The therapies I write about range widely from the likely beneficial, to the plausible but mostly untested and over-marketed, to the implausible and even completely ridiculous. The subject of this post is in the last category, and it is a treatment I have not yet addressed because, thankfully, it is seldom recommended even by proponents of the more extreme varieties of alternative medicine. However, Dr. Carol Osborne, a prolific advocate for unproven and pseudoscientific therapies, has latched onto this one in a recent blog post, Could a Coffee Enema Save Your Dog’s Life? For those of you who don’t have time to slog through the rest of the post, I’ll give you the answer now: No. But it could take your dog’s life.
Dr. Carol begins, as proponents of such nonsense treatments so often do, with a meaningless heartwarming anecdote.
Dr. Carol Osborne has seen first-hand the effects a coffee enema can have a dog – and in one particular case, the effect was nothing short of miraculous. When a friend and clients dog suffered acute liver failure, other veterinarians recommended euthanasia. Unable to part with her pet without at least a second opinion, the pet’s owner contacted Dr. Carol as her last resort. In addition to the administration of intravenous fluids, Dr. Carol gave the small dog a coffee enema. Not only did the dog improve, he began to thrive.
Anyone who follows this blog is familiar with the unreliability of such stories, and all the reasons why bogus therapies may seem to work when they really don’t. Acute liver disease is a classic example of a problem which often, and sometimes unexpectedly, resolves on its own with only supportive care (such as IV fluids), due to the regenerative capacity of the liver. I always find it strange that proponents of alternative medicine frequently talk about the body’s innate healing abilities and yet always seem fine taking the credit when a patient gets better.
The arguments Dr. Osborne gives for why this therapy ought to be helpful are no more valid or convincing than the opening anecdote.
Coffee, when administered via enema, stimulates the production of glutathione by the liver. Glutathione is required by the liver to function properly. When the liver fails, glutathione production ceases. By stimulating production of this vital nutrient, the coffee enema helps the liver to once again perform.
Coffee enemas also work as a detox…
The walls of the intestines, once thin and clean, will become thicker over time with the debris that sticks to the walls preventing the body from digesting and absorbing vital nutrients.
If something is not done to counteract the thickening of the intestinal walls due to residue and debris the pet or person will gradually begin to lose their energy and the ability to function normally…
Interesting theory. Also complete nonsense.
Glutathione is, of course, present in the liver and important for normal liver functioning, along with thousands of other chemicals. The evidence does not support the assertion that coffee enemas increase glutathione levels in humans. (1) There is mixed evidence for changes in glutathione levels from oral coffee intake, with some human and rat studies finding and increase and others not. (2) There is no evidence that coffee can increase this enzyme in dogs. And there is no evidence that any increase in glutathione which might happen from some kind of intake of coffee has meaningful clinical benefits. So this claim is probably wrong and would be of questionable significance even if it were true.
The argument that coffee enemas are “detoxifying” is based on the vague and mythological understanding of “toxins” that underlying many quack therapies. This mythology is not a legitimate understanding of the cause of disease, and it is not a sound rationale for coffee enemas. (3, 4, 5) The colon is not a primary site of digestion and absorption of nutrients, though there are some nutrients that are absorbed there (notably B vitamins) as well as water. And it does not become caked with debris over time which impedes its functioning. The notion that we are fundamentally incapable of normal health without some periodically flushing out our large intestine is simply ridiculous.
So is there any evidence that coffee enemas have health benefits despite the lack of a plausible theory why they should? Nope! The subject has been debated in human medicine for some time, particularly due to claims that coffee enemas can be beneficial in cancer treatment. There is no credible evidence to support this claim and clear evidence against it. (6, 7, 8, 9, 10) And, of course, there is no clinical research of any kind in dogs or cats to test this therapy. And there shouldn’t be!
While not having shown any benefits, coffee enemas unquestionably can cause harm. There are numerous reports of serious harm done to human patients, including dehydration and electrolyte disturbances, tears of the colon and rectum, burns in the colon and rectum, infections transmitted by the procedure, and death. (11, 12, 13, 14, 15)
The fact that caffeine, a prominent chemical in coffee, is a well-known and serious toxin in dogs makes the notion of coffee enemas in these species even more insane, if that is possible.
While it seems as if it shouldn’t even need to be said, clearly coffee enemas for pets are a bad idea. The theoretical reasons for using them range from unproven to completely crazy, there is no evidence in humans or veterinary patients of any benefits, and there is ample evidence of potentially serious harm, including death. Recommending this treatment for pets is irrational to the point of being indefensible.
- Teekachunhatean S, Tosri N, Sangdee C, Wongpoomchai R, Ruangyuttikarn W, Puaninta C, Srichairatanakool S. Antioxidant effects after coffee enema or oral coffee consumption in healthy Thai male volunteers. Hum Exp Toxicol. 2012 Jan 16. [Epub ahead of print]
- Chen TS, Chen PS. Intestinal autointoxication: A gastrointestinal leitmotive. Journal Clinical Gastroenterology 11:343-441, 1989.
- Green, S. A critique of the rationale for cancer treatment with coffee enemas and diet. JAMA. 1992,Dec 9; 269(13),1635-6.
- Ernst, E. M.D., Ph.d., F.R.C.P. (Edin). Colonic Irrigation and the Theory of Autointoxication: A Triumph of Ignorance over Science. Journal of Clinical Gastroenterology. 24(4):196-198, June 1997. (Make sure to follow the references to the primary sources).
- Alison Reed, Nicholas James and Karol Sikora. Mexico: Juices, coffee enemas, and cancer. The Lancet. Volume 336, Issue 8716, 15 September 1990, Pages 677-678.
- M. E. Shils and M. G. HermannBull . Unproved dietary claims in the treatment of patients with cancer.N Y Acad Med. 1982 April; 58(3): 323–340.
- Brown BT. Treating cancer with coffee enemas and diet. JAMA. 1993;269:1635-1636.
- Cassileth, B. Gerson Regime. Oncology, Volume 24, Issue 2, 2010 Page 201.
- Atwood, K. “Gonzalez Regimen” for Cancer of the Pancreas: Even Worse than We Thought (Part I: Results). Science-Based Medicine Blog, Accessed May 13, 2012 at http://www.sciencebasedmedicine.org/index.php/gonzalez-regimen-for-cancer-of-the-pancreas-even-worse-than-we-thought-part-i-results/
- Keum, B. et al. Proctocolitis caused by coffee enemasAm J Gastroenterol. 2010 Jan;105(1):229-30.
- Lee, C.; Song, S.; Jeon, J.; Sung, M.; Cheung, D.; Kim, J.; Kim, J.; Lee, Y. (2008). Coffee enema induced acute colitis. [The Korean journal of gastroenterology] Taehan Sohwagi Hakhoe chi 52(4): 251–254
- Eisele, J.; Reay, D. (1980). Deaths related to coffee enemas. JAMA: the Journal of the American Medical Association 244(14): 1608–1609.
- Sashiyama, H.; Hamahata, Y.; Matsuo, K.; Akagi, K.; Tsutsumi, O.; Nakajima, Y.; Takaishi, Y.; Takase, Y. et al (2008). Rectal burn caused by hot-water coffee enema. Gastrointestinal Endoscopy 68(5): 1008–1009
- Jones LE, Norris WE. Rectal burn induced by hot coffee enema. Endoscopy.2010;42 Suppl 2:E26.