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(The following article represents the method used by Pam Crawford and is not necessarily indicative of the procedure or equipment used by all colon hydrotherapists.) 

The Process of Colon Hydrotherapy – What to Expect at Your First Colonic 

I am often asked (quite understandably) how the process of colon hydrotherapy works. Colon hydrotherapy (or CHT) is a safe, mild, and effective way to remove material from the colon (also known as large intestine), while gently stimulating the large intestine’s natural peristaltic action to release the softened waste. If you’ve been experiencing constipation, gas or intestinal bloating, something which may help is CHT (also known as colonics). Please let me explain how the process works when you come to my office for a procedure. 

When someone calls me who is interested in CHT, I ask them if they have ever had a colonic before. I then ask a list of pre-screening questions to help determine if there are any health reasons that would prevent them from having CHT. An affirmative answer to some of the questions does not necessarily rule out CHT - it may only mean that a little more information is required.  Here is the list of those pre-screening questions: 

  •  Are you at least 18 years old?

  •  Do you have a history of severe anemia?

  •  Do you have a history of aneurisms?

  •  Do you have a history of blood clots?

  •  Do you currently have cancer – specifically of the colon, kidney, or liver?

  •  Do you have any problems with congestive heart failure?

  •  Do you have Crohn’s Disease or Irritable Bowel Syndrome?

  •  Are you mentally challenged?

  •  If you are a female, are you pregnant?

  •  Have you had any recent abdominal surgery?

  •  Are you currently experiencing rectal bleeding, hemorrhoids, or fissures?

  •  Do you have any reduced hepatic (liver) function, specifically cirrhosis of the liver?

  •  Do you have a redundant (an extra long) colon?

  •  Do you have any renal (kidney) insufficiency?

  •  Do you have uncontrolled hypertension (high blood pressure)? 

If the answers to these questions indicate that CHT is safe for the caller, and if the caller would like to become a client, we then proceed to set up an appointment. When the client arrives, they sit in the waiting area and fill out a one-sheet health questionnaire which has questions such as “What is the frequency of your bowel movements?” and “What is a typical breakfast for you?” After the client has filled out the questionnaire, they come into my office and see the machine. The machine has a disinfectant which is used between clients to disinfect the machine. The water filtration system on the machine has hot-water and cold-water particle filters which remove particles from the city water, as well as a carbon filter which removes chemicals from the water (such as chlorine, fluoride, aluminum, etc.) and an ultra-violet light, which destroys 98 – 99 percent of any remaining bacteria from the water so that the filtered water from the machine which enters the client is as purified as possible. There is also a temperature control which ensures that the water is comfortably warm, as well as a viewing tube which has a light behind it to make viewing easier should the client wish to see the waste as it evacuates. 

The client sees the massage table where they will be lying. On the massage table is a foam mattress pad to make the table more comfortable, as well as a slant pillow to make their head and shoulders comfortable. There is also a cushion which goes under the buttocks to elevate them slightly and take the pressure off the low back. On top of the table and pillows is a full-length paper sheet, as well as an underpad which goes under the buttocks. Both are disposed of after each client. 

The client then sees the sterile, single-use kit which is new for each client. It consists of a tube for the purified water, which attaches to the machine, as well as a tube for the waste, which also attaches to the machine. Both tubes attach to a Y-branch on the outside of the rectal speculum (tube). I then give the client a towel and ask that they go into the attached bathroom and urinate if they need to and use the container of moistened wipes to wipe from front to back to ensure that the area is cleaned. The client will then disrobe from the waist down and wrap the towel around themselves and come back into the office, where I will ask them to get on the table and lie comfortably on their back with the towel on top of them. This makes sure that the client is in a comfortable spot on the table.  I will then ask them to turn onto their left side, while I hold the towel in place. 

I then fold the towel partially over their buttocks and, with gloves on, lubricate one finger (with a non-petroleum-based salve) and insert it rectally into the client. This is done to lubricate the area, as well as help enable me to know the angle of the rectum and if there are any hemorrhoids.  I then put on a fresh glove and lubricate the speculum (which is approximately the diameter of a magic marker) and insert it only about 2 ½ to 3 inches into the rectum. This is ordinarily an easy step because the anal region has been lubricated and I use gentle pressure. Clients often say “That was easier than I thought it would be.” I then remove the obturator from inside the speculum – it is the rounded guide which helps the speculum glide into the rectum. After removing it, I am able to attach the waste water tube. Once I’m sure the client is comfortable, I ask them to gently roll back onto their back (with their knees bent and feet on the table) while I hold the tubing in place. Once the client is settled on their back, I release my hold of the tubing. Helping to hold the speculum in place is a strip from the underpad, which has been tied onto the speculum before insertion.  That strip is placed under the buttocks before the client rolls onto their back. 

Now that the client is relaxing comfortably on their back, listening to the music on the CD player, I offer them a neck roll pillow and a heated eye pillow. I then begin a flow of warm water which goes into the rectal region only, circulates, and comes back out the waste tube. This is done to make sure that the water temperature is comfortable for the client and to get them used to the feeling of water coming into their body. I adjust the lighting in the room to soften it and begin adding water to the colon. I turn the nozzle on the machine to “Fill” and allow the water to flow with gentle pressure through the speculum and into the colon for about six seconds.  I have measured the amount of water in a six-second fill and it is approximately one cup. 

In my training at the International School of Colon Hydrotherapy in Juno Beach, Florida, we were taught the “slow fill” method.  This process gently introduces water into the colon to greatly reduce any chance that the client will be uncomfortable during the process. The client allows the water to soak in the colon for a minute or two and then we allow another six seconds of water into the colon and pause for a minute or two before adding another six seconds of water. This process is repeated until the client feels the need to release. Ideally, the client should try to retain as much water as possible before needing to release. This is because the more water that goes in without being released, the further that water is able to flow into the colon and that lengthens the amount of time that the colon is allowed to soak and increases the amount of colon that is being soaked. However, I don’t want the client to be uncomfortable trying to hold the water if they really do need to release it. If the client begins to feel pressure that lasts for more than five or six seconds without gradually decreasing, it is time to release. 

When the client feels the need to release the water (the feeling is very similar to the feeling one would normally have when they feel the need to have a bowel movement), they tell me and I turn the nozzle to “Empty” and the contents of the colon which are ready to be released flow freely into the waste tube, through the viewing tube, and into the sewer pipes of the plumbing. A fully enclosed, hygienic system is used, so there is no mess and no odor. The client should not bear down or do any pushing – the fecal matter will come out on its own. We then start putting water in again and soaking. 

The cycle of filling and releasing continues for up to 45 minutes, at which time the client will roll again onto their left side and I will remove the speculum. The client then goes into the attached bathroom and sits on the toilet, where there is usually another release. Afterwards, clients report feeling refreshed, lighter, and less bloated.

I hope I have helped answer any questions you may have had about the process of colon hydrotherapy and relieve any fears you may have had about it. If you have any questions or would like to schedule an appointment, please call me. 

Pam Crawford is a Certified Colon Hydrotherapist, a graduate of the International School of Colon Hydrotherapy (, and a full member of the professional association I-ACT (the International Association of Colon Hydrotherapy []). She uses FDA-registered equipment and disposable, single-use rectal speculums and tubing. She is located in Greensboro at 7325 West Friendly Avenue, Suite # A-1 and is available by appointment only. For an appointment, please call (336) 482-0270.