constipation

• Gas/Wind

• Bloating

Declaration

I agree to undergo a possibly rectal examination and subsequent colon hydrotherapy treatment and to
receive enema herbs as part of my treatment if recommended by my Therapist

Name ____________________________________________________________________________

Signed ____________________________________________________________________________

Therapist __________________________________________________________________________

Date _____________________________________________________________________________

Colon Hydrotherapy is a safe and effectively cleanses your large intestine –colon. Your Therapist does not
diagnose disease or prescribe medications. Should any of your responses to any of the above questions
contraindicate colon hydrotherapy you will be advised to seek your doctor’s help. It is responsibility to
provide full and complete answers so your Therapist can treat you correctly. Also you must inform us of any
changes to your health between treatments.

General Data Protection Regulations (GDPR)

• I consent to the data I have given to be used by _____________________________

for the purposes of documenting and communication in regards to the treatment I am undertaking.

__________________________________________________________________________
________

• I understand the data and information on paper copies will be stored securely and
any data stored on electronic devices will be password protected.

• Only information to my treatment will be held and it will be stored for no longer
than necessary
 •

__________________________________________________________________________
________

• I am happy to receive any information on promotions and/or newsletter

YES / NO

• I consent to being contacted by

EMAIL - YES/NO PHONE – YES/NO TEXT- YES/NO

Signed ____________________________________________________________________________

Date _____________________________________________________________________________
Clients Name
_____________________________________________________

Session No & Date

Mucus

Gas

Colour

Undigested Food

Consistency of Faeces on Bristol Stool Chart

Pain

Nausea

Diet

Implants
Supplements

Candida/Parasites

Result

Additional Remarks

Initials of Therapist

Date
Knowledge Review and Research
• Why do clients need to fill in a treatment questionnaire?

• What is a consent form and why it is important?

• Why is it important for the therapist to accurately complete the

treatment observation sheet?

• How do you, as a therapist maintain client confidentiality?

Icebreaker and interview

Putting the client at ease is very important. Here are a few icebreaker questions you can
ask:

“Is this your first colonic?”

“Have you ever had a colonic before?”

Or open questions like:

“Why have you decided to have a colon hydrotherapy treatment?”

“Have you had any friends who have had this treatment with us?”

“What do you expect to achieve from the treatment?”

So once you have got your first question in mind, you can start your interview.
The client interview is extremely important.

As a therapist, if you see that your client is really nervous, engage the client into a
conversation about something that doesn’t have direct relevance to colonics. For example,
ask the client what they do, ask them to tell you a little bit more about themselves, their
family, work and so on. Help them relax first.

During the interview you also need to describe the treatment procedure. You may say for
example:

“After we have spoken, I’ll ask you to change into the treatment gown, and to lie on the
bed lie on your left side and draw your knees up towards your chest.

Following this then:

I am now going to lubricate and insert the speculum, once it’s in I am going to connect the
speculum to the machine and then we will start the treatment, at any time you can ask me
to stop, you are always in control.

Generally it will be comfortable for you. From time to time, you may experience a cramp
like during diarrhoea or a period, but the discomfort will be of a short duration.
Treatment Procedure Guidance
Set treatment room up with your equipment prior to client arrival
Welcome client and discuss treatment
Ask the client to complete the questionnaire and consent form
Check contraindications or make sure that you are aware of any changes since the last
visit.
Hand client robe and ask client to change into the robe, if desired and use the toilet if
necessary (keeping tops and socks on if they wish) and making sure they put the robe on
with the opening at the back

While client is changing:

Make sure there is provision to accommodate the obturator

Make sure that your disposable treatment equipment is to hand
Make sure the tissues are readily available
Prepare the clinic environment

Client changed:

Raise bed if applicable

Put on gloves
Ask client to lie on the left, and draw knees up
Lubricate speculum

Treatment starts:

Advise client you are going to insert the speculum and make sure you get consent to start
the treatment
Lubricate anal area with lubricant
Insert speculum (for guidance on speculum insert see Appendix ??)
Remove the obturator
Change gloves if they are smeared with bodily fluids
Start timer
Start flow gently and watch the pressure gauge and temperature gauges and respond to
client need and feedback
When release on the side decreases, turn the client onto the back – remember to support
the speculum with a suitable tie to make sure the speculum stays in place.

Treatment on the back

Massage the client’s abdominal area as appropriate

Watch the waste line and drain when the client is releasing
Treatment ends:

Ask client to turn on left side, and drain any residue of water and turn off equipment.
Remove speculum and advise the client to sit up carefully, if necessary on edge of couch
for a few moments
Ask the client to go to the toilet and get changed
Turn off treatment timer
Dispose of treatment consumables appropriately
Wipe all surfaces, scrub hands.
Provide the client with post-treatment information
Clean the toilet once the client has left
Record the treatment and the time spent
Client and therapist interaction during the treatment

The technical aspect

The way you perform the treatment will be influenced to an extent on the type of
equipment that you use.

If you use a gravity-fed closed system or the majority of pressurised devices, you will need
to regulate manually the water inflow and outflow during the treatment and may be support
the pipe.

If you use some other automatic systems, which are hands-free, you should be able to
move around the room more.

With open systems, clients regulate their own water intake and outflow, but you need to be
in close proximity to them and help them with the treatment and the interpretation of the
processes happening in their bodies.

Treatment focus – work with the client!

The main thing you need to remember is that colonics is about letting go: letting go of
wastes, letting go of emotions, letting go of the things that are stopping the client from
having a healthy lifestyle or a high level of energy and wellbeing.

Start gradually
That is why you should start your fills gradually. With a Gravity System a good treatment
practice to adopt is to ask the client to say the word ‘now’, or ‘release’ when the client
needs to open the bowels. If the client says ‘now’ too often, and you feel that you cannot fill
the bowel with water sufficiently, ask the client to hold the water for a little bit longer to the
point of mild discomfort.

Whereas with a pressure system, the device can sense the pressure in the client’s
intestines, the client’s colon is filled slowly with water and the amount of water can be
increased or decreased by the therapist using the pressure gauge. To discharge the
waste water from client again this is under the control of the client who asks the therapist
to discharge the water. What you to be aware of is that you may need to focus your
attention on the client’s discomfort threshold, because sometimes the person’s discomfort
threshold and the bowel’s discomfort threshold are different.

It usually takes five to ten minutes for a new client to get used to the treatment. Sometimes
the client would ask you: should I be holding more water? The answer to this is yes, they
can hold more water, as long as it doesn’t make them too uncomfortable. It is better to fill
and then empty more often or use gentler pressure than make the client too uncomfortable
and have to interrupt the treatment.

IBS sufferers
A very important point must be made about those people suffering from IBS.

People suffering from IBS feel the changes in temperature a lot more than non-IBS clients.
This could be related to a higher than average number of CNS nerve endings in the
digestive system of this group. These nerve endings relate the information from the
intestines to the central nervous system. These clients are a lot more aware of the
changes in their digestive systems.

That is why these clients need particular supervision. Keep the temperature as close to the
body temperature as possible and fill gently.

Working with the whole person

Remember that although you are cleansing the client’s digestive system, you are working
with the whole person, and what you are doing affects the whole person.

During the treatment, watch the clients’ facial expressions; watch their toes and their fists.
If they are clenching their fists and curling their toes, it means you have gone too far:
check with the client if she or he wants a gentle soaking break. Most of the time, clients
are perfectly comfortable with the treatments, but it is those of the clients that are not
comfortable that you need to pay particular attention to.

Water temperature
During the treatment you can regulate water temperature. Cooler temperature will mobilise
the bowel, warmer temperature will relax the bowel. By alternating cooler and warmer
temperature, you might achieve a significantly deeper release.

Remember that, unless you are dealing with an IBS client, the bowel itself does not
respond to the changes of temperature unless the changes are quite significant. That is
why you need to make sure that you stay within the parameters of the temperature
prescribed by the manufacturers of your equipment. Also make sure that your temperature
gauge always works. If in doubt, check the temperature of the incoming water against the
inside of your arm. If it is too hot for the inside of your arm, it may be too hot for the bowel.

Educating the client

Talk to the client during the treatment: this is your opportunity to educate the client about a
healthy lifestyle.
Less is more!
Remember: it is not about how many litres of water you use in treatment or how much a
client discharges. It is, however, about delivering a comfortable, unique, holistic treatment
that cleanses the bowel in a way that reflects each person’s individual needs.

Act relaxed
However, it is very important to act relaxed, even if you are not relaxed, because if you are
tense, your tension will be transferred to the client, and you will not achieve a satisfactory
treatment both for yourself and the client.
Abdominal Massage
Massage in the direction of bowel processes and only massage when a client is releasing
NOT filling.

Generally your massage should be light, achieving the following goals:

• Client relaxation
• Lymph draining
• Bowel activation
• Bowel relaxation
• Better elimination

Often during the treatment it helps to massage the client’s abdominal area. Always
massage in the direction of the bowel processes rather than against the traffic.

A simple massage routine is:

THE ABDOMINAL AREA

• Massage the sigmoid area towards the anus

• Massage the descending and the sigmoid
• Massage the transversal and the descending
• Massage the ascending and the transversal
• Drain the two flexures, hepatic and splenic, with long gentle strokes or
circular massage of the lower back; if you know how, you can use gentle traction.
• Concentrate on the ileocecal valve.

Also, it is very helpful to have is a portable massager that has an infra-red head and a vibration
head. Gentle vibration, which is not uncomfortable for the client, achieves a lot more than strong
manual massage around the abdominal area, because vibration activates the enteric nervous system
and promotes better elimination.

In addition infra-red heat calms down even the most hyperactive clients.
Release Techniques
When people come to a colon hydrotherapy treatment they usually have an initial problem.
That initial problem is normally related to gas, bloating or constipation. So we can predict
that the treatment might meet some kind of obstacle that is also related to gas, bloating or
constipation.

The tools we can use are obviously the temperature and the flow control, which are the
basic techniques, as well as some other techniques, which we can describe as soaking,
teasing and burping.

The soaking technique can be used very well for clients with atonic constipation and no
discomfort related to bloating or gas at any stage of the treatment. If you feel that you are
putting the water in, taking the water out and not getting anywhere, try this technique.

If the client has a lot of gas, a very useful technique is burping the waste line. Burping the
waste line is just like burping a child. It will release the gas. To burp the waste line, quickly
scrunch and release it a few times. This will help break up larger gas bubbles into smaller
gas bubbles and releases them helping water to come out as well.

Finally the last technique is teasing. You can use teasing very well when large pieces of
faecal matter that do not fit into the speculum cause discomfort to the client.

Take hold of the waste line close to the speculum, raise it a little bit, and move it up and
down as if you were “teasing” the bowel. This helps engage the bowel muscle and the
nerve endings, helping contractile activity and breaking up any stubborn matter releasing it
into the waste line.
Finishing the treatment
There are a few pointers showing you that the treatment can be finished.

If, about half an hour into the treatment during which you have observed several good
releases from the client’s bowel, you may see the caecum flush (which looks a bit like pea
soup), that means that the water has reached as far as the ileo-caecal valve. Do a couple
more flushes and massage the client between the flushes.

If you see that the distension and the bloating reducing when you let the water out, then
you could probably terminate the treatment and let the client release the rest of the matter
on the toilet.

Sometimes the treatment is quite uncomfortable for the client at the start. This often
applies to heavily constipated clients. The treatment needs to be interrupted at least once
or twice so the client can have a release on the toilet.

People with specific reactions to food, intolerances etc. may need a course of
several treatments during a short period of time to achieve a significant difference
in “gut reaction”.
Post Treatment Advice

What should I recommend to my client after the treatment?

As a general rule, you should recommend your client to relax, take it easy and not to
engage into any strenuous activities. One should also eat light, with the bulk of the
nutrients coming from vegetables, fruit, and juices and light proteins, and not eat any spicy
or rich foods at least for the next couple of days. It is recommended to abstain from alcohol
in any form for 48 hours after the treatment.

It is recommended that you provide the RICTAT post-treatment advice sheet to clients

What about probiotics?

It is generally advised to take probiotic supplements and eat live yoghurts. Eating
fermented foods, such as live yoghurts, sauerkraut and other fermented vegetables, miso,
tofu, is recommended after a colonic. The bowel is a naturally acidic environment.
Probiotic bacteria survive best in lactic acid, and this is what fermented products help
create.

Clients often ask if it is worth buying the probiotic drinks that are sold in supermarkets. The
reservation therapists have about some of these probiotic drinks is that they contain sugar,
and sugar should generally be avoided in the nutritional regime recommended after
treatment.

Eating natural yoghurt and sauerkraut makes a lot more sense, because they are natural,
living foods. If for some reason your client can’t have live yoghurts or fermented foods, and
is unable to get hold of probiotic supplements, then a probiotic drink is certainly better than
nothing.

Be Mindful
Sometimes, after an uncomfortable spell, if the client has achieved a satisfactory release
on the toilet, it may make sense to stop the first treatment and book in the client for a
second treatment after a couple of days’ interval, and may be even the next day.

