Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
CONTENTS Introduction Benefits of Colonic Treatment Contra-Indications of Colonic Treatment Role of a Colonic Therapist The Digestive Tract Peristalsis Digestion in the Mouth – Salivary Glands; Teeth; Tongue Digestion in Stomach; Anatomy of Stomach 4 Layers of Stomach Wall; Digestive Phases; Mechanical Digestion of Stomach Chemical Digestion of Stomach; The Small Intestine – Structure; Villi Chemical Digestion in Duodenum, Jejunum and Ileum The Large Intestine; 4 Layers of Colon 3 3 4 4 5-6 5 6-7 7 8 9-10 11-12 12-13 ACCESSORY ORGANS OF DIGESTION 14-15 Liver – Functions Gall Bladder – Gall Stones; Functions; Bile Pancreas – Functions Juices and Enzymes of Digestive Tract – Proteases; Lipase; Amylase; Nucleases 14 15 16 17 ANATOMY & PHYSIOLOGY IN RELATION TO COLONICS 18-19 Endocrine; Lymphatic; Muscular; Nervous; Skin 18-19 DISORDERS OF THE LARGE INTESTINE 20-21 Cancers & Benign Tumours Candida Coeliac Colon abnormalities – atonic; collapsed; hypertonic; prolapsed; redundant; spastic Constipation & Diarrhoea Chron’s Disease Diverticulosis / Diverticulitis Dysbiosis Flatulence Haemorrhoids Hernia Irritable Bowel Syndrome Leaky Gut Syndrome Parasitic Infestations Rectal Fissures Ulcerative Colitis 20 20 20 20 20 21 21 21 21 21 21 22 22 22 22 22 HISTORY OF COLONIC HYDROTHERAPY 23 Colonics v Enemas Colonic Equipment Disposables The Room Personal Appearance Hygiene Water temperature and pressure Treatment duration Treatment preparation Comments from clients 23 23 23 23 23 24 24 24 24 24 CLIENT REACTIONS AND EXPERIENCES DURING TREATMENT 25 Caecum flush 25 UKHolistics/ColonicHydrotherapy/Mar13© 1 Erratic breathing Lack of oxygen; Low Sugar Levels Weight Loss How many treatments are recommended? 25 25 25 25 AFTERCARE ADVICE 26 Supplements 26 CAUSES OF DIFFERENT BOWEL MOVEMENTS 27-30 The need for acidic colon How constipation develops Laxatives Chronic diarrhoea Autointoxication – Putrefaction and Stagnation The Transit Time Composition of Faeces The Bristol Stool Form Scale Healthy & Unhealthy Faeces 3 Stages of Bowel Movements – Segmentation; Peristalsis; Mass Movements BOWEL DISORDERS 27 27 27 27 28 28 28 88 28 29 29 29-31 Anal Itching Blood in Stools Gassy/Smelly Stools Greasy Stools Mucus in Stools Pale or Grey Stools Rabbit Droppings Skid Marks Straining Undigested Food White Chalk-Like Stools 29 30 30 30 30 30 30 30 31 31 31 IMPROVING THE QUALITY OF BOWEL ELIMINATIONS 31 Advice to clients Reasons for dehydration Water reabsorption from bowel Initial Assessment of Anal Area Re-insertion and Insertion Difficulties Benefits of Chi Machine 31 32 32 33 33 33 COLONIC TREATMENT 34 Colonic Treatment; Observations during Treatment IBS; Lifestyle Changes; Massage Routine; Water temperature Working with the Whole Person - Holistic Approach Toilet Break Release Techniques – Soaking; Burping; Teasing When to close treatment Qualifications; Insurance; Records Supportive Treatments – Body Wraps; iLIPO; Lymph Drainage; Massage; Reflexology 34 35 35 36 36 36 37 37 38 DIET & NUTRITION 39 REQUIREMENTS FOR COLONICS BUSINESS Fat Burning; Food Intolerances and Allergies Vitamins; Minerals; EFA’s; Carbs to Glycogen; Cell Renewal Glossary Diagram of Digestive System UKHolistics/ColonicHydrotherapy/Mar13© 39 40 41-42 43 2 INTRODUCTION Colonic hydrotherapy is both a body and emotional release treatment. It’s a treatment encompassing your physical, emotional and holistic skills. Colonic hydrotherapy is a treatment that introduces approximately 100-150 litres of water into the back passage, which often results in removal of wastes from the large intestine. There are very few treatments that can treat the internal part of the large intestine so effectively. Colonic hydrotherapy is about promoting the wellbeing of clients, encouraging clients to improve their own lifestyle by more exercise; nutritional improvements; advice on supplements; other beneficial complementary treatments; plus emotional support. When the colon is out of balance it is necessary to clean out toxins that have accumulated as all health problems which affect our body originate in the bowel. Water temperature and pressure are observed throughout the treatment, so that a combination of fills and releases will encourage the colon with its peristaltic movements. There are usually no adverse smells or odours during release of the waste materials. During the fill, the client may experience stomach cramps or discomfort as wastes and water move along the colon ready for evacuation. Initially, as water is introduced into the colon, the treatment may have some degree of discomfort, due to the amount of gas or wind that needs to be released before any faecal matter is evacuated. As more and more gas and faecal matter is released, a longer section of the bowel will be cleared of the residual waste and more water will be put in without causing discomfort. Is colonic hydrotherapy