WWW.LACOLON.COM Norman N. Hoffman M.D., Inc. Gary H. Hoffman M.D. Eiman Firoozmand M.D. Liza M. Capiendo M.D. Stephen Yoo M.D. Does a Clean Colon Lead to a Clean Mind and Clean Body? The Data (or Lack of Data) About Colon Cleansing. (Check out page 2 of this Newsletter) THE END Papyrus, hollow reeds were inserted into the rectum Psyllium may be added to the hydrotherapy fluid. For those with a short attention span and a desire while bathing in the Nile, to induce water flow into When the fluid is evacuated the solid mass of for immediate answers, here is the conclusion of the rectum. Did the Schistosomiasis trematodes get psyllium may indeed look like sludge or a cast of this article: CONCLUSION– Save your time and a free ride through the reed into the rectum as well? the colon, encouraging the now cleansed, horrified money. Do not bother trying to clean or cleanse The Greeks used cleansing to enhance fitness and and relieved victim to plunk down more cash for your colon. Your colon does not require any user strength. Colonic irrigation was widely used in hos- future relief. intervention. pitals and doctors’ offices until the 1920’s, when it Despite all of the hype and claims, there is no sci- began to fall out of favor due to questions regarding THE BEGINNING entific evidence to support any of these practices. its necessity and efficacy. Recently, colon cleansing Normally, the mucosal lining of the colon con- Proponents of colon cleansing claim that cleansing has staged somewhat of a comeback due to aggres- stantly regenerates, sloughing old cells along with is necessary to maintain a healthy colon, lose sive marketing via infomercials and the internet. If any associated particulate matter. Numerous glands weight, prevent colon cancer, and clear the body of it is on television or the internet, it must be true. secrete mucus, making it difficult for anything to toxins or parasites. Ads for colon cleansing supple- OMG! LOL! ments warn that mankind is living with an average truly adhere to the walls of the colon. The of 20 pounds of undigested, impacted, rotting symptoms of lethargy, low appetite, weight colonic fecal matter stuck to the colonic wall. gain, headache, and irritability are not caused Furthermore, this “spackle” has been stagnating by autointoxication of rotting food stuck to the for years, creating an ideal environment for para- colon. Many of these symptoms are explained by sites and interfering with the absorption of nutri- the normal mechanical distention of the bowel, ents. As reported in USA Today on January 11, activating the body’s autonomic nervous system. 1999, “Most people who eat the standard There is abundant evidence that the colon walls American ‘goo and glue’ diet have about 5-10 are superbly resistant to the movements of bacte- pounds of matter stored in the colon. It’s said that, ria, viruses and toxins through the colon. according to the autopsy, John Wayne had 40 Translocated bacteria and viruses are rapidly pounds of impacted fecal matter in his body at Who wouldn’t want a “healthy colon”? cleared by the B-cell and T-cell systems in the death. Elvis reportedly had 60 pounds.” None of bloodstream and lymphatics. There is no this reportage was ever confirmed. TODAY objective evidence that cleansing the colon can relieve the vague symptoms described by colonic The result of this supposed build-up of poisonous Methods used to irrigate the colon involve colonic cleansing device manufacturers. fecal waste is that the toxic matter becomes hydrotherapy (enemas or “high colonics”), dietary absorbed through the colon wall and into the changes, and oral purgatives. According to the There are risks associated with colon cleansing. circulation, leading to a new syndrome called advertisements, there are many substances used to Mechanical colonic irrigation tubes can perforate autointoxication. Autointoxication then causes remove stubborn colonic wall plaque and sludge. the rectum and the large volume of cleansing fluid lethargy, headaches, decreased sexual drive, acne, Activated charcoal, cascara, fennel seed, turmeric, may cause electrolyte imbalances and cardiac arrest. and body odor. betaine HCL, magnesium oxide or green-black Unclean equipment used to irrigate the colon may walnut hull are just a few of the many products The jump to therapeutic colon cleaning seems easy lead to infections. Oral colon cathartics lead to psy- used. The process may require several weeks to one chological or physiological dependence and may and logical. Who wouldn’t want to have a better year to dislodge the mucoid plaque. memory, clearer vision, immunity to disease, clearer interfere with the absorption of certain prescription skin, and a better sex life? A clean colon must lead During colonic irrigation, a colon hydrotherapist medications. inserts