Important note
It’s worth reiterating here that you can only give general advice and recommendations.

You cannot prescribe or diagnose unless you have other

qualifications and insurance.
CLIENT AFTERCARE ADVICE
Some people have immediate positive benefits as soon as they have had a colonic
These can be
• General feeling of wellness and increased energy
• Reduced bloating
• Flatter abdomen
• Clearer, sharper vision
• Increased mental agility
• Better quality sleep

Your colonic is the start, it is up to you to take an active part by reviewing your diet, lifestyle and by
having regular colonics, and you can significantly improve your health and wellbeing.

If you can…….

• Have a relaxing day and take some time for yourself

• Try to follow the advice as discussed with your therapist
• Eat lightly and simply and remember to chew well
• Drink an extra litre of water especially for the first 48 hours
• You will have absorbed a lot of water during your treatment, so you may pass
more water than usual, this will settle quickly
• You may have more wind and ‘rumbling’. This is the colon becoming active
again and producing ‘good bugs’
• Avoid rigorous exercise, especially lifting heavy weights for 24 hours.

Some people feel a little ‘washed out’ for a while as toxins have been moved from your colon
around your body.

This is known as a ‘healing crisis’ and can be mild or quite noticeable.

It is the body cleaning itself and should disappear within 24-48 hours
Not all people experience this, but it is something to be aware of,

BUT NOT TO WORY ABOUT

It is a positive reaction!

Drink plenty of water to help your body flush these toxins and waste out.

You may experience -

• cold like symptoms
• Headaches
• Tiredness
• Skin Blemishes
• Passing more urine

DO NOT HESITATE IN CONTACTING US IF YOU ARE WORRIED OR FOR

FURTHER ADVICE

Begin to Care For Yourself

Here are a few simple measures to follow:

• CHEW! CHEW! CHEW! An old saying ‘Drink your food and chew your
 water!’

• Drink plenty of fluids, preferably water. Try to drink a large glass ½ an hour
before a meal or 1 hour after, NOT WITH MEALS as this dilutes your digestive juices. Try
to avoid alcohol, coffee, tea and other caffeine drinks.

• Try to reduce red meat intake, don’t eat it every day. ‘Lighter’ meats such as
fish and chicken are easy to digest, vegetarian meal more so.

• Move to wholegrain – brown rice and pasta, wholegrain cereals and

wholemeal flour rather refined white flour, white bread, pasta or rice.

• Eat lots of different vegetables. Make fresh soups, easy and tasty. Roast or
stir-fry - don’t overcook keep the crunch. Eat a ‘rainbow’ of colours – more antioxidants.

• Try and eat what the planet gives us – natural, organic and unprocessed foods.

• Get interested in what makes you – YOU ARE WHAT YOU EAT ……
AND CAN ABSORB!

• If you have a problem with wind or you get ‘gripes’ drink warm fennel,
chamomile or peppermint tea, not cold or carbonated drinks, don’t eat ‘gassy’ foods.

Here are some things to try and change in your diet –

• Use lots of Garlic! Add chilli, ginger, turmeric and oil then blitz to make a
paste, a great start to stir- fry’s, soups or casseroles. Put it on fish, chicken or even roast
veggies for a tasty, healthy dish.

• ¼ to ½ teaspoon of cinnamon and nutmeg on cereals, porridge or fruit salads

(max 3 times a day!) or use in soups, casseroles or curries etc.

• Cook with high ‘flash-point’ oils such as sunflower, groundnut, rapeseed,

ghee or coconut oil.

• Don’t cook with extra virgin olive oil – put it ON food after cooking!

• Add beans and pulses, nuts and seeds to your diet – especially pumpkin
seeds!

• Eat soda bread , wholemeal pitta or wraps, chapattis or ‘grain’ crackers,

oatcakes, rice cakes, ryevita

Foods to avoid to help your bowel re-balance -

• Yeast – bread, mushrooms, ‘mouldy’ cheeses, yeast extract spreads

(Marmite), wine, beers or lagers.

• Sugars – stop adding sugar to food, if needs be, use a natural source like
honey or fruit.

• Artificial sweeteners, refined and convenience foods contain ‘non-natural’

additives and chemicals which our body never had to process until more recent years.
 • Avoid mucus producing dairy products and refined flour products. Try soya,
oat or rice milk.
Knowledge Review and Research
1. Why is it important to explain the treatment procedure to the client?

2. What is the importance of changing temperature?

3. How would you adapt your treatment if your client suffers from IBS?

4. What are the main rules of the insertion?

6. Imagine you are unable to insert the speculum – what would you do?

7. Why do you need to work in the direction of bowel movements?

11. Why do vibrations and light percussions achieve a better effect than
strong muscle work?

13. What signs can show that the treatment can be finished?
FAQ’s by Clients
What is Colon Hydrotherapy?

Also known as a ‘Colonic’, ‘Colonic Lavage’, ‘Colonic Irrigation’ or ‘High

Colonic’, colonic hydrotherapy is safe, effective method for cleansing the colon of
waste material by repeated, gentle flushing with water.

What is the Colon?

The colon or large intestine is the end portion of the human digestive tract
(food carrying passageway extending from the mouth to the anus).

The colon is approximately 1.5 m long and 6-7 cm in diameter. Its major
functions are to eliminate waste to conserve water. Also, there are bacteria living in
the colon which synthesize valuable nutrients such as Vitamins K and portions of
the Vitamin B complex.

What is the purpose of having a Colonic?

Waste material, especially that which has remained in the colon for some
time, (i.e. impacted faeces, dead cellular tissue, accumulated mucous, parasites,
worms etc.) poses several problems. First this material is quite toxic (poisonous).
These poisons can re-enter and circulate in the blood stream making us feel ill, tired
or weak. Second, impacted materials impair the colon’s ability to assimilate
minerals and bacteria-produced vitamins and finally, a build-up of material on the
colon wall can inhibit muscular action causing sluggish bowel movements, linked to
constipation

How can I tell if I have toxic material in my colon?

This condition is prevalent in all civilized societies and particularly in the UK.
Common signs include: headaches, backaches, constipation, fatigue, bad breath,
body odour, irritability, confusion, skin problems, abdominal gas, bloating, diarrhoea,
sciatic pain and so forth. As you can see, intestinal toxicity is part and parcel of
many peoples everyday experience.

Is intestinal toxicity a common disorder?

Yes it is, but toxicity is not limited to just the colon. Toxic material if found
throughout the body, particularly in fat tissue, joints, arteries, muscles, liver etc.
Colonics effectively eliminate large quantities of toxic waste, affecting the condition
of the entire body.
As the colon isn’t the only organ of elimination, what makes the colonic so
important?

While the lungs, skin, kidneys and liver also serve to eliminate toxins, people have
experienced throughout history that when they ensure that the colon is cleansed
and healed, the well-being of the whole body is greatly enhanced. Colonic
hydrotherapy has been found to be the most effective process available to
accomplish this work quickly and easily.

Why not use enemas, suppositories or laxatives instead?

Everything has its proper place, but those things really aren’t substitutes for
colonics. Enemas are useful for emptying the rectum (the lowest 20 – 30 cm of the
colon). Usually, one or two pints of water are used to do that. Suppositories are
intended to accomplish the same task. Laxatives particularly herbal laxatives are
formulated for various purposes, such as: to undo the effects of temporary
constipation, to build up the tone of the colon muscle, etc. But the premier method
of colon cleansing without question is colonic hydrotherapy.

What makes a colonic so special?

In a 45 minute session approximately 68 – 70 litres of water is used to gently flush

the colon. Through appropriate use of massage, pressure points etc. the colon
therapist is able to work loose and eliminate far more toxic waste than any other
short-term technique.

What will colonics do to the colonic?

•
• Specifically a colonic is used to accomplish the following:
•
• Cleanse the Colon – Toxic material is broken down so it can no longer
harm your body or inhibit assimilation and elimination. Debris that has built up over
a long period is gently removed in the process of a series of treatments. Once
impacted material is removed, your colon can begin to co-operate as it was
intended to. In this very real sense a colonic is a rejuvenation treatment.
• It Exercises the Colon Muscles – The build-up of toxic debris weakens
the colon and impairs its functioning. The gentle filling and emptying of the colon
improves peristaltic (muscular contraction) activity by which the colon naturally
moves material.
• It Reshapes the Colon – When problem conditions exist in the colon,
they tend to alter its shape which in turn causes more problems. The gentle action
of the water, coupled with the massage techniques of the colon therapist helps to
eliminate bulging pockets of waste and narrowed, spastic constrictions finally
enabling the colon to resume its natural state.
• It Stimulates Reflex Points – Every system and organ of the body is
connected to the colon by reflex points, colonics stimulates these points, thereby
affecting the corresponding body parts in a beneficial way.

Is it embarrassing to have a colonic?

No, you will fully maintain your personal dignity. You will be in a private room with
only your therapist, who fully appreciates the sensitivity of the colonic procedure
and will help you feel at ease. Your emotions will be acknowledged and respected.
After the gentle insertion of a small tube into the rectum, you are completely
covered. Disposable tubing carries clean water in and waste out in a gravity
pressured system. The mess and odour sometimes present during an enema
simply do not exist with a colonic.

Is there anything I need to do to get ready for a colonic?

Since your abdomen will be massaged it is a good idea to eat or drink lightly in the
2 hours immediately preceding a colonic. Also, helpful but not essential, emptying
the rectum with a bowel movement just prior to the colonic saves time and permits
more to be accomplished.

What can I expect afterwards?

Most likely you’ll feel great. Probably you’ll feel lighter and enjoy a sense of well-
being. Not infrequently, someone having their first colonic will remark that it was
one of the most wonderful experiences of their life. As soon as the colonic is
finished you can carry on with your daily routine. For some, the colonic may trigger
several subsequent bowel movements for the next few hours, but there won’t be
any uncontrollable urgency or discomfort. It’s also possible you may feel light-
headed or chilled for a few moments following a colonic – this is known as a healing
crisis.

If colonics are so good, why haven’t I heard about them before?

Historically, artefacts and records show that people have regularly purified their
bodies, including cleansing their colon. Around the turn of the 20th century, the
present-day colonic machine was developed, providing a significantly improved
method of accomplishing colon cleansing. Up to the late 1920’s many doctors had
colonic machines in their offices and machines were found in hospitals as well.
Articles dealing with colon health frequently appeared in prestigious medical and
scientific journals until the early 1930’s. At that time modern man began a 50 year
love affair with drugs and surgery. These seemed to offer a relatively instant relief
for body aliments, resulting in purification and prevention techniques becoming less
attractive. Recently however, there has been a resurgence of interest in using
natural approaches for healing the body and colonics have rapidly been regaining
the respectability they have already earned.
Are colonics dangerous in any way?

Being an essential natural process there is virtually no danger with a colonic. Our
intent is to provide a safe and healthy service so that you do not have to worry.
Cleaning and sterilisation of the necessary equipment is done as normal procedure
and clean linen is used for each colonic as well. High standards of cleaning are
paramount along with the use of disposable speculums and tubing to ensure that
there is no risk of cross contamination.

Are there any additional benefits I might expect from a colonic?

Working with a skilled therapist a colonic can be a truly enlightening educational

process. You will learn to expand your awareness of your bodies functioning by
including signals form your abdomen, your skin, your face and even from that most
taboo of natural products, your elimination’s. You will find that you can spot the
beginnings of developing conditions through clues from these body regions and
functions before they become serious. You can deal with them sooner and more
easily than you otherwise might if you waited until they produce effects seen
elsewhere in the body. Also, the solar plexus is the emotional centre and the
transverse colon passes right through it. If an emotional event is left uncompleted,
it often results in physical tension being stored in the solar plexus, which affects all
organs of the area, including the colon. This on-going tightening of the colon
muscle results in diminished movement of faecal material through the colon, which
is experienced as constipation. Not only do colonics alleviate the constipation, they
can assist you in creating a fully holistic view of your body’s functioning, leading to a
better quality of life.

What are the characteristics of a healthy, well-functioning colon?

Healthy babies, animals and adults not subjected to the ‘refinements’ of civilisation
(i.e. Aboriginal peoples) have bowel movements shortly after each meal is eaten.
So, assuming there is sufficient fibre and water available to the colon, one
characteristic is a bowel movement shortly after a meal is eaten. Once the urge to
eliminate is honoured by a trip to the toilet, the elimination should be easy and take
no more than a few seconds. The stool will be long, large in diameter, light brown in
colour, without offensive odour and should float or sink very slowly. When the toilet
is flushed, the stool immediately begins to breaking apart by the action of the water
movement. As incredible as this may sound, it is true and commonly experienced in
cultures where people live more naturally.

How can I tell if I personally benefit from a colonic?

Does your colon now exhibit the signs of a well-functioning colon? If not, one or
more sessions with a knowledgeable colon therapist may bring you great benefits.

Is a colonic painful?