a treatment or therapy? The answer is both. A treatment or procedure is when someone is going through the robotic motions of an appointment, when the end result is known. Colonic hydrotherapy introduces purified filtered water into the anus and removes the toxins and wastes. A therapy considers the holistic approach for the total wellbeing of the client and offers much more support to the client that just delivering a treatment. The holistic approach looks at much more than one aspect. BENEFITS OF COLONIC HYDROTHERAPY • • • • • • • • • • • • • Hydration of the colon Removal of wastes from the colon Stress relief by encouraging relaxation, of both mind and bowel Relief from diarrhoea, spastic colon, headaches, depression Improving peristaltic action within the bowel Increased nutrient absorption Helping liver, blood and kidney cleansing Support with IBS, bloating, constipation/diarrhoea, flatulence, haemorrhoids Skin problems such as acne, psoriasis, dermatitis Increasing the energy levels, stamina, and reducing the need for more sleep Encouraging weight loss and long-term weight management Helping with the release of emotional wastes stored in the colon As a kick-start of healthy living UKHolistics/ColonicHydrotherapy/Mar13© 3 CAN EVERYONE HAVE THIS TREATMENT? Most people can have colonics, but a thorough consultation will establish if there are any contra-indications or reasons that somebody could not receive one. If you are unsure whether a client could receive a colonics treatment or not, then a general guideline will be that if they are fundamentally healthy, able to go to work, enjoy holidays, raise or look after family, then they will probably be able to receive a treatment. Any client arriving for a colonics treatment would normally be interested in becoming healthier, improving wellbeing by alleviating any digestive disorders such as constipation, diarrhoea, bloatedness, IBS, bad skin, bad breath. Therapists can also give nutritional and lifestyle advice, with appropriate aftercare on the use of supplements. CONTRAINDICATIONS TO COLONIC HYDROTHERAPY Warnings or Local Contra-Indications Irritable Bowel Syndrome (spastic colon) – caution with temperature of water Inflammations, such as diverticulitis; ulcerative colitis; Crohn’s disease – depends on the severity of the conditions. Anything inflamed, caution needed with hot water temperature Haemorrhoids / Fissures / Fistules – caution when inserting speculum (more lubrication) Constipation / Diarrhoea – caution Medical Contra-Indications – needing GP Referral Severe cardiac disease – how long ago, how severe? High or low blood pressure not controlled by a doctor – only clients on medication for blood pressure can receive colonics Aneurysm (widening of an artery resulting from weakening of the artery wall) – how recent? GI haemorrhage or perforation – find out more about the history and how recent Ulcerative colitis – find out more about the history and how recent Active fistulas and fissures – gauge pain levels from clients and how recent Carcinoma of the colon (cancer) – anything cancerous needs GP referral Hepatitis/ HIV / Aids – GP referral Absolute Contra-Indications – no treatment Severe or bleeding haemorrhoids – (haemorrhoids not painful or bleeding are okay) Cirrhosis of the liver – liver is main organ of detoxification, so under duress Pregnancy – no treatment throughout whole 9 months Abdominal hernia – too much pressure of water in and out during the treatment Recent colorectal surgery – GP referral at a later time once healing has taken place Role of a Colonic Hydrotherapist 1. Respect of all personal information supplied to you by the client, in order to honour Data Protection and Confidentiality. Personal information can only be disclosed as a legal requirement. Health & hygiene should be observed at all times, using surgical spirit and spray bleach to ensure all surfaces are cleansed after treatments. 2. Using disposable equipment as this is legally accepted, ie the speculum; water inlet; waste pipe; medi-pad placed under the client; plastic sheet; couch roll; disposable pants. Sometimes disposable gowns are used, but it would be preferable to use gowns that have been made for this purpose, that can be washed after each treatment, then working out cheaper overall. 3. Appreciation of the holistic approach to the treatment. The colon metaphysically hangs on to the past. When clients release emotional trauma, they also release waste from the colon. If you listen and don’t prejudge, if you help people to release their hidden emotions, they will come to you again and again. A lot of people come to therapists to talk, so allowing time for them to do so will encourage release from the colon. 