Dr. Maged Rizk, a gastroenterologist with The Cleveland Clinic, has noticed an increased interest in “cleansing,” a restrictive diet that proponents claim removes toxins from the body and aids in weight loss. Celebrities from Madonna to Denzel Washington have reportedly tried it. Some alternative practitioners even call it a cure-all for illnesses such as ulcers and asthma. Is this really a panacea—or just a passing fad? Dr. Rizk weighs in.
What’s your experience with cleansing? Comment below.
- FOF: Why is cleansing on the rise?
- Dr. Rizk: Fads ebb and flow. A lot of it has to do with the late-night type of Hugh Downs infomericals with guests selling “cures.” Just like the Atkins diet was hot 10-years ago, I’d expect this trend to ebb and flow as well.
- What are some popular methods of “cleansing?”
- Most cleanses involve some sort of organic ingredient taken over a long period of time—usually 2-4 days—that causes the release of large amounts of fluid from the all over body into the colon. So for example, the Master Cleanse is a lemon juice-based cleanse. Usually people throw in some organic maple syrup and ground cayenne pepper as well. The Blueprint Cleanse is juice-based–all sorts of different juices. Again, it’s relying on an osmotic effect.
- Why do people do cleanses?
- There’s a lot of hype about the idea that chemicals and material within the colon can be harmful to the body. Some people believe these chemicals have oxidative effects that increase one’s risk of cancer. They believe that by cleansing, you can regulate your bowel habits and remove some of the “harmful” chemicals. People also feel that cleansing increases their energy–they feel lighter and more energetic.
- Are these claims true?
- There’s no literature or scientific evidence to support this. In my practice, we will only cleanse the colon under certain indications such as chronic constipation, abdominal pain due to pre-colonoscopy, constipation, gastrointestinal motility and fecal impaction. Otherwise we don’t recommend it.
- Why not?
- It can cause an imbalance in the electrolytes and the kidneys. When you take something that is highly sugary or highly salty–such as any of these “cleansing” solutions–a large amount of fluid moves from all over the body into the colon. When that happens, there’s a risk of dehydration. Modern cleanses have gotten better. In the past, patients simply drank a bottle of magnesium citrate or engaged in enemas. Both had an immediate effect. The juice-based cleanses are less harsh and take a longer period of time to work. The amount of liquid is not as extreme, but there’s still a risk of imbalance.
- Are there any other side effects of cleansing?
- A few different things… if you are ingesting something acidic such as the lemon juice in the Master Cleanse, you can develop acidosis, where the blood in your body becomes acidic–a serious issue. Headaches, muscle pains, weakness, mental status changes and heart wave abnormalities can happen as side effects of electrolyte imbalances, dehydration, and acidosis.
- What sort of cleansing do you use on your patients for special cases such as pre-colonoscopy?
- We use a non-digestible, non-absorbable, osmotically-balanced, laxative lavage. In other words, a liquid that has the same electrolyte balance as the body, and thus does not cause major fluid shifts. To accomplish this, it typically can’t be absorbed or digested by the body.
- Do the Master Cleanse or the Blueprint Cleanse fit this criteria?
- No. There are tons of these different fad cleanses. I would highly doubt that any of them fulfill that criteria or that they have been tested to fulfill that criteria. I’m not aware of anything on the market like this but it doesn’t mean it doesn’t exist.
- Are there alternatives to cleansing if you feel irregular or as if your diet is leaving you ”toxic”?
- Keep yourself regular–then you don’t have to go through “cleansing” processes. Eating between 50 and 75 grams of fiber per day can improve your bowel habits, facilitate a fuller evacuation and reduce the amount of remnant feces in your body. Regular exercise, staying hydrated, drinking at least eight cups of water a day, also helps. Some medications help, but we don’t like to use them just for cleansing.
- So ultimately, you wouldn’t recommend it?
- Right. Patients will often say, “We understand you don’t recommend it, but if people are doing it anyway, what do you recommend?” It becomes such a hairy issue because you can’t monitor them. A person drinking twelve cups of lemonade–that’s no good. A person drinking a ton of juices over a week–that’s not good either. The only thing I can tell you is, for it to be safe it must be a non-digestible, non-absorbable, osmotically-balanced laxative.
Do you agree with Dr. Rizks assessment, or do you have your own cleansing experience? Let us know by commenting below.
Cleveland Clinic, Gastroenterology and HepatologyDr. Maged Rizk, M.D., is gastroenterologist who practices at The Cleveland Clinic Center. Dr. Rizk is board-certified in internal medicine-gastroenterology. His specialties include chronic abdominal pain, patient-reported outcomes and quality in endoscopy. He is a member of the American Society for Gastrointestinal Endoscopy, American Gastroenterological Association and American College of Gastroenterology.