Usually, a painful experience is the result of resistance and tension. A professional

colon therapist is skilled a putting you at your ease and minimizing discomfort.
Most people actually enjoy the colonic and are pleased with the unaccustomed
sensation of feeling lighter, clean and clear afterwards. Sometimes during a
colonic, the colon muscles will contract suddenly expelling considerable amounts of
liquid and waste into the rectum. This may feel like cramping or gas and may
create a feeling of urgency to empty the rectum. Such episodes if they do occur are
brief and easily tolerated.

Some people say that colonics wash out intestinal flora and valuable
nutrients. Is this so?

The truth is that the washing out of putrefied materials in the large intestine,
increases the food intestinal flora to flourish. Good bacteria can only breed in a
clean environment which has been washed free of putrefaction and its
accompanying harmful bacteria. This is why the intestines of a new born baby
immediately begin to grow good intestinal flora. Each time you clean out the
putrefying rubbish and make a better environment for the good flora, they start to
multiply immediately in their natural media. It also stands to reason that valuable
nutrients can better be absorbed in a clean environment than in a putrefied one.

What effect does colonic hydrotherapy have on our immune system?

The removal of stagnant waste material and hardened, impacted toxic residue could
rejuvenate the immune tissue that resides in the intestines. Recent European
studies speculate that 80% of immune tissue resides in the intestines. This is much
higher than previously thought and makes it logical to believe that this type of
therapy could influence such immune deficiency diseases as M.E., cancer and
A.I.D.S. Colon Hydrotherapy is not a cure-all, but an important adjunctive therapy
in the overall health care of the client.

How long does a colonic last?

Probably 90% of all colonics take about 45 minutes. It could be shorter or longer
than that, based upon the judgement of the therapist and sometimes, the wishes of
the client. There will also be about 15 minutes required before the colonic for the
therapist to go over your medical history, another 15 minutes should be allowed for
changing. On a first colonic you should expect to spend an hour and half at the
clinic.

Is there a special kind of water used for colonic hydrotherapy?

We use highly filtered water, which passes through a number of filters before being
heated to the correct temperature. This is capable of absorbing and flushing more
toxins out of the colon because of its drawing effect on solid particles, chemicals
and other matter. Tap water is not used because it already has numerous
chemicals and inorganic substances present.

Will it be okay to eat after having a colonic?

We suggest that you eat at your normal meal time and consume a moderate
amount of whatever seems gentle and nourishing to you. Just as it doesn’t make
sense to have you car cleaned and then immediately drive it through mud, eating a
meal known to cause trouble in your abdomen directly after a colonic isn’t an
intelligent choice. Salads, vegetable soups or broths, fruit or juices are the best
choice.

Are colonics habit forming?

The colonic is tool intended to be used to create a clean and healthy colon. A colon
therapist, who is dedicated to your health, will encourage you to set a goal of having
a well-functioning colon. Our fulfilment comes from assisting you in healing your
colon, not in making you dependent upon colonics. Actually, one of its features it
that a colonic can be used to tone the colon muscle so that the colon doesn’t
perform so sluggishly. Many people have sluggish colons. It may take days for
bowel movements to return after a good colonic. This is when people think they are
becoming ‘dependent’ on colonics. One good colonic is worth 20 or so regular
bowel movements, so it may take some time for faecal material to build up in the
colon once again if one has a sluggish colon. When the colon is sluggish and
bowel movements do not return for a few days after one colonic, it is an indication
that extensive colon work is needed to remove the debris that the bowel has built up
over the years. The build-up of faecal material has decreased the muscular action
in the colon. Once a series of colonics is completed, the colon will begin to function
like Mother Nature intended. Colonics give you a feeling of being lighter, cleaner
and healthier with a sense of well-being. Cleansing and building programs offer
preventative measures so that you can be in control of your own health. Dietary
changes may be necessary to ensure long lasting and vital health. Your therapist
may well ask you to consider dietary and lifestyle changes to promote your optimum
health. Your therapist will advise you on nutrition and lifestyle.

Will a colonic make me constipated or give me diarrhoea?

The most frequent post-colonic experience is to have a slight delay in bowel

movements and then a resumption of a somewhat larger, easier to move stool.
Sometime if the colon is weak and sluggish, there may be no bowel movement for
several days following a colonic. However, this is not due to the colonic, but rather
to the weakness of the colon and should be interpreted as an indication that the
colon requires strengthening and healing. Very infrequently diarrhoea or loose
bowels maybe experienced. This could be due to the extra water introduced into
the colon or to the stirring up of toxic waste. If this should occur, it is usually of very
short duration. However, since severe diarrhoea dehydrates the body, it must be
carefully monitored.

Suppose I have been suffering from constipation for a long time, will colonics
help?

Constipation can be successfully treated with natural, harmless techniques,

including the use of colonics. Constipation is one of what may be termed ‘civilised
man’s disease’. There are three factors involved in having a well-functioning colon:
diet, exercise and attitude. All three must be in balance for the colon to function
well. Often, however, because the colon has been sluggish for so long, it has
become severely weakened due to being constantly bathed in toxic waste,
stretched from holding excessive amount of stools and frequently constricted by
chronic tension in the colon. The process of colonic hydrotherapy is excellent for
cleansing and healing the colon sufficiently so that changes in diet, exercise and
attitude are then able to produce their effects. Many people find the relief provided
by colonics stimulates the motivation and enthusiasm to institute positive changes
in their lifestyle.

Will one colonic completely empty the colon?

Almost never. Firstly, many of us have a considerable amount of impacted faeces
in our colon; these is hardened, rubbery or wallpaper like material. Substantial work
must be done to remove it. Secondly, there is a subtle learning process involved in
receiving colonics. As you become more aware of what is going in your abdomen
and your body learns how to allow the cleansing experience you are better able to
enter into that process and therefore more material is released. One colonic will
removed some of the stagnant waste in the colon. The second and subsequent
colonics will remove more. How many you wish to have will depend upon your
personal objectives. Your qualified therapist will advise you after your initial colonic
treatment.

How will I know when the colon is empty?

It will be probably never be completely empty, as it is an organ in continuous use.

As more of the old impacted material is release you will actually feel the water enter
higher regions of the colon without any sense of obstruction. The objective should
not be an empty colon, but rather a well-functioning colon.
Will a colonic clear up my skin?

Your skin actually ‘breathes’ and is an important organ of elimination of waste

material. Sometimes, if the colon, liver or kidneys are functioning poorly, the skin
will be required to make up the difference. Surface eruptions on the skin of various
sorts may occur due to toxins being released. Cleansing and healing the colon
diminishes the burden placed upon the skin as well as other organs of elimination:
lungs, liver and kidneys. As elimination is accomplished through its proper
channels, the skin will very often clear up.

How expensive is a colonic?

This varies dependent upon location. Although cost is relevant, far more important
is your health. A knowledgeable therapist can help you on the road to vital health.
Always ensure that the therapist you choose is a member of a recognised
professional association. Ask to see their qualifications and insurance policy. It is
important that you feel comfortable with your therapist as you work with them.
Knowledge Review and Research

• How would you respond if a client asks how long does the
treatment last ?

• How do you know when the treatment is finished?

• How can the client prepare for the treatment?

• What would you tell a client to eat after the treatment?

• How would you respond if a client asks how much weight will I
lose?

• How would you respond if a client asks how long will it be before
I have a bowel movement again?
 • How would you respond if a client asks how often can I have the
treatment?

• How would you respond if a client asks is it dangerous and are

there any risks involved?

• How would you respond if a client ask can I go for a run or to the
gym after my colonic session?

• How would you respond if a client asks Is it just water you use?
Aftercare Guidance
Generally the first treatment you give to a client is exploratory, both for you and for the
client. Of course, you want to get as much cleansing as possible for the client; however
you also need to take into account the condition of the client’s body and state of mind.

Frequency of treatments
In a spa environment, where clients relax fully between 3 and 7 nights, you can
comfortably fit in two or three treatments, provided that between the treatments the clients
take probiotic supplements and have light, healthy meals, drink a lot of water, have alcohol
in moderation, relax and so some physical exercise.

In the environment of a complementary health clinic or a beauty clinic, where clients don’t
stay with you but come back to normal lifestyle, you need to realise that they need to give
their bodies more time to feel the full effects of the treatment.

People will go back to work; they probably will not be able to focus as much on their health
as the clients who are staying in a residential establishment. That is why the approach
here should focus on aftercare between treatments to a higher extent.

You need to recommend to your client to hydrate their body, eat healthy foods, take
probiotic drinks and possibly take other supplements that will support their digestive
system. You could suggest that they return in a short period of time to continue their
cleansing regime.

Generally, you would want to put your clients on a maintenance program, so that by the
third or fourth treatment they can determine what period of time is necessary between
treatments that helps them maintain their optimum level of health.
Starting your own colon hydrotherapy business
Once you have successfully complete the RICTAT Foundation Course in Colon
Hydrotherapy you can now start your own business,

You will need:

Insurance
It is necessary to have:

• Public liability insurance, in accordance with the laws of the country

that you practice in;
• Product liability insurance if you sell products on your premises;
• Employers’ liability insurance, if you employ even one person, for
example a receptionist or an assistant.

Premises
The following is required for the premises:

The premises must

• Be well lit,
• Have good extraction (ideally, an extractor fan),
• Have an enclosed area where the clients can change and store their
personal belongings,
• Have an adjacent toilet and wash facility, where clients can go
immediately after the treatment, without going through public areas,
• Fully washable floors,
• Area for the therapist to take notes and keep promotional materials,
• A bin for discarding disposables,
• Special bags for discarding disposables- clinical waste if required.
• Lockable cupboard to hold clients records

It is recommended to use paper towels in the client washroom for the purpose of
cleanliness and reduction of the possibility of cross-contamination. The floor of your room
must be washable; the room must be warm for the client. It is recommended to have music
and to create an environment that would be conducive to a high quality relaxing treatment.
Purchasing your equipment
In purchasing your equipment you need to research the information from all equipment
manufacturers and suppliers. You need to take into consideration:

• Your initial budget;

• The ease of purchasing and delivery of disposables;
• The cost of disposables and delivery;
• The cost of maintenance of the equipment;
• The ease of getting engineers out to fix and service the equipment;
• The space that you have got available;
• Plumbing requirements and so forth.

It is worth considering all these factors and making your choice of the equipment before
you start decorating your room and making it attractive for yourself and your clients.

Equipment prices can start from a couple of hundred pounds for a gravity system, that you
can use with disposable kits, to several thousand for a modern advanced colon
hydrotherapy device.

Get a good quality treatment couch, in budgeting for your equipment; don’t forget to
budget for a high quality hydraulic or electrical treatment couch.

Having a couch that can be raised and lowered is an advantage to both yourself and for
your client, especially if you work with gravity equipment, where the couch needs to be
quite high.

Investing in a good couch will also enable you to expand your practice, by offering a
service to disabled clients.

A variable height couch with the option of lifting the head and feet sections, which is easy
to adjust, can also be used for other treatments that you might want to offer, such as
massages, wraps, reflexology or aromatherapy.

Gloves
You’ll have to learn to do absolutely every operation using disposable gloves. That is why
before you start practising you need to investigate and try for comfort different types of
disposable gloves. There are latex powdered and non-powdered; vinyl powdered and
non-powdered, gloves with aloe-Vera moisturiser, to name but a few.

Ask suppliers to send you various glove samples in your size. Be mindful of clients with
latex allergies when using your gloves.

Record- keeping
If you are self-employed, record keeping is required by law. There is a legal requirement in
most countries to keep all the details of your client confidential and in a locked cabinet.
Therefore you will require a lockable filing cabinet from the very start of your practice. You
will need to keep your client and treatment records for a period of 5 years for insurance
purposes however, do check with your insurance company.

Make notes as soon as you have finished the treatment, rather than leaving this to the end
of the day: if you are tired, you will end up forgetting to note down important things, and
not giving the service that the client deserves.

Pre-care and aftercare advice

Pre-care and aftercare advice must be given to your clients after each treatment. Every
time the client comes for subsequent treatments you must ask if anything has changed:
whether they have had any injuries, illnesses or surgeries, had to take antibiotics, steroids
and so on. Update their case histories and adjust your treatments and recommendations in
view of the new information and ensure they sign the amended record.

Marketing materials and restrictions

As a colon hydrotherapist you cannot diagnose or prescribe, all you can do is recommend
and suggest.

Therefore none of your marketing material can contain any claims, express or
implied that you can diagnose and offer a cure for any disease.
Your marketing must focus on increasing hydration, removing stagnation,
increasing bowel motility, general well-being effects etc.

All your marketing materials must also state that colon hydrotherapy works best in
conjunction with a healthy diet, exercise and a positive lifestyle.

Consider setting up a Facebook Page to promote your business or investing a website

promoting your business and the benefits of Colon Hydrotherapy.

Follow best practices

Generally, when starting your practice, look around; see what other therapists in your area
are doing: go to them, get a treatment from them, pick up their marketing materials, use
their experience. Reproduce best practices, especially at the start: if it works for others, it
might work for you.