a tube into the rectum and instills up to 20 to a clean body and an even cleaner mind. Buy the A daily diet containing 25-35 grams of fiber and gallons of water. Supplements such as coffee, pro- product and reap t he benefits. adequate hydration will help maintain adequate biotics, enzymes, even oils may be added to the colonic throughput. BEFORE THE BEGINNING irrigation fluid. The abdomen is massaged and the Practiced for both religious and health reasons in colon contents are evacuated through the tube. Save your time and money. Your colon will take Egypt since 1500 B.C. and recorded in the Eber Some techniques approach downright quackery. care of itself. No user intervention is required. Beverly Hills: (310) 273-2310 • Culver City: (310) 836-0013 PAGE 2 WWW.LACOLON.COM Norman N. Hoffman M.D., Inc. Gary H. Hoffman M.D. Eiman Firoozmand M.D. Liza M. Capiendo M.D. Stephen Yoo M.D. How to Remove a Rectal Foreign Body in ONE Easy Step. (Rare is the Patient who Experiences this Problem Twice.) (Check out page 2 of this Newsletter) THE END tion kits filled with red wine instead of the stan- during a digital exam. With the operator’s well- For those with a short attention span and a desire dard enema fluid. lubricated gloved fingers placed slowly, gently and for immediate answers, here is the conclusion of this carefully into the rectum, abdominal pressure with article: CONCLUSION– From a safety standpoint, HOW TO REMOVE A RECTAL the left hand is used to guide the object towards the anal opening is best used for outgoing mail only. FOREIGN BODY. STEP ONE… CALL the rectum. If lucky, the surgeon may be able to Insertion of a foreign body into the anus holds the SOMEONE WITH EXPERIENCE. grasp and extract the object. A Foley catheter potential for a painful and embarrassing injury. In an asymptomatic, stable patient, after a thor- inserted past the object can be used to release the ough abdominal and anal exam, a careful and negative pressure that has created a vacuum above WHY DO OBJECTS BECOME gentle proctosigmoidoscopy may be performed to the object. Ring forceps may be used if the object STUCK IN THE RECTUM? both evaluate the colorectal lining and possibly is visible through an anoscope, taking care not to Not uncommonly, a call is placed from the emer- visualize the foreign body. If there is no evidence of pinch the rectal mucosa. Vacuum extraction can gency room physician to the surgeon, requesting rectal perforation, an attempt to remove the object also be used if available. Extraction of the object help extracting a rectal foreign body. In most in the emergency department is appropriate. with a sharp tenaculum should be avoided due to cases, the uncomfortable and embarrassed patient the possibility of rectal perforation. If extraction in has tried for hours or days to remove the offend- If there are symptoms of rectal perforation, such as abdominal or pelvic pain or a rigid abdomen, the E.R. is successful, close follow-up is needed as ing object himself or herself. Why did the foreign there is always a risk of delayed sigmoid or rectal object become stuck in the first place? urgent operative treatment is required. An elevated white blood cell count or free intraperitoneal air perforation secondary to pressure necrosis. The The rectum is a muscular tube measuring 12-15 seen on plain x-ray also may lead to operative inter- patient should be admitted for observation, or cm in length, with the sigmoid colon located vention. discharged home and seen in the office the next proximal to the rectum and the anus located day for follow-up. distal to it. To enter the rectum, an object must Overly aggressive extraction attempts should be pass through the internal and external anal avoided in the E.R. If all gentle attempts are sphincters. Once inside the rectum, if the object unsuccessful, then the patient is brought to the travels beyond the coccyx, manual retrieval is operating room. Under general anesthesia, difficult not only because it is out of reach, but manual transanal extraction is attempted. If because the object will be lodged proximal to unsuccessful, exploratory laparotomy is needed. the anterior curvature of the coccyx. The coccyx will now act as a check point, preventing egress With the abdomen open, the object is palpated of the solid foreign body. Even if the foreign in the sigmoid colon and is gently pushed or body can be removed, repeated dilatation of the milked toward the rectum and extracted. In sphincteric complex holds the potential to some stubborn cases, the colon must be opened damage the sphincteric muscle fibers, causing to extract the object. Judgment is used to deter- permanent difficulty with anal continence. Figure 1. The Foreign Body of Interest is NOT mine whether or not a temporary colostomy is the hip prosthesis.