4. Advancing your skills by studying 3 fundamental courses in Nutrition; Anatomy & Physiology and Emotional Freedom Technique – to be able to offer the holistic approach. UKHolistics/ColonicHydrotherapy/Mar13© 4 The Digestive Tract The digestive tract is known as the alimentary canal, which is approximately 10 metres from mouth to anus, ie buccal cavity; pharynx; oesophagus; stomach; small intestine; large intestine; rectum and anus. Duration of the digestive process ranges from 24 to 72 hours. In addition there are accessory organs which support the digestive system known as the teeth; tongue; salivary glands; liver; gall bladder and the pancreas. Mechanical digestion is achieved by using teeth, tongue, jaw and peristalsis. Chemical digestion is the action of enzymes on food, in order for it to be broken down Peristalsis This is the movement along the alimentary canal, to ensure that any food eaten makes it way through to the colon. The walls of the colon; stomach; small intestine and large intestine are responsible for propelling the food along its journey. It is a mechanical action of digestion. Buccal Cavity and Oesophagus Food gets ingested in the mouth, being chewed (masticated) with the assistance of teeth and tongue. The mastication process stimulates the release of saliva, which contains a digestive enzyme called salivary amylase. This begins the chemical breakdown of carbohydrates in the mouth. Saliva assists the transition from food into a bolus that can be easily swallowed, via the pharynx into the oesophagus. The food is forced towards the stomach by gravity and a rhythmic wave-like contraction and relaxation movement called peristalsis. The Stomach The food bolus enters the stomach through the cardiac sphincter. The stomach muscles churn the bolus into chyme by mixing it with digestive juices (hydrochloric acid and other digestive enzymes). The stomach has a capacity of 1 - 1.5 litres. The bolus spends 3 - 4 hours in the stomach, being transformed into chyme. During this time it is digested mainly mechanically, but some chemical digestion of proteins and fats also takes place. Fat and fibre will extend the length of time food stays in the stomach. The Small Intestine Chyme is released from the stomach into the small intestine where it takes around six hours to digest an average meal, so that the nutrients are absorbed into the bloodstream. The inner walls contract around 12 times per minute. Bile and pancreatic juices break the chime down into simple chemical structures easily assimilated by the blood-rich villi. Water and indigestible substances move onto the large intestine. The ileocaecal valve allows liquid chyme to pass into the large intestine, but with no backflow. UKHolistics/ColonicHydrotherapy/Mar13© 5 The Large Intestine The undigested food stays in the large intestine, (1.5m long) for about 8 to several days. Structure - The caecum (first part after the ileocaecal valve); ascending colon; transverse colon; descending colon and sigmoid colon, rectum and anus. Bacteria breakdown the remaining carbohydrates. The colon re-absorbs most of the remaining water and mineral salts, passing them into the bloodstream. Fibre assists the transformation of wastes into faeces, which are stored in the descending colon, and evacuated through the rectum and anus. DIGESTION IN THE MOUTH Digestion begins in the mouth, which is the first section of the alimentary canal, or digestive tract. The mouth is a moist, neutral or slightly alkaline environment. The main functions of the mouth are: Introducing food into the digestive tract Mechanical breakdown of food by chewing (mastication) Start of chemical breakdown of carbohydrates by salivary amylase Lubrication of food with saliva Interpreting information about sensations and smell Salivary Glands Saliva is a digestive juice, manufactured by glands of the digestive system and released at different stages. There are three pairs of salivary glands that release saliva daily into the oral cavity. Parotid glands are the largest salivary glands located below the ear and between the skin of the cheek and masseter muscle. Sublingual glands are the smallest salivary gland, on the floor of the mouth covered by mucous membrane. Submandibular glands are the size of a small olive. They are both situated under the lower jaw at the corner on both sides. Saliva comprises 99.5% water; plasma salts and salivary amylase. The Teeth The teeth are the hardest substances in the body, performing the actual process of chewing, which is known as mastication. They are accessory digestive organs that help mix food with saliva. There are different types of teeth in the human mouth. Out of the total of 32 teeth there are 8 Incisors – thin, sharp teeth best used for cutting 4 Canines – conical teeth used for tearing 8 Pre-molars –grinding teeth 12 Molars – larger grinding teeth UKHolistics/ColonicHydrotherapy/Mar13© 6 The Tongue The tongue is a gland consisting of voluntary muscle. It forces the bolus towards the pharynx, then onto the oesophagus. Each tongue has 10,000 taste buds. People lose some of them as they grow older. Taste buds send the brain information about taste, texture and temperature of the food, which in turn releases digestive juices from the stomach that are required to process the food further. DIGESTION IN THE STOMACH Food enters the stomach. The stomach’s main functions include: a site of mechanical and chemical digestion (mainly) of proteins a food reservoir – normally 1 – 4 litres, but can range from 0.5 - 6 litres absorption site for alcohol, water and some salts peristalsis of food into chyme The stomach is an important digestive organ, serving as a reservoir and blender for chyme before it enters the duodenum, which is the first part of the small intestine. 