As time goes on, you will find your own unique way of doing things, you will find your own
strengths, you will go on continuing professional development courses, you will learn other
modalities, you will grow as a person and therapist, and then you will probably adjust your
marketing materials to your unique way treating your clients.
Appendix 1 – Colon Hydrotherapy and Other Holistic Modalities
Colon Hydrotherapy and Other Holistic Modalities.

Colon hydrotherapy is a great stand-alone treatment, but it can work even more effectively
when combined with other educational, bodywork, health and emotional awareness tools.
You will find below information on some possible combinations of colonics with other
holistic modalities and the reasoning behind these combinations. If you are already trained
in massage, nutrition, iridology, kinesiology or some other therapies, you may start thinking
about these combinations quite early into the start of your colonic practice.

If you do not have any other training, then this chapter may help you with the choice of
other modalities you may wish to learn, as well as with advising clients as to other holistic
health promotion options that are open to them.

Colonics and visual medicine self-awareness tools

Enabling treatments

The first group of treatments combines colonics with education and health awareness tools
– kinesiology, iridology and naturopathy, including tongue, nail and skin analysis and
emotional freedom tapping.

This category of treatments can be described as ‘enabling treatments’; because they give
clients a tool they can use to enhance their own state of health.

Kinesiology

Kinesiology works on the body’s energy circuits and involves testing large muscles, as well as the
body’s responses to food, chemical, herbal and homeopathic remedies. The main premise of
kinesiology is that the body has innate wisdom, and it knows what it needs.

It is a great self-assessment tool for people with a strongly developed ‘gut feeling’ and self-
awareness.

Iridology

Iridology is art-based naturopathic science. Iridologists can look into your eyes with a
magnifying glass and read imbalances of your internal organs from what they see in your
eyes. Many colon hydrotherapists use iridology as an initial diagnostic tool in their practice,
and it works very well for a lot of practitioners.

Being a good iridologist involves a certain degree of spirituality, as well as a sound

knowledge of the body’s anatomy and physiology.

Naturopathy

A very effective combination is that of colonic irrigation with a naturopathic consultation. An

ideal naturopathic consultation would involve live blood analysis, elements of kinesiology,
some iridology, a nutritional review and a tongue, nails and skin analysis.
Emotional Freedom Tapping (EFT)

EFT as it is often to referred to, is a combination of both ancient and Chinese acupuncture
and modern psychology that works to physically alter the brains energy system and body
in one easy to learn tapping sequence, which consists of tapping on specific energy
meridians with the fingertips. It is a useful tool when addressing deep emotional problems
that are stored in the subconscious mind.

Colonics is also an extremely liberating treatment at a deeply physical level.

The combination of colonics and emotional release treatments is sometimes extremely
effective in resolving longstanding emotional conflict and issues and reaching the closure
that is so badly needed.

Colonics and bodywork treatments

The next group of treatments that add value to colon hydrotherapy is bodywork treatments
such as massage, reflexology and body wraps.

The power of human touch

All these forms of bodywork have a great power of touch. Many of us, living in the modern
world, suffer from lack of touch. If you are a practising bodywork therapist already, then
you must have met in your daily practice the clients who come to you just to get the human
touch.

Massage

Massage, especially such gentle forms of massage as lymph drainage, is extremely

beneficial both before and after the colonic treatment.

Lymph drainage enhances the detoxification effect of colon hydrotherapy by speeding up

toxins removal from the system. It is beneficial to perform it both before the colonic
treatment, to promote more thorough cleansing, and after the colonic treatment, to
promote speedier recovery.

Body wraps

Body wraps, such as mud or seaweed wraps, engage our largest organ of the body, the
skin. They nourish and detoxify the skin and the internal organs by combining heat,
hydration and active agents in the substances used for body wraps. Mud, for example,
achieves the cleansing effect by hunting for free radicals; both mud and seaweed are also
beneficial because they nourish the body with micro-minerals.

The other extremely beneficial effect of body wraps is the combination of heat and hydration. This
combination has a calming and relaxing effect on the central nervous system. Relaxing the central
nervous system means that while the brain and the spinal cord are relaxed rather than engaged, the
digestive system can make better use of the blood and oxygen during the colonic treatment.

Performing body wraps after the colonic promotes general body detoxification and speedier
recovery.

Colon hydrotherapy and emotional balancing therapies

Sometimes colon hydrotherapy addresses such long-term complaints as irritable bowel
syndrome or constipation, which are caused by outstanding emotional issues waiting for
closure. You may experience during a treatment a client will start to cry as they release
both physical toxic waste along with toxic memories.

To help clients resolve these issues, it is beneficial sometimes to offer colon hydrotherapy
treatments combined with hypnotherapy, journey therapy and emotional freedom tapping.

Hypnotherapy

Hypnosis works by bypassing the critical conscious mind (usually through relaxation or
linguistic techniques), and speaking directly to the unconscious in a language, which it
understands. The unconscious mind is basically in charge. It allows people to explore
painful thoughts, feelings and memories that are hidden in their subconscious mind. It is a
tool used by psychotherapists and counsellors.

Journey therapy

Journey therapy is a globally recognised healing therapy, which promotes physical and
emotional healing. It is a simple set of techniques that free lifelong emotional and physical
blocks relating to addictions, depression, low-self-esteem along with chronic pain and
illnesses. The therapy aims to uncover unresolved emotions from the past that get trapped
in the physical tissues of our bodies and restrict our current lives. It is attributed to Brandon
Bays who healed herself without the use of conventional medicine of a large uterine
tumour in six and half weeks. There are qualified Journey practitioners in 47 different
countries.

Advice to colon hydrotherapists

One of the best tools given to you as a therapist is your ears. Start by listening to what
your client has to say, ‘tune into’ the client’s needs, and make your client, the most
important person in your life during the time they spend with you.

Letting people talk, don’t pre-judge, don’t invade their space, just let them express
themselves, because if they do, they let go and you have one satisfied customer after
another.

As a therapist, you will probably realise at some point that you will need to learn additional
skills that will be important to your practice. It must be a therapy with a philosophy that not
only resonates with but most importantly you enjoy doing the additional therapy.

Colonics and exercise

Another very powerful combination is that of colonics with physical exercise, such as yoga
and stretching.
Appendix 2 – Diet and Nutrition
Overview of Diet and Nutrition

Nutritional advice after the colonic

If you are not a nutritional therapist and you have not had any specific nutrition-related
training, then the advice that you should provide can be only general.
The general nutritional advice is presented below. This is the kind of ‘common sense’
advice that will, at least, put the client on the path to better health.

If you feel that the client could benefit from more specific nutritional advice that you are
unable to provide, recommend a visit to a naturopath or a nutritionist. If you have a
professional naturopath or nutritionist working in your practice, this constitutes an ideal
referral and enhances both the comprehensive service that you are able to provide to your
client, and the business element of the practice.

Eating a healthy balance

Anything that we eat should nourish every cell of our bodies. We can perform at our best
only when each cell of the body is happy with its nutrition. As each cell performs its task of
respiration, growth, repair and so on, it excretes metabolic wastes, which are acidic. These
wastes are the end product of cellular metabolism and must not be allowed to build up.
The body goes to great lengths to neutralize and detoxify these acids before they are in a
position to act as poisons in and around the cell, changing its environment.

A healthy eating system is based on eating natural, organic foods that form an alkaline
residue in the body that helps neutralise and detoxify the acidic wastes.
An acid-forming food contributes hydrogen ions to the body, making it more acidic. An
alkalising food removes hydrogen ions from the body, making it more alkaline. This
classification is based on the effect foods have on the body after digestion, not on their
own intrinsic acidity or alkalinity (or how they taste). The term "residue" or "ash" is often
used to indicate the effect of a food on the body. A food with an acid ash after digestion
contributes hydrogen ions, making the body more acidic; a food with an alkaline ash after
digestion removes hydrogen ions, making the body more alkaline.

Acid forming foods are proteins and concentrated carbohydrates and highly refined foods.
Meat, fish and grains as well as junk food and sugar all leave an acid residue. Alkaline
forming foods are most vegetables and fruit and quinoa.
The alkaline residue in the body is its store of alkaline forming minerals (electrolytes such
as potassium, calcium, magnesium and naturally occurring sodium), which are vital to the
metabolic functions of our body systems. When we have a sufficient reserve of electrolyte
minerals, the buffering process (the cushioning and removing of unwanted acids from our
systems), is not a problem as there is a ready store.

Acid foods are sometimes described as having a tensing, contracting, constipating energy
on the body and alkaline foods as having a relaxing, expanding, laxative effect on the
body. Too much acidity caused constipation, talkativeness and hyperactivity. Too much
alkaline causes loose, flaccid bowels, languidness, listlessness and apathy.

There are various theories on the proportions of acid: alkaline: neutral foods compose a
healthy diet. People vary, but for most, the ideal diet is 75 percent alkalizing and 25
percent acidifying foods by volume.
The typical western diet is composed of lots of processed food that contain high amounts of white
flour and sugar and chemical flavourings, colours and preservatives, and some estimates consider
that it contains 80% acid forming foods.

If a diet high in acid forming foods is eaten over time, the electrolyte mineral reserves can
become depleted as they are used to buffer the excess acids. Once the electrolyte
reserves become depleted, the body begins to take electrolytes from the various organs
and systems of the body to maintain the pH level. This is where the imbalance begins to
show. Blood and tissue alkalinity is then maintained, for example, by abstracting calcium
salts from the cell spaces of bones and teeth and by abstracting the alkaline element,
potassium, from muscles. Thus alkalinity leaves the bones and teeth weakened, and
causes the muscles to become acid contracted.

Alkaline forming foods are generally rich in minerals, fibre and plant protein. They are also
often low glycaemic foods: those that are broken down slowly and steadily.

This means that their digestion allows a smooth curve of blood sugar levels throughout
the day rather than the sharp peaks and troughs associated with high glycaemic foods
such as refined sugar.

Generally a diet rich in alkaline forming foods has many advantages: it is more nutritious,
keeps the excretory systems in good order and maintains blood sugar levels while
providing the optimum pH of tissue fluids for the body to function well maintaining good
health.

Indigestion creates rancidity, fermentation, putrefaction and sourness. It will happen due to
poor eating habits, no matter how good are the dietary choices. Over-eating has an
acidifying effect - due to food indigestion and spoilage. Inadequate rest, inadequate water
intake, anger, poor attitude, and overall stress are acidifying.

The chart below provides information that shows the contribution of various food
substances to the acidifying of body fluids, and ultimately, to the urine, saliva, and blood. In
general, it is important to eat a diet that contains foods from both sides of the chart.

Alkalizing foods – 70% -80% of the diet in volume

Acidifying foods – 20% - 30% of your diet in volume
Examples of acid-forming foods

Proteins Most Grains

Bacon Amaranth
Beef Barley
Carp Bran, oat
Clams Bran, wheat
Cod Bread
Corned Beef Corn
Fish Corn flour
Haddock Crackers, soda
Lamb Flour, wheat
Lobster Flour, white
Mussels Hemp Seed Flour
Organ Meats Kamut
Oyster Macaroni
Pike Noodles
Pork Oatmeal
Rabbit Oats (rolled)
Salmon Quinoa
Sardines Rice (all)
Sausage Rice Cakes
Scallops Rye
Shellfish Spaghetti
Shrimp Spelt
Tuna Wheat Germ
Turkey Wheat
Veal
Venison
Poultry
Eggs
Refined Sugars
Food Additives
Most Dairy, such as Butter, Cheese & Yoghurt

Examples of alkalizing foods

Vegetables Fruits
Alfalfa Apple
Barley Grass Apricot
Beet Greens Avocado
Beets Banana
Broccoli Berries
Cabbage Cantaloupe
Carrot Cherries, sour
Cauliflower Coconut, fresh
Celery Currants
Chard Greens Grapes
Chlorella Grapefruit
Collard Greens Lemon
Cucumber melon
Aubergines Lime
Fermented Veggies Nectarine
Garlic Orange
Greens and Beans Peach
Kale Pear
Lettuce Pineapple
Mushrooms Raisins
Onions Rhubarb
Parsnips Tangerine
Peas Tropical Fruits
Peppers Watermelon
Pumpkin
Radishes
Sea Veggie
Spinach, Green
Sprouts
Sweet Potatoes
Tomatoes
Watercress
Wheat Grass
Appendix 3 – Physical Exercise for Digestive Conditioning
PHYSICAL EXERCISE FOR DIGESTIVE SYSTEM CONDITIONING
Constipation and bloating relief; stimulation of digestion
(Not advised during the menstrual period or when pregnant)

Main pointers:
• Stand straight, focusing on your centre of gravity. Feet parallel,
shoulder-width.
• Bend your knees at 45 degrees, lower your head slightly, and rest your
hands just above your knees. Make sure that your hands are resting on the knees
(rather than supporting your weight).
• Spine and head should form one line.
• Exhale and pump (contract and relax) your abdominal muscles six
times while the lungs are empty.
• Inhale and pump your abdominal muscles six times whole the lungs
are full.
• Stand up, relax, and then repeat two more times.

Exercise routine for stress and tension relief, bowel support & digestive health
We acknowledge Ernest Coates, a modern Yoga guru and past chairman of Friends of
Yoga International, for allowing us the use of his text and illustrations in this exercise
routine.

It is based on a more detailed description of the same exercises in Ernest Coates’ Living
Yoga (ISBN: 0-95291-820-X).

It is recommended to perform this routine with someone more experienced or a teacher for
the first couple of times, till you are confident that you are exercising in the right way.

This routine needs to be performed daily or at least every other day, to achieve
effectiveness.

According to ancient teaching, all functions of the body are controlled by phlegm, wind and
bile, known as humours.

The wind is not only gastric and intestinal gases but also the wind formed in every joint
due to chemical reactions causing rheumatic pains and stiffness. The acid and bile
associated with the digestive juices, as well as the uric acid, need to be eliminated from
the body in order to stop excessive acidity from affecting some organs and parts of the
body.

This routine is useful for everyone suffering from stress, tension and digestive discomfort,
as well as for people recovering from illness, or those who have muscular problems.

Ideally, these exercises should be performed in the order given.

After the exercises can be performed comfortably, attention can be given to the breath.

A general guide, you should

• Breathe in while lifting any part of the body
• breathe out lowering any part of the body or bending forwards.

Please follow more detailed breathing instructions given with specific exercises below.

It is essential to focus and be very aware of the body part being exercised. Think of toes,
or feet, or ankles, etc., and do not let the mind wander, if it does, bring the mind back every
time.

The positions included in this book can be performed at any time of the day and will help
relieve the day’s stress, release tension, massage organs and glands, relax the nerves
and help to bring about a more tranquil mental state.

Adapted from Living Yoga by Ernest Coates

“Rep” stands for “repetitions”
Gas and Toxic release exercises

Exercise 1 Leg Rotation (5-10 reps CLOCKWISE AND ANTICLOCKWISE FOR EACH
LEG)
Lie on the back with the arms close to the body, palms pressed down to the floor. Raise
the right leg off the floor and rotate in a clockwise direction, then in an anti-clockwise
direction. Repeat with the left leg, and then relax. The exercise can be repeated with both
legs together.

Exercise 2 Cycling, One Leg

5-10 reps CLOCKWISE AND ANTICLOCKWISE FOR EACH LEG)

From the same position, raise the right leg to the vertical, cycle forwards, and then reverse
cycle movements. Repeat with the other leg.

Exercise 3 Cycling, Alternate Legs

(5-10 ROUNDS CLOCKWISE AND ANTICLOCKWISE)

From the same position perform alternative leg forward cycling movements, then in
reverse.
Exercise 4 Cycling, Both legs

(5-10 ROUNDS CLOCKWISE AND ANTICLOCKWISE)

Keeping both legs together, cycle forward, and then back.

Exercise 5 Head to Each Knee (5 reps each leg)

Lie on the back and bend the right leg to the chest. Breathing in, interlace the fingers over
the knee and breathe out, now raise the head and upper part of the body to touch the knee
with the chin or nose. Breathe in and return to lying on the back.

Exercise 6 Head to Knees (5-10 reps)

Bend both legs to the chest and wrap both arms around the knees, breathing in. Raise the
head to the knees breathing out.

Exercise 7 Rolling (5-10 rounds)

From the above position, roll the body sideways from one side to the other 5 – 10 times.

Alternatively the fingers can be interlaced behind the head with the knees bent to the chest and the
rolling motion done keeping the elbows to the floor.

Exercise 8 Rocking (5-10 rounds)

From the position with the knees bent and the arms around the knees, rock the body
backwards and forwards so as to massage the back. Try to reach a squatting position on
the forward movement and take care when rocking back to avoid the head hitting the
ground hard.

Exercise 9 Sit-Ups (5 reps)

Lie on the back with the arms above the head. Breathe in and raise the trunk to about 30
degrees off the floor, bring the arms up and over to point the hands to the feet. Breathe out
and lower back to the floor.

Exercise 9 Boat (5 reps)

Lie on the back with the arms close to the body, palms down. Breathe in and raise the legs, arms,
trunk and head off the floor, the arms to be parallel to the floor, breathe out and lower to the floor.
During the last round hold the breath in the raised position, tensing the body. Breathe out and lower
to the floor and relax.

To finish off the exercises, lie down on the mat and stretch with your arms fully extended
behind your back and the eyes closed, restoring your breathing.
Appendix 4

Speculum Insertion Techniques

Tutorial on Insertion 1
Ask Permission

Before you insert, you have to explain to the client your actions:
• you need to emphasize that all equipment that will be used on the
client is disposable and won’t be used on anyone else;
• explain that you will be lubricating the anus and then lubricating the
speculum;
• then you will insert the speculum into the anus;
• then you will connect the speculum to the inlet and outlet water lines
so that you can perform the treatment.

Finally, you should ask the client’s permission to begin the procedure.

Once you’ve got permission from the client to start the procedure make sure that all your
disposables are within reach and a glove box nearby so that you can change your gloves
as soon as you need to.

Assessment
Then ask the client to turn onto their left side and pull the legs towards their tummy.

Lift the left cheek with your left hand, standing comfortably, and observe for haemorrhoids
or anal fissures that may effect how you proceed with the treatment.

There are several common variations:

Type 1 (Pic 1) Type 1 represents the anus which is held together well by the sphincter
muscle, there are no external haemorrhoids and no loose skin. Muscle tension appears to
be evenly distributed.

Picture 1
Type 2 (Pic 2 and Pic 3) External sphincter muscle is slightly stretched to one side, and
sometimes there is also a haemorrhoid around, on the outside or on the curve between the
outside and the inside. You will need to protect that part where the sphincter muscle is
stretched. The haemorrhoid, which is often present, may look quite innocuous without
active blood supply to it. Sometimes the haemorrhoid looks like there is quite a lot of blood
supply to it. In this case you will obviously need to check with the client before insertion
whether the client has any pain when you touch the haemorrhoid.

Picture 2

Picture 3

Finally type 3 (pic 4) is when we can virtually cannot see the anal opening because its
covered in what can be described as “a daisy wheel ” or a “rosette” (technical term) of
haemorrhoids. In the majority of cases these daisies do not bother the client. However it’s
worth checking with the client before starting the procedure.

Picture 4
Lubrication
Once you have established the appearance of the anus and anal opening, you need to
lubricate the anal opening.

People who were trained as colon hydrotherapists a few years ago were trained by doctors who
suggested that a colon hydrotherapist should perform a digital examination. In this day and age, we
don’t think that in most cases a digital examination would be necessary. However when you
lubricate it makes sense to lubricate the anus about a quarter of an inch deep to the inside of the
muscle. You can lubricate with your gloved finger, or with a speculum.

Lubrication will enable you to gauge the client’s sensitivity and make the insertion more
comfortable. It will also enable you to ascertain that there is no immediate obstacle to
inserting the speculum. Once you have lubricated, you need to change the glove that has
bodily fluids on it, or even both gloves if they both have body fluids on them.

Start Insertion

The next step is to insert the speculum.

You need to ask the client to breathe in and then breathe out when you start inserting the
speculum. Take the speculum into your right hand, holding firmly the obturator to make
sure it does not slide back. Next, you firmly lift the left cheek of the client with your left
hand, as you lift the left buttock you should also use one of your fingers to control the
sphincter muscle by pulling it up slightly (Pic. 5).

Picture 5 Picture 6

The right hand inserts the speculum and slides it past the controlling finger, firmly and
slowly in the direction of the client’s navel. (Pic. 6)

Check the Client’s Reaction

As soon as you start sliding the speculum, you need to stop for a second and gauge the
reaction of the client. If the client is relaxed, then slide the speculum firmly in. Once you
have gained experience, you will feel the speculum being grabbed by the internal sphincter
muscle in the anus and the rectum.

IF THE CLIENT EXPERIENCES PAIN RATHER THAN DISCOMFORT, OR IF YOU FEEL

ANY OBSTRUCTION WHATSOEVER, DISCONTINUE THE INSERTION.

PAIN IS THE SIGNAL TO STOP.

Insertion variations
If you are inserting into the anus which has a haemorrhoid (as in Pic 3) then, as you lift the
cheek and position your finger to control the sphincter, move the haemorrhoid out of the
way, by placing your finger on the sphincter at a slight angle to protect the haemorrhoid.
(Pic. 7)

Picture 7

Finally, if your dealing with “the daisy wheel” entry, then you need to make sure that the
finger or sometimes two fingers of your left hand is covering and protecting a considerable
section of the “daisy wheel” (Pic. 8), and that your speculum slides past the finger firmly
and slowly in the direction of the navel. (Pic. 9)

Picture 8 Picture 9

The most important thing is to make sure to the best of your ability that no loose
skin, haemorrhoids or piles could be dragged into the anal canal with the speculum.
Protect them, keep them on the outside of the anus, and again, make sure that the client is
comfortable.

Post-insertion actions

After the insertion, check the client’s reaction. Sometimes in the first few seconds’ clients
(especially first-time nervous clients) feel discomfort. Let the speculum stay in the anus for
3 to 5 seconds, and the feeling should subside.

All the clients should feel a few seconds after insertion is that there is a smooth foreign
body in their anal canal. In case clients continue to experience pain or start experiencing
unexpected pain, you may need to remove the speculum.

Once you have made sure the client is comfortable, remove the obturator, and ask the
client to hold the speculum while you are preparing the water lines. This achieves two
goals.

• First it secures the speculum in the client;

• Secondly it makes sure that the client takes ownership and control of
the treatment, and relaxes a lot more.

Warning
If the speculum pulls out, you will need to reinsert starting the process from stage one.

NEVER EVER TRY TO REINSERT THE SPECULUM WITHOUT PUTTING BACK THE
OBTURATOR AND WITHOUT RE-LUBRICATING THE AREA.
YOU HAVE TO REINSERT THE OBTURATOR INTO THE SPECULUM AND THEN
REPEAT THE PROCEDURE FROM STAGE ONE. ANY OTHER MANNER OF
INSERTING THE SPECULUM IS STRICTLY PROHIBITED AND MAY DAMAGE THE
CLIENT.

Once you have connected the water lines you can start the treatment.

Difficulties with Insertion and No-Go Situations

So what happens if when you start your insertion the client experiences pain or discomfort
bordering on pain?

This could be for a few reasons.

To establish what reason is causing the pain to the client, you will need to perform a
slightly deeper digital examination: put a glove on, lubricate your gloved finger to the depth
of about an inch or slightly more, and try to gently insert it into the client’s anus.
You might feel three things.

• You might feel that there is a raised vein, an internal haemorrhoid

quite close to the entry that causes pain on insertion. (Pic. 10)

Picture 10
In this case, you can do two things:

• you can lift the external sphincter muscle slightly more, creating more
space for the speculum to get inserted, and slide the speculum past your lifting
finger (Pic. 11);

• Or may be you can lower, with your sphincter-controlling finger, the

floor of the anus, and slide the speculum past the finger which is lowering the floor
of the anus and protecting the raised vein (Pic. 12).
Picture 11 Picture 12

Be very careful whatever you do and make sure that the client is in control.

• Alternatively, you might feel that the client’s anus is too narrow
and then you realise that probably the speculum size would not be suitable
for this client. In this case, you may need a child speculum or you may want
to recommend a treatment on the open system

• Finally when you insert your finger, you hit what appears to be a
wall. This means that the anus is at a sharp angle to the rectum and you
won’t be able to insert. Again you need to explain this to the client and
suggest that the client has a treatment using the open system, where the
rectal tip is soft and may be able to bend to accommodate the client’s
physiological makeup.
Appendix 5 – Nervous and Endocrine Systems (Further Reading)
The nervous system comprises the brain and various types of nerves, including

• Afferent nerves (from the Latin “carrying towards”), which carry

sensory impulses from all parts of the body to the brain, and
• Efferent nerves (from the Latin “carrying away”) through which
“messages” are conducted from the brain to the muscles and all of the organs of the
body.

The functional units of the nervous system are called neurons. There are three main types
of neurons.
• Sensory neurons which convey sensations from the eyes, the nose
and other sensory organs to the brain where most of the impulses reach our
awareness, and
• Motor neurons transmitting impulses to the skeletal muscles in the
limbs and trunk permitting voluntary control of movements.
• Interneurons relate messages from sensory neurons to motor
neurons.

The nervous system is one of the most complex systems of the human body. The nerves
do not form one single system, but several which are interrelated. Some of these are
physically separate; others are different in function only.

It consists of the Central Nervous System (the brain and the spinal cord with its
protective sheathing) and the Peripheral Nervous System that contains the nerves going
from the spine to the periphery of the body.

The brain and spinal cord make up the Central Nervous System, which is largely
responsible for any of our actions involving consciousness.