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. Hydrochloric acid has 1.5pH and the mineral zinc makes HCI. The stomach is a smooth muscle consisting of three layers - longitudinal layer; circular layer of smooth muscles, plus an internal oblique layer of smooth muscles, for diagonal stretching. The folds in the stomach help increase its surface area and retain mucus to protect the stomach muscle. The mucosa produces a thick alkaline mucus, rich in bicarbonate, which protects it from gastric juices. Mucosa cells renew very quickly so damaged ones are rapidly replaced. Carbonated drinks cause the stomach to expand due to the bubbles. Anatomy of the stomach The cardia is the opening of the stomach that receives bolus from the oesophagus. The fundus is a temporary storage site for foods and liquids, sometimes filled with gases, causing pain and discomfort. The body or the corpus is the mid-portion of the stomach - the main processing area. It leads to the pylorus, that propels the bolus, now called chyme, through the pyloric sphincter to the first part of the small intestine called the duodenum. As food enters the stomach the walls of the stomach expand dramatically due to the thick layers of smooth muscle and the numerous folds of the mucosa, called rugae UKHolistics/ColonicHydrotherapy/Mar13© 7 Four layers of the stomach (gut) wall Mucosa - first layer, acting as a lubricant, protecting blood and other organs from gut bacteria. Deep gastric pits have narrow channels containing gastric glands that secrete gastric juices. Different cells secrete different digestive substances. Submucosa - second layer, made up of elastic connective tissue containing blood vessels, nerves and lymphatic vessels. Muscularis - third layer consisting of powerful involuntary muscles responsible for peristaltic movement, ie churning the contents to reduce them into chyme. Serosa - fourth layer (also known as the visceral peritoneum) is connective tissue strengthening the gut and massaging other internal organs. 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): 1. Cephalic phase is the shortest – 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. 2. Gastric phase is the longest, lasting about 2.5 hours from the start of the meal. It is triggered by the presence of food in the stomach and distension of the stomach. 3. Intestinal phase is triggered by the release of chyme into the duodenum, which inhibits gastric secretion, ie stops the release of stomach acid. Layers of the Gastrointestinal Tract Mechanical digestion in the stomach The stomach has three mechanical tasks to do: 1. It serves as a 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. 2. 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 muscular action. 3. It produces highly liquefied chyme; emptying 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). Protein in the form of meat takes about 2 hours for gastric emptying, whereas a protein shake would only take about 20 minutes. UKHolistics/ColonicHydrotherapy/Mar13© 8 Chemical Digestion in the Stomach Chemical digestion in the stomach requires the action of hormones and nerve stimulation – Nerve stimulation: Long before food makes its way into the stomach, its sight, smell and taste initiate the cephalic phase, including release of gastric digestive juices and muscular contractions by stimulating the vagus nerve (in charge of parasympathetic nervous system). Hormonal action: When partially digested food enters the stomach, gastrin, a hormone of the pyloric mucosa, activates further release of gastric digestive juices and muscular contractions. More hormonal action: As chyme passes from the stomach to the intestine, the intestine produces a hormone that stops further secretions of gastrin and stimulates release of intestinal digestive juices and muscular contractions. The important role of hydrochloric acid The hormone gastrin in the blood triggers release of hydrochloric acid (HCl) in the stomach. This makes the stomach a very acid environment, ie 1.5pH. HCl: activates the enzyme pepsinogen into pepsin curdles milk liquefies chyme begins the process of protein digestion kills almost all bacteria present in the bolus from the oesophagus The Small Intestine The small intestine extends from the pyloric sphincter to the ileocaecal valve where it links with the large intestine. The small intestine is the longest part of the digestive tract, approximately 6 metres long, but much narrower than the large intestine. 