The Peripheral Nervous System is responsible for the body functions, which are not
under conscious control - like the heartbeat or the digestive system.

The smooth operation of the peripheral nervous system is achieved by dividing it into
Sensory-Somatic (responsible for informing the Central Nervous System of the sensory
stimulae) and the Autonomic nervous system.

The sensory- somatic nervous system deals with skeletal muscles, bones and skin.

The autonomic nervous system deals with internal organs, glands, blood vessels,
muscles and mucous membranes.

THE AUTONOMIC NERVOUS SYSTEM

The human body performs a number of activities automatically, without any need for
conscious effort. These activities
• Need to be carried out continuously
• Are important for the maintenance of homeostasis
• Must not depend in any meaningful way on the conscious thought.

These activities include, for example, unconscious, reflex, bodily adjustments such as in
the size of the pupil, the digestive functions of the stomach and intestines, the rate and
depth of respiration and dilatation or constriction of the blood vessels.
Such activities are controlled by the autonomic nervous system, which is the part of the
peripheral nervous system.

The autonomic nervous system conveys sensory impulses from the smooth musculature
(blood vessels, the heart and all of the organs in the chest, abdomen and pelvis, including
all visceral organs) through afferent nerves to the brain (mainly the medulla, pons and
hypothalamus). These impulses, often called reflexes, often do not reach our
consciousness, thus largely bypassing the brain’s involvement, but elicit largely automatic
or reflex responses through the efferent autonomic nerves, thereby eliciting appropriate
reactions of the heart, the vascular system, and all the organs of the body to variations in
environmental temperature, posture, food intake, stressful experiences and other changes
to which all individuals are exposed.

There are two major subsections of the autonomic nervous system, the sympathetic and
the parasympathetic systems.

Generally speaking, the two systems work together to ensure that energy and a swift
response are available when required (the sympathetic system); but the body is not in the
heightened state of alert unnecessarily (the parasympathetic system).

Functions of the Autonomic Nervous System

The Sympathetic Nervous System (“Fight or Flight”)

• The sympathetic nervous system is virtually automatic and is not

subject to voluntary control. Sympathetic nerves that run from the vertebral column
to the organs increase the body’s activity. For example, they elevate the heart rate,
regulate the secretion of sweat, raise the blood pressure and speed up our
metabolic rate. This system is most involved in the period of physical and mental
activity.

A great example of the effective operation of the sympathetic nervous system is the body’s
reaction to change in the environmental temperature.

When the environmental temperature is raised on a hot summer’s day, the increased
temperature initiates several automatic responses:

• Thermal afferent receptors convey stimuli to sympathetic control

centres of the brain from which messages travel along the sympathetic nerves to
the blood vessels of the skin resulting in dilatation of the cutaneous blood vessels,
thereby greatly increasing the flow of blood to the surface of the body and
consequent loss of heat by radiation from the surface of the body.
• The sympathetic nervous system responds to environmental heat in
another important way. The rise in body temperature is sensed by the hypothalamic
centre from which stimuli emanate via sympathetic nerves to the sweat glands,
resulting in appropriate sweating. This serves to cool the body by the loss of heat
resulting from evaporation of the sweat, aided by a cool breeze.

Control of the rate and strength of cardiac contractions is also under the predominant
control of the sympathetic nervous system.

Situations such as emotional excitement, fear, apprehension, psychic distress, panic

reactions, and sexual activity and fight-or-flight stimuli activate many parts of the
sympathetic nervous systems including the adrenal medullae.

The Parasympathetic System (“Rest and Digest”)

It is very important for colon hydrotherapists to understand the workings of the

parasympathetic nervous system because it is in charge of the quality, timing and duration
of digestive processes.
The Parasympathetic System.
The parasympathetic nervous system consists mainly of the vagus nerve, which has its
branches in the internal organs of the thoracic cavity and the abdominal cavity. Its function
is to lower the blood pressure, slow down the heart, decrease the secretion of sweat and
so on, in order to help the body restore its stamina and recharge.
The Autonomic Nervous System Overview
Structure
Sympathetic Stimulation
Parasympathetic Stimulation
Iris (eye muscle)
Pupil dilation
Pupil constriction
Salivary Glands
Saliva production reduced
Saliva production increased
Oral/Nasal Mucosa
Mucus production reduced
Mucus production increased
Heart
Heart rate and force increased
Heart rate and force decreased
Lung
Bronchial muscle relaxed
Bronchial muscle contracted
Stomach
Peristalsis reduced
Gastric juice secreted; motility increased
Small Intestine
Motility reduced
Digestion increased
Large Intestine
Motility reduced
Secretions and motility increased
Liver
Increased conversion of glycogen to glucose
Kidney
Decreased urine secretion
Increased urine secretion
Adrenal medulla
Norepinephrine and epinephrine secreted
Bladder
Wall relaxed Sphincter closed
Wall contracted Sphincter relaxed
The hypothalamus is part of the brain that lies just above the pituitary gland. It releases
hormones that start and stop the release of pituitary hormones. The hypothalamus
controls hormone production in the pituitary gland through several “releasing”
hormones.

Pituitary Gland

The pituitary gland is sometimes called the ‘master gland’ because of its great influence on
the other body organs. Its function is complex and important for overall well-being.

The pituitary gland is divided into two parts, front (anterior) and back (posterior)

The anterior pituitary produces several hormones:

• Prolactin or PRL - PRL stimulates milk production from a woman’s

breasts after childbirth and can affect sex hormone levels from the ovaries in
women and the testes in men.
• Growth hormone or GH - GH stimulates growth of long bones and
muscles in childhood and is important for maintaining a healthy body composition in
adults, such as muscle mass, bone mass and fat distribution in the body
• Adrenocorticotropin or ACTH - ACTH stimulates production of
cortisol by the adrenal glands. Cortisol, also called ‘stress hormone,” is vital to
survival. It helps maintain blood pressure and blood glucose levels.
• Thyroid-stimulating hormone or TSH – TSH stimulates the thyroid
gland to make thyroid hormones, which, in turn, control (regulate) the body’s
metabolism, energy, growth and development and nervous system activity.
• Luteinizing hormone or LH – LH regulates testosterone in men and
oestrogen in women.
• Follicle-stimulating hormone or FSH – FSH promotes sperm
production in men and stimulates the ovaries to release eggs (ovulate) in women.
LH and FSH work together to allow normal function of the ovaries or testes.

The posterior pituitary produces two hormones:

• Oxytocin – Oxytocin causes milk production in nursing mothers and

contractions during childbirth.
• Antidiuretic hormones or ADH - ADH also called vasopressin is
stored in the back part of the pituitary gland and regulates water balance. If this
hormone is not secreted properly, this can lead to problems of sodium (salt) and
water balance and could also affect the kidneys.

In response to over or underproduction of pituitary hormones, the target glands affected by

these hormones can produce too many or too few hormones of their own. For example,
too much growth hormone can cause gigantism or excessive growth, while too little GH
may cause dwarfism and stunt growth.

Thymus
The thymus is a gland needed early in life for normal immune function. It secretes
hormones that are essential for normal development of T lymphocytes and immune
response.

It is very large just after a child is born and weighs its greatest when a child reaches
puberty. Then its tissues are replaced by fat. The thymus gland secretes hormones called
humoral factors. These hormones help to develop the lymphatic system, which is a
system throughout the body that help it to reach a mature immune response in cells to
protect them from invading bodies, like bacteria.

Pineal Gland

Scientists are still learning how the pineal gland works. They have found one hormone so
far that is produced by this gland: melatonin. Melatonin may stop the action of (inhibit) the
hormones that produce gonadotropin, which causes the ovaries and testes to develop and
function. It may also help to control sleep patterns.

Testes

Males have twin reproductive glands, called testes that produce the hormone testosterone.
Testosterone helps a boy develop and then maintain his sexuality During puberty,
testosterone helps to bring about the physical changes that turn a boy into an adult male,
such as growth of the penis and testes, growth of facial and pubic hair, deepening of the
voice, increase in muscle mass and strength, and increase in height. Throughout adult life,
testosterone helps maintain sex drive, sperm production, male hair patterns, muscle mass,
and bone mass.

Ovaries

The two most important hormones of a woman’s twin reproductive glands, the ovaries, are
oestrogen and progesterone. These hormones are responsible for developing and
maintaining female sexuality, as well as maintaining a pregnancy. Along with the pituitary
gonadotropins (FH and LSH), they also control the menstrual cycle. The ovaries also
produce inhibin, a protein that curbs (inhibits) the release of follicle-stimulating hormone
from the anterior pituitary and helps control egg development.

The most common change in the ovarian hormones is caused by the start of menopause,
part of the normal aging process. It also can occur when ovaries are removed surgically.
Loss of ovarian function means loss of estrogen, which can lead to hot flashes, thinning
vaginal tissue, lack of menstrual periods, mood changes and bone loss, or osteoporosis.

A condition called polycystic ovary syndrome (PCOS) is caused by overproduction of male

hormones in females. PCOS can affect menstrual cycles, fertility, and hormone levels, as
well as cause acne, facial hair growth, and male pattern balding.

Thyroid

The thyroid is a small gland inside the neck, located in front of the trachea and below your
Adam’s apple. The thyroid hormones control your metabolism, which is the body’s ability to
break down food and store it as energy and the ability to break down food into waste
products with a release of energy in the process. The thyroid produces two hormones, T3
(called tri-iodothyronine) and T4 (called thyroxine).
Thyroid disorders result from too little or too much thyroid hormone.

Symptoms of hypothyroidism (too little hormone) include decreased energy, slow heart
rate, dry skin, constipation, and feeling cold all the time. In children, hypothyroidism most
commonly leads to slowed growth. Infants born with hypothyroidism can have delayed
development and mental retardation if not treated. In adults, this disorder often causes
weight gain. An enlarged thyroid, or goiter, may develop.

Symptoms of hyperthyroidism (too much hormone) include anxiety, fast heart rate,
diarrhoea, and weight loss. An enlarged thyroid gland (goiter) and swelling behind the eyes
that causes the eyes to push forward, or bulge out, are common.

Adrenal Glands

Each adrenal gland is actually two endocrine organs. The outer portion is called the
adrenal cortex. The inner portion is called the adrenal medulla. The hormones of the
adrenal cortex are essential for life. The hormones of the adrenal medulla are not. The
adrenal cortex produces over two dozen of steroid hormones: glucocorticoids (such as
cortisol) that help the body control blood sugar increase the burning of protein and fat, and
respond to stressors like fever, major illness, and injury. The mineral corticoids (such as
aldosterone) control blood volume and help to regulate blood pressure by acting on the
kidneys to help them hold onto enough sodium and water. The adrenal cortex also
produces some sex hormones, which are important for some secondary sex
characteristics in both men and women.

Two important disorders caused by problems with the adrenal cortex are Cushing’s
syndrome (too much cortisol) and Addison’s disease (too little cortisol).

The adrenal medulla produces epinephrine (adrenaline), which is secreted by nerve

endings and increases the heart rate, opens airways to improve oxygen intake, and
increases blood flow to muscles, usually when a person is scared, excited, or under stress.

Norepinephrine also is made by the adrenal medulla, but this hormone is more related to
maintaining normal activities as opposed to emergency reactions. Too much
norepinephrine can cause high blood pressure.
Parathyroid

Located behind the thyroid gland are four tiny parathyroid glands. These make hormones
that help control calcium and phosphorous levels in the body. The parathyroid glands are
necessary for proper bone development. In response to too little calcium in the diet, the
parathyroid glands make parathyroid hormone, or PTH, that takes calcium from bones so
that it will be available in the blood for nerve conduction and muscle contraction.

If the parathyroids are removed during a thyroid operation, low blood calcium will result in
symptoms such as irregular heartbeat, muscle spasms, tingling in the hands and feet, and
possibly difficulty breathing. A tumour or chronic illness can cause too much secretion of
PTH and lead to bone pain, kidney stones, increased urination, muscle weakness, and
fatigue.

Pancreas

The pancreas is a large gland behind your stomach that helps the body to maintain healthy
blood sugar (glucose) levels. The pancreas secretes insulin, a hormone that helps glucose
move from the blood into the cells where it is used for energy. The pancreas also secretes
glucagon when the blood sugar is low. Glucagon tells the liver to release glucose, stored in
the liver as glycogen, into the bloodstream.

Diabetes, an imbalance of blood sugar levels, is the major disorder of the pancreas.
Diabetes occurs when the pancreas does not produce enough insulin (Type 1) or the body
is resistant to the insulin in the blood (Type 2). Without enough insulin to keep glucose
moving through the metabolic process, the blood glucose level rises too high.

In Type 1 diabetes, a patient must take insulin shots. In Type 2 diabetes, a patient may not
necessarily need insulin and can sometimes control blood sugar levels with exercise, diet
and other medications.