90% of digestion takes place in the first two sections. 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 the majority of absorption occurs in the small intestine. Acid chyme from the stomach is neutralised in the intestine by pancreatic, liver and intestinal secretions, which contains enzymes. The pH of the intestine is continually increasing as chyme moves from the duodenum toward the ileocaecal valve. Chyme takes 3 - 10 hours in the small intestine. Cross-section of the Small Intestine UKHolistics/ColonicHydrotherapy/Mar13© 9 Structure of the Small Intestine The small intestine consists of three parts, in the shape of a convoluted tube – duodenum 20-30cm; jejunum approx 2m; ileum approx 3m. The small intestine is able to absorb nutrients efficiently because of its large surface area. Although the width of the small intestine is approx 3cm it has a total absorptive area the size of a tennis court, due to the concentric folds in the intestine wall. Each fold is 5-6 cm in length and 3.2 millimetres (1/8”) 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. Villi and Microvilli Intestinal mucosa contains small organs called villi which consist of a lymph gland and capillary network. They are found along the walls and are tiny finger-like projections, through which nutrients are absorbed. Microvilli are located on top of the villi. They are known as brush border cells and help with absorption. The villi and microvilli increase the active surface of the small intestine. 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 through 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. Peyer's patches are lymphoid organs, usually found in the lowest portion of the small intestine (ileum). UKHolistics/ColonicHydrotherapy/Mar13© 10 Mechanical Digestion in the Small Intestine Intestinal movements are controlled by the autonomic nervous system. Propulsion: foodstuffs need to be propelled along the length of the digestive tube in order to be absorbed and assimilated. Peristalsis: muscular contractions that move from the oesophagus toward the anus, propelling contents along their journey. Mixing: process of combining digestive enzymes with chyme, to ensure digestion and absorption through the epithelial cells that absorb nutrients. Chemical Digestion in the Small Intestine The Duodenum This is the first section of the small intestine and is the thickest section. It is shorter, wider and less mobile than the other parts of the small intestine. It receives chyme from the stomach, through the pyloric sphincter, which prevents chyme from regurgitating back into the stomach. Cells that line the duodenum secrete hormones, which are chemical messengers to regulate secretion of pancreatic juices and emptying of the gallbladder and flow of bile. Below the pylorus, the common bile duct and the major pancreatic duct merge in the duodenum. Both are surrounded by the Sphincter of Oddi. Through these ducts the duodenum receives juices containing salts and enzymes, required 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 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 an important site of iron absorption. Jejunum The jejunum is 1-3m in length and 3cm in diameter. The jejunum and its lining absorbs carbohydrates, proteins and folic acid. The majority of carbohydrates and proteins are absorbed within the first 30% of its length. Ileum The ileum is 2-3m long. Unlike the duodenum, the jejunum and ileum are both attached to the abdominal wall by a thin mucous membrane and can shift positions within the body. The ileum has numerous coils and its diameter is 2cm smaller than that of the Duodenum or Jejunum. It has only a few folds which disappear entirely towards the lower end. The Peyer’s patches are larger and more numerous. UKHolistics/ColonicHydrotherapy/Mar13© 11 The ileum is important for absorbing products of fat digestion: fatty acids & glycerol, bile salts and vitamin B12, plus absorption of water. The ileum enters the large intestine at the ileocaecal valve, which prevents the backward movement of substances from the large to small intestine. The Large Intestine The colon or bowel is also known as the large intestine. It starts from the ileocaecal valve and finishes at the anus. It is approximately 1.5m long and has an average diameter of 5 cm - double the size of the small intestine. The mucosa lacks villi and microvilli and has a smoother surface than in other sections of the alimentary canal. Goblet cells line the walls, secreting mucus into the lumen (passage), hence mucus can sometimes be seen in the faeces. The colon holds on average about 3lb bacteria. Bacteria acts upon the remaining food residue and this bacterial fermentation produces about 500ml of gas each day - hydrogen, nitrogen, methane, carbon dioxide and hydro-sulphide. 4 Tissue Layers of the Wall of the Colon Mucosa - first layer, acting as a lubricant, with absorptive cells that absorb water and goblet cells that secrete mucous. It also contains a few lymphatic nodules. Bacteria reside in the mucosa and are beneficial, only causing harm if leaking through to other organs. Powerful bacterial enzymes are produced by bacteria, with the function of breaking down cellulose (undigestible fibre) so that it absorbs toxic wastes in the digestive system. Submucosa - second layer, made up of elastic connective tissue containing blood vessels, nerves and lymphatic vessels. Its function is an immunity barrier between the sealed eliminative system and the rest of the body. This is where nutrients from the large intestine are absorbed into the bloodstream, but sometimes the enzymes migrate from the mucosa to the submucosa, and start digesting cells, which is called autodigestion. Toxins escape into the bloodstream, called Leaky Gut Syndrome. A healthy body can cope well, however a compromised one will struggle. Candida albicans causes alcohol to be absorbed directly into the bloodstream, weakening the immune system. Muscularis - third layer consisting of powerful muscle fibres responsible for peristaltic movement. Laxatives and food intolerances or allergies overexcite nerve endings, causing overactive peristaltic contractions, reducing absorption from the mucosa, which compromises the immune system. Longitudinal muscle fibres collect into three thickened bands at intervals, called taeniae coli, known as ribbons of the colon. These are always slightly contracted into pouches called haustra. Serosa - fourth layer (also known as the visceral peritoneum) is connective tissue strengthening the gut and massaging other internal organs. Constipation stretches the serosa by stretching it, causing the gut wall to weaken. UKHolistics/ColonicHydrotherapy/Mar13© 12 The large intestine begins just above the right groin, known as the caecum, from which grows the appendix, a gland of the immune system. Its function is to fight possible infections in the incoming chyme and is also thought to help with digestion of meat. Inflammation of appendix is referred to as appendicitis. The next section of the large intestine is the ascending colon (20cm long). It starts at the caecum and ascends up to the liver, then approx 90 degrees bend, known as the hepatic flexure. Hepatic means relating to the liver. It is now known as the transverse colon (35-55cm), extending across the abdomen. The transverse colon reaches the splenic flexure, again another 90 degrees turn into the area known as the descending colon (22-30cm). Finally, the colon makes a curve resembling the letter S known as the sigmoid colon (15cm) before emptying into the rectum. The rectum is 8-18 cm long. Three semilunar valves (Valves of Houston) are present in the mucosal layer of the rectum, which slows faecal movement through this region. When straightened out, the muscular tube of the rectum evacuates stools from the sigmoid colon. The descending and sigmoid colon normally evacuate at the same time. The last section of the rectum is known 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 sphincter is a skeletal muscle. The external sphincter muscle is under voluntary control, while the internal muscle is an involuntary muscle, not under our conscious control. Functions of the Large Intestine Supporting and massaging the organs of the abdominal cavity Recycling water, electrolytes and nutrients back into circulation Producing serotonin, the mood-regulating neurotransmitter, with an important role in digestion and absorption Producing vitamin K and B12 Producing stool-fermenting enzymes and fermenting wastes Storing and eliminating wastes Supporting the body’s immune system and hosting the bacterial population Bowel motility is the least active at the caecum, where the large intestine has the widest diameter, and it intensifies when wastes reach the transverse colon which is considered to be the most active. In colonic treatments, the transverse colon is a crucial area to massage, remove any hardness within that area and release any emotional trauma that is stored there. UKHolistics/ColonicHydrotherapy/Mar13© 13 ACCESSORY ORGANS OF THE DIGESTIVE SYSTEM Liver, Gallbladder and Pancreas Liver The liver is the largest gland in the body. It weighs around 3-4 pounds and is located in the right side of the thoracic cavity, beneath the diaphragm, on top of the stomach. There are two sources that supply blood to the liver: oxygenated blood from hepatic artery deoxygenated, nutrient blood from hepatic portal vein (drugs, toxins, microbes absorbed from gastrointestinal tract which the liver needs to make safe) Functions of the Liver There are more than 500 vital functions. 