A condition called hyperinsulinism (HI) is caused by too much insulin and leads to
hypoglycemia (low blood sugar). Symptoms of low blood sugar include anxiety, sweating,
increased heart rate, weakness, hunger, and light-headedness. Low blood sugar
stimulates release of epinephrine, glucagon and growth hormone, which help to return the
blood sugar to normal.
Appendix 6 – Emergency Medical Situations

• Allergic Reaction

• Asthma Attack

• Cardiopulmonary Resuscitation (CPR)

• Diabetes

• Fainting

• Seizure/Epilepsy

• Stroke
Allergic Reaction
An allergy is a reaction the body has to a particular food or substance.

Allergies are very common. They're thought to affect more than one in four people in the
UK at some point in their lives.

They are particularly common in children. Some allergies go away as a child gets older,
although many are lifelong. Adults can develop allergies to things they weren't previously
allergic to.

Having an allergy can be a nuisance and affect your everyday activities, but most allergic
reactions are mild and can be largely kept under control. Severe reactions can
occasionally occur, but these are uncommon.

Common allergies
Substances that cause allergic reactions are called allergens. The more common
allergens include:

• grass and tree pollen – an allergy to these is known as hay fever

(allergic rhinitis)
• dust mites
• animal dander (tiny flakes of skin or hair)
• food – particularly nuts, fruit, shellfish, eggs and cow's milk
• insect bites and stings
• medication – including ibuprofen, aspirin, and certain antibiotics
• latex – used to make some gloves and condoms
• mould – these can release small particles into the air that you can
breathe in
• household chemicals – including those in detergents and hair dyes

Most of these allergens are generally harmless to people who aren't allergic to them.

Symptoms of an allergic reaction

Allergic reactions usually happen quickly within a few minutes of exposure to an allergen.

They can cause:

• sneezing
• a runny or blocked nose
• red, itchy, watery eyes
• wheezing and coughing
• a red, itchy rash
• worsening of asthma or eczema symptoms

Most allergic reactions are mild, but occasionally a severe reaction called anaphylaxis or
anaphylactic shock can occur. This is a medical emergency and needs urgent treatment.

Anaphylaxis is a severe and potentially life-threatening reaction to a trigger such as an

allergy.
It's also known as anaphylactic shock.

Symptoms of anaphylaxis

Anaphylaxis usually develops suddenly and gets worse very quickly.

• The symptoms include:
• feeling lightheaded or faint
• breathing difficulties – such as fast, shallow breathing
• wheezing
• a fast heartbeat
• clammy skin
• confusion and anxiety
• collapsing or losing consciousness

There may also be other allergy symptoms, including an itchy, raised rash (hives), feeling
or being sick, swelling (angioedema), or stomach pain.

What to do if someone has anaphylaxis

Anaphylaxis is a medical emergency. It can be very serious if not treated quickly.

If someone has symptoms of anaphylaxis, you should:
• use an adrenaline auto-injector if the person has one – but make sure
you know how to use it correctly first
• call 999 for an ambulance immediately (even if they start to feel better)
– mention that you think the person has anaphylaxis
• remove any trigger if possible – for example, carefully remove any
wasp or bee sting stuck in the skin
• lie the person down flat – unless they're unconscious, pregnant or
having breathing difficulties
• give another injection after 5-15 minutes if the symptoms don't
improve and a second auto-injector is available
Asthma

Asthma is a common lung condition that causes occasional breathing difficulties.

It affects people of all ages and often starts in childhood, although it can also develop for
the first time in adults.

There's currently no cure, but there are simple treatments that can help keep the
symptoms under control so it doesn't have a big impact on your life.

Symptoms

The main symptoms of asthma are:

• wheezing (a whistling sound when breathing)

• breathlessness
• a tight chest, which may feel like a band is tightening around it
• coughing

The symptoms can sometimes get temporarily worse. This is known as an asthma attack.

Symptoms of an asthma attack

Signs that you may be having an asthma attack include:

• your symptoms are getting worse (cough, breathlessness, wheezing

or tight chest)
• your reliever inhaler (usually blue) isn't helping
• you're too breathless to speak, eat or sleep
• your breathing is getting faster and it feels like you can't catch your
breath
• your peak flow score is lower than normal
• children may also complain of a tummy or chest ache

The symptoms won't necessarily occur suddenly. In fact, they often come on slowly over a
few hours or days.

What to do if your client has asthma attack

If you think the client is having an asthma attack, you should:

• Sit them upright (don't lie down) and try to get them to take slow,
steady breaths. Try to remain calm, as panicking will make things worse.
• Get them to take 1 puff of their reliever inhaler (usually blue) every 30
to 60 seconds, up to a maximum of 10 puffs.
• Call 999 for an ambulance if they don't have your inhaler with them, if
they feel worse despite using their inhaler, they don't feel better after taking 10 puffs
or you're worried at any point.
• If the ambulance hasn't arrived within 15 minutes, repeat step 2.
Diabetes
Diabetes is a lifelong condition that causes a person's blood sugar level to become too
high.

There are two main types of diabetes:

• type 1 diabetes – where the body's immune system attacks and
destroys the cells that produce insulin
• type 2 diabetes – where the body doesn't produce enough insulin, or
the body's cells don't react to insulin
•
Type 2 diabetes is far more common than type 1. In the UK, around 90% of all adults with
diabetes have type 2.

A low blood sugar, also called hypoglycaemia or a "hypo", is where the level of sugar
(glucose) in your blood drops too low.

It mainly affects people with diabetes, especially if you take insulin.

A low blood sugar can be dangerous if it's not treated promptly, but you can usually treat it
easily yourself.

Symptoms of low blood sugar

A low blood sugar causes different symptoms for everybody. You'll learn how it makes you
feel if you keep getting it, although your symptoms may change over time.

Early signs of a low blood sugar include:

• feeling hungry
• sweating
• tingling lips
• feeling shaky or trembling
• dizziness
• feeling tired
• a fast or pounding heartbeat (palpitations)
• becoming easily irritated, tearful, stroppy or moody
• turning pale
• If not treated, you may then get other symptoms, such as:
• weakness
• blurred vision
• difficulty concentrating
• confusion
• unusual behaviour, slurred speech or clumsiness (like being drunk)
• feeling sleepy
• seizures (fits)
• collapsing or passing out
Treatment for low blood sugar

Treating a low blood sugar yourself

Follow these steps if your blood sugar is less than 4mmol/L or you have hypo symptoms:

• Have a sugary drink or snack – try something like a small glass of

non-diet fizzy drink or fruit juice, a small handful of sweets, or four or five dextrose
tablets.
• Test your blood sugar after 10-15 minutes – if it's 4mmol or above and
you feel better, move on to step 3. If it's still below 4mmol, treat again with a sugary
drink or snack and take another reading in 10-15 minutes.
• Eat your main meal (containing carbohydrate) if you're about to have it
or have a carbohydrate-containing snack – this could be a slice of toast with spread,
a couple of biscuits or a glass of milk.

You don't usually need to get medical help once you're feeling better if you only have a few
hypos, but tell your diabetes team if you keep having them or if you stop having symptoms
when your blood sugar goes low.

Treating someone who's unconscious or very drowsy

Follow these steps:

• Put the person in the recovery position and don't put anything in their
mouth – so they don't choke.
• Give them an injection of glucagon medicine – if it's available and you
know how to do it. Call 999 for an ambulance if an injection isn't available or you
don't know how to do it.
• Wait about 10 minutes if you've given them an injection – move on to
step 4 if the person wakes up and starts to feel better. Call 999 for an ambulance if
they don't improve within 10 minutes.
• Give them a sugary drink or snack, followed by a carbohydrate-
containing snack – the drinks and snacks used to treat a low blood sugar
yourself should work.
Treating someone having a seizure (fit)

Follow these steps if someone has a seizure due to low blood sugar:

• Stay with them and stop them from hurting themselves – lie them
down on something soft and move them away from anything dangerous (like a road
or hot cooker).
• Give them a sugary snack once the seizure stops – if the seizure
stops in a few minutes, treat them as you would treat a low blood sugar
yourself once you're able to.
• Call 999 for an ambulance if the seizure lasts more than five minutes.
Fainting

Fainting (syncope) is a sudden temporary loss of consciousness that usually results in a

fall.

When you faint, you'll feel weak and unsteady before passing out for a short period of
time, usually only a few seconds.

There may not be any warning symptoms, but some people experience:

• yawning
• a sudden, clammy sweat
• feeling sick (nausea)
• fast, deep breathing
• confusion
• lightheadedness
• blurred vision or spots in front of your eyes
• ringing in your ears
•
What to do if you or someone else faints

If you feel you're about to faint, lie down, preferably in a position where your head is low
and your legs are raised. This will encourage blood flow to your brain.

If it's not possible to lie down, sit with your head between your knees. If you think someone
is about to faint, you should help them lie down or sit with their head between their knees.

If a person faints and doesn't regain consciousness within one or two minutes, put them
into the recovery position.

You should then dial 999, ask for an ambulance and stay with the person until medical
help arrives.
Seizures/Epilepsy

The main symptom of epilepsy is repeated seizures. These are sudden bursts of electrical
activity in the brain that temporarily affect how it works.

Seizures can affect people in different ways, depending on which part of the brain is
involved.

Some seizures cause the body to jerk and shake (a "fit"), while others cause problems
like loss of awareness or unusual sensations. They typically pass in a few seconds or
minutes.

Seizures can occur when you're awake or asleep. Sometimes they can be triggered by
something, such as feeling very tired.

Types of seizures

Simple partial (focal) seizures or 'auras'

A simple partial seizure can cause:

• a general strange feeling that's hard to describe
• a "rising" feeling in your tummy – like the sensation in your stomach
when on a fairground ride
• a feeling that events have happened before (déjà vu)
• unusual smells or tastes
• tingling in your arms and legs
• an intense feeling of fear or joy
• stiffness or twitching in part of your body, such as an arm or hand
• You remain awake and aware while this happens.
•
These seizures are sometimes known as "warnings" or "auras" because they can be a
sign that another type of seizure is about to happen.

Complex partial (focal) seizures

During a complex partial seizure, you lose your sense of awareness and make random
body movements, such as:

• smacking your lips

• rubbing your hands
• making random noises
• moving your arms around
• picking at clothes or fiddling with objects
• chewing or swallowing

You won't be able to respond to anyone else during the seizure and you won't have
any memory of it.

Tonic-clonic seizures
A tonic-clonic seizure, previously known as a "grand mal", is what most people think of as
a typical epileptic fit.

They happen in two stages – an initial "tonic" stage, shortly followed by a second "clonic"
stage:

• tonic stage – you lose consciousness, your body goes stiff, and you
may fall to the floor
• clonic stage – your limbs jerk about, you may lose control of your
bladder or bowel, you may bite your tongue or the inside of your cheek, and you
might have difficulty breathing
•
The seizure normally stops after a few minutes, but some last longer. Afterwards, you may
have a headache or difficulty remembering what happened and feel tired or confused.

Absences

An absence seizure, which used to be called a "petit mal", is where you lose awareness of
your surroundings for a short time. They mainly affect children, but can happen at any age.

• During an absence seizure, a person may:

• stare blankly into space
• look like they're "daydreaming"
• flutter their eyes
• make slight jerking movements of their body or limbs
•
The seizures usually only last up to 15 seconds and you won't be able to remember them.
They can happen several times a day.

Myoclonic seizures

A myoclonic seizure is where some or all of your body suddenly twitches or jerks, like
you've had an electric shock. They often happen soon after waking up

Myoclonic seizures usually only last a fraction of a second, but several can sometimes
occur in a short space of time. You normally remain awake during them.

Clonic seizures

Clonic seizures cause the body to shake and jerk like a tonic-clonic seizure, but you don't
go stiff at the start.

They typically last a few minutes and you might lose consciousness.

Tonic seizures
Tonic seizures cause all your muscles to suddenly become stiff, like the first stage of
a tonic-clonic seizure.

This might mean you lose balance and fall over.

Atonic seizures

Atonic seizures cause all your muscles to suddenly relax, so you may fall to the ground.
They tend to be very brief and you'll usually be able to get up again straight away.

Status epilepticus

Status epilepticus is the name for any seizure that lasts a long time, or a series of seizures
where the person doesn't regain consciousness in between.

It's a medical emergency and needs to be treated as soon as possible.

If you see someone having a seizure or fit, there are some simple things you can do to
help. You should call an ambulance if you know it's their first seizure or it's lasting longer
than 5 minutes.

It might be scary to witness, but don't panic.

If you're with someone having a seizure:

• only move them if they're in danger – such as near a busy road or hot
cooker
• cushion their head if they're on the ground
• loosen any tight clothing around their neck – such as a collar or tie to –
aid breathing
• when their convulsions stop, turn them so they're lying on their side –
read more about the recovery position
• stay with them and talk to them calmly until they recover
• note the time the seizure starts and finishes
• If they're in a wheelchair, put the brakes on and leave any seatbelt or
harness on. Support them gently and cushion their head, but don't try to move
them.
• Don't put anything in their mouth, including your fingers. They
shouldn't have any food or drink until they fully recover.

When to call an ambulance

Dial 999 and ask for an ambulance if:

• it's the first time someone has had a seizure

• the seizure lasts for more than 5 minutes
• the person doesn't regain full consciousness, or has several seizures
without regaining consciousness
• the person is seriously injured during the seizure
People with epilepsy don't always need to go to hospital every time they have a seizure.

Some people with epilepsy wear a special bracelet or carry a card to let medical
professionals and anyone witnessing a seizure know they have epilepsy.

Make a note of any useful information

• If you see someone having a seizure, you may notice things that could
be useful for the person or their doctor to know:
• What were they doing before the seizure?
 • Did the person mention any unusual sensations, such as an odd smell
or taste?
• Did you notice any mood change, such as excitement, anxiety or
anger?
• What brought your attention to the seizure? Was it a noise, such as
the person falling over, or body movements, such as their eyes rolling or head
turning?
• Did the seizure occur without warning?
• Was there any loss of consciousness or altered awareness?
• Did the person's colour change? For example, did they become pale,
flushed or blue? If so, where – the face, lips or hands?
• Did any parts of their body stiffen, jerk or twitch? If so, which parts
were affected?
• Did the person's breathing change?
• Did they perform any actions, such as mumble, wander about or
fumble with clothing?
• How long did the seizure last?
• Did the person lose control of their bladder or bowels?
• Did they bite their tongue?
• How were they after the seizure?
• Did they need to sleep? If so, for how long?
Stroke

A stroke is a serious life-threatening medical condition that occurs when the blood supply
to part of the brain is cut off.

Strokes are a medical emergency and urgent treatment is essential.

The sooner a person receives treatment for a stroke, the less damage is likely to
happen.
If you suspect that you or someone else is having a stroke, phone 999 immediately and
ask for an ambulance.

Symptoms of a stroke

The main symptoms of stroke can be remembered with the word F.A.S.T.:

• Face – the face may have dropped on one side, the person may not
be able to smile, or their mouth or eye may have dropped.
• Arms – the person with suspected stroke may not be able to lift both
arms and keep them there because of weakness or numbness in one arm.
• Speech – their speech may be slurred or garbled, or the person may
not be able to talk at all despite appearing to be awake.
• Time – it's time to dial 999 immediately if you see any of these signs or
symptoms.

Causes of a stroke

Like all organs, the brain needs the oxygen and nutrients provided by blood to function
properly. If the supply of blood is restricted or stopped, brain cells begin to die. This can
lead to brain injury, disability and possibly death.

There are two main causes of strokes:

• ischaemic – where the blood supply is stopped because of a blood

clot, accounting for 85% of all cases
• haemorrhagic – where a weakened blood vessel supplying the brain
bursts
•
There's also a related condition known as a transient ischaemic attack (TIA), where the
blood supply to the brain is temporarily interrupted

This causes what's known as a mini-stroke, often lasting between a few minutes and
several hours.

TIAs should be treated urgently, as they're often a warning sign you're at risk of having a
full stroke in the near future. Seek medical advice as soon as possible, even if your
symptoms resolve.
Appendix 7

Suggested Reading List

Suggested Reading List

• THE COLON HEALTH HANDBOOK by Robert Gray, Emerald

Publishing 1991
ISBN 0 9615757 2 7

• CLEANSE AND PURIFY THYSELF by Richard Anderson N.D. N.M.D

Christobe Publishing 2000
ISBN 0 9664973 1 7

• HEALING WITHIN by Stanley Weinberger, Healing with Products

1996
ISBN 0 9616184 7 7

• COLON HEALTH: THE KEY TO VIBRANT HEALTH by Norman

Walker D.Sc, PH.D
Revised and updated by Helen Walker, published by Norwalk Press 1995
ISBN 0 89019069 0

• THE YEAST CONNECTION HANDBOOK by William Crook MD,

published by Professional Books Inc 1997
ISBN 0 933478 23 2

• THE AMAZING LIVER CLEANSE by Andreas Moritz published by St

Anne’s Press 2000
ISBN 0 9538102 0 8

• EDGAR CAYCE’S GUIDE TO COLON CARE by Sandra Dugan RN,

published by Inner Vision Publishing Co. USA 1995
ISBN 0 917483 32 4

• ACIDOPHILUS AND COLON HEALTH by David Webster, published

by Kensington Books 1999
ISBN 1 57566 4607

• TOXIC RELIEF by Don Colbert MD, published by Siloam 2003

ISBN 1 59 185 213

• TISSUE CLEANING THROUGH BOWEL MANAGEMENT by Bernard

Jenson PH.D Co-author Sylvia Bell, published by Bernard Jenson International
1981
 • RENEW YOUR LIFE: IMPROVE DIGESTION AND
DETOXIFICATION 2002
ISBN 0 9719309 0 2

• PRESCRIPTION FOR NUTRITIONAL HEALING by James Balchin

MD and Phyllis Balch, published by Avery Publishing Group 1997
ISBN 0 89 52972 7 2

• ALWAYS LOOK AFTER NUMBER TWO by Galina Imrie published by

Fotherby Press 2006

• GUT – THE INSIDE STORY by Giulia Enders, published by Scribe

Publications 2015
ISBN 978 1 925228 60 1

• HOW TO OVERCOME CONSTIPATION, A TOXIC COLON AND

DIARRHOEA ONCE AND FOR ALL by Peter Jackson, Published by The Healthy
Bowel Publishing Company
ISBN 978 02 9564011 06

• GUT INSTINCT by Pierre Pallardy, published by Rodale International

2002 ISBN 978 1 905744 05 3

• DR JENSEN’S GUIDE TO BETTER BOWEL CARE by Dr Bernard

Jensen, published by Avery 1999
ISBN 0 89529 584 9

• TISSUE CLEANSING THROUGH BOWEL MANAGEMENT by Sylvia

Bell, published by Bernard Jenson International
ISBN 0 960836 07 1

• TIMELESS SECRETS OF HEALTH AND REJUVENATION by

Andreas Moritz 2005 published by Wellness Press
ISBN 0 9765715 1

• ROSS AND WILSON – ANATOMY AND PHYSIOLIOGY by Anne

Waugh and Allison Grant 2004 published by Churchill Livingston
ISBN 0 443 064868 7

• AN HOLISTIC GUIDE TO ANATOMY AND PHYSIOLOGY by Tina

Parsons published by Thomson Learning 2002
ISBN 1 86152 976 7

• ANATOMY AND PHYSIOLOGY by Helen McGuiness published by

 Dynamic Learning and Hodder Press 2010
ISBN 978 1 444 10923 8
Appendix 8

• Student Study Hours Log

• Case Study Document
• Colon Hydrotherapy Supervised Practice Treament Session
 RICTAT
STUDENTS STUDY LOG
Date
Topic
Study Time
Case Studies
Introduction
Case studies are an invaluable record of the clinical practices of a profession. While case
studies cannot provide specific guidance for the management of successive patients, they
are a record of clinical interactions which help us to frame questions for more rigorously
designed clinical studies. Case studies also provide valuable teaching material,
demonstrating both classical and unusual presentations which may confront the
practitioner. Quite obviously, since the overwhelming majority of clinical interactions occur
in the field, not in teaching or research facilities, it falls to the field practitioner to record
and pass on their experiences.
General Instructions
This set of guidelines provides both instructions and a template for the writing of case
reports. You might want to skip forward and take a quick look at the template now, as we
will be using it as the basis for your own case studies later on.
After this brief introduction, the guidelines below will follow the headings of our template.
Another important general rule for writing case studies is to stick to the facts. A case study
should be a fairly modest description of what actually happened. Speculation about
underlying mechanisms of the disease process or treatment should be restrained. The
thing of greatest value that you can provide to your colleagues is an honest record of
clinical events.
Finally, remember that a case study is primarily a chronicle of a patient’s progress, not a
story about colon treatment. Editorial or promotional remarks do not belong in a case
study, no matter how great our enthusiasm. It is best to simply tell the story and let the
outcome speak for itself.
 RICTAT CASE STUDY

Name of Client Date of Treatment

Case Presentation

• Reason for clients requesting treatment eg. constipation, IBS, bloating,

detox, kick start healthy lifestyle, migraines, skin problems etc.

• Describe clients lifestyle ie. Stressful job, sedentary lifestyle, water intake,
exercise, medication, diet etc.

• Include patients demeanour ie. Nervous, challenging etc.

• Review all contraindications – should you treat your client?

Treatment Procedure

• Give a brief summary of the treatment procedure that you under took.

• Include any issues that may have arisen both with the client and equipment.

• Did you need to adapt your treatment plan for your client to accommodate
their individual needs eg. bad back, neck support, haemorrhoids, vertigo, sensitivity to latex
or lubrications used.

Outcome

• How did the client feel during the treatment ie. Cramping, nausea, anxious

• Did you observe fermentation?

• Did you observe any signs of Candida Albicans?

• Did you observe any parasites?

• Did you observe of trapped gas during the treatment?

• If the client release any faecal matter what was the consistency according to
the Bristol Stools Chart?

• Did the client have a good release on the toilet post treatment?

Post Treatment Advice to Client

• What post treatment advice did you give (remember you cannot diagnose)?

• What did recommendation did you make to improve bowel function eg.
increase water intake, dietary advice, stress reduction techniques, probiotics etc.

• Did you give the client a post treatment advice sheet?

• List other any other additional information you have have given?

• Did you feel that the client would benefit from further treatments?

Summary and Reflective Practice

• If the client was to book a further treatment would you change your treatment
plan?
• How did you found the treatment process on your client?

• On reflection is there anything you would do differently?

• What have you learnt from this treatment?

 RICTAT CASE STUDY

Name of Client Date of Treatment

Case Presentation

Treatment Procedure

Management & Outcome

Summary

Reflective Practice
 COLON HYDROTHERAPY
SUPERVISED PRACTICE TREATMENT SESSION
Student Name __________________________________

Date __________________________________________
Preparation of Room

Communications Skills

Maintaining Client’s Privacy & Dignity

Sequence of Treatment

Maintaining Safe Environment

Minimising Cross Infection

Massage Techniques

Recording Treatment Session

Verbal Post Treatment Advice

Any Other Comments

Observed By _____________________ Date ____________

Appendix 9 – RICTAT Examination
 International Ass
Final Examination
The final exam is a three hours written paper. You will need to obtain 80% to pass.

On a blank piece of paper please put your name and date. Please ensure that you state
the question number.

1. List five contraindications relating to Colon Hydrotherapy

2. Name the four layers of the colon

3. Which layer of the colon is responsible for peristalsis?

4. Name the five regions and the two flexures of the colon

5. What is the name of the artery that nourishes the colon?

6. What is the function of the peritoneum?

7. Name the five accessory organs of the digestive system?

8. What vitamins does the colon synthesise?

9. What do pale chalky stools suggest?

10. The following enzymes break down

a. Amaylaise
b. Lipaise
c. Protease

11. Explain the term Dysbosis.

a. what is the cause?

B what is the treatment?

12. What is a Caecum Flush?

13. Explain the term hypomotilty.

a. How would you proceed with a client suffering from a hypotonic

bowel?
b. What dietary advice would you promote to the client?

14. What is a fistula and how would you proceed?

15. What causes haemorrhoids, how could a colonic help?

16. What is the purpose of a digital examination?

17. List eight ways to minimize cross infection within your clinic

18. A client asks what is the difference between an enema and a colonic.
Explain?

19. List six reasons why it is important to drink water especially following a
colonic treatment

20. What is the healing crisis?

a). What are the common symptoms?

b. What advice would you offer?

21. A new client comes to your clinic and complains about the treatment she
received from another therapist. The client said that nothing came away and she felt
unwell for days after the treatment. What would you say to the client?

22. A client asks you to add some herbs they have brought with them to the
water, what would be your response?

23. How would you proceed if after 30 minutes nothing had been eliminated and
the client asks why?

24. A client asks for extra time on the machine after 45 minutes, how would you
respond?

25. A male client has an erection during the colonic treatment how would you
respond?

26 A client starts to cry during the treatment as the colon starts to empty how
would you respond?

27. A client complains of feeling nauseas during a treatment how would you
respond?

28. A client insists that their partner is present in the room during the treatment
how would you respond?

29. A client rings asking for a colonic as her friend has told her that she lost
weight after a colonic treatment. How would you approach her treatments and what
advice would you offer her?
 30. A client is having trouble lying on his back due to back pain how would you
adapt the treatment to ensure his comfort?

31. A client is having chemotherapy for breast cancer and is asking if she can
have a colonic? How would you respond?

32. A client is convinced that they have Candida Albicans however she has not
had any tests done.

a. What are the symptoms associated with Candida?

b. Describe an anti candida diet?
c. What advice would you give her?

33. How would you ensure that client’s records are kept confidential?

34. What post treatment information would you give a client following a colonic
treatment?

35. List six ways you would ensure that health and safety regulations are
implemented in your practice.