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, taking 6-8 weeks to do so. 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 bile. Some of the liver’s other well-known functions are: • Production of cholesterol to help carry fats through the body • Filtering drugs, alcohols and other poisonous substances out of blood • Production of heparin which helps prevent blood clotting • Removal of dead red blood cells from circulatory system • • Storage of trace metals (such as copper and iron) Production of certain proteins for blood plasma • Storage of fat-soluble vitamins A, D, E and K • Production of bile, to carry away waste • • Delivery of bile onto gall bladder Removal of toxins from the blood • Storage of absorbed nutrients • Processing of haemoglobin for use of its iron • Conversion of glycogen into glucose for energy • Conversion of excess glucose into glycogen for storage • Production of urea and uric acid, end products of protein metabolism and excreted in the urine • Resisting infections by producing immune factors and removing bacteria from the bloodstream UKHolistics/ColonicHydrotherapy/Mar13© 14 Functions of Gall Bladder This is located underneath the liver and is a small pear-shaped organ, which stores bile from the liver and transports bile to the duodenum through cystic duct and the common bile duct. It is connected to the liver (which produces the bile) by the hepatic duct. It is approximately 3 to 4 inches (7.6 to 10.2 cm) long and about 1” (2.5 cm) wide. To store 70% bile concentrate, reducing it from bile which is continually secreted by the liver. The bile emulsifies fats and neutralizes acids in partly digested food. As the sphincter of Oddi in the common bile duct opens, the bile flows from the gallbladder into the duodenum. Gallstones Sometimes the bile salts crystallize in the gallbladder, forming gallstones. These small, hard lumps are more common in persons over 40, especially in women and the obese. They can cause inflammation of the gallbladder, with symptoms similar to indigestion, especially after a fatty meal is consumed. If a stone becomes lodged in the bile duct, it produces severe pain. Gallstones may pass out of the body spontaneously, but often results in the need for surgical removal of the gallbladder. Bile Bile, yellow to green in colour and bitter in taste, is produced by hepatic (liver) cells from cholesterol. 500ml is produced daily. It is composed of bile salts, bile acids, lipids (fats), and pigments biliverdin and bilirubin (dead red blood cells). They must be removed from the circulatory system. Jaundice is a result of malfunction in the liver where they stay in the system. Visual observations are that the skin and whites of the eyes develop a yellowish tinge. In addition to its excretory functions, 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. UKHolistics/ColonicHydrotherapy/Mar13© 15 Pancreas The pancreas is responsible for secreting hormones to maintain the blood sugar levels. It secretes gastric juices, to neutralise the acidity of food, into the small intestine. The pH in the stomach needs to be acidic so that the hydrochloric acid kills bacteria. Once chyme reaches the small intestine, it changes the pH from acidic to alkaline. Insulin is a hormone that helps glucose move from blood into cells, so that it can be used for energy. Another hormone, glucagon, is secreted to allow the liver or muscles to released its stores of glycogen and convert it into glucose – as the body needs more energy. The liver and muscles store glycogen. The body uses glucose for energy, but is unable to store it as glucose, so can only store it as glycogen. Glycogen is continually converted into glucose, and glucose is also constantly converted back into glycogen. Diabetes, an imbalance of blood sugar levels, is a 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). In Type 1 diabetes, a client must take insulin shots In Type 2 diabetes, a client may not necessarily need insulin and can sometimes control blood sugar levels with exercise, diet and other medications Too much insulin can lead to hypoglycaemia (low blood sugar), with symptoms of anxiety, sweating, increased heart rate, weakness, hunger, and light-headedness. Low blood sugar stimulates release of adrenaline, glucagon and growth hormone, which help to return the blood sugar to normal. Alpha cells produce glucagon Beta cells produce insulin UKHolistics/ColonicHydrotherapy/Mar13© 16 JUICES AND ENZYMES OF THE INTESTINAL TRACT Absorption in the small intestine Absorption takes place by diffusion and active transport. Monosaccharides (simplest form of carbohydrates), amino acids (simplest form of proteins), tripeptides and dipeptides are actively transported into the epithelial cells lining the wall, together with the absorption of sodium. 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. 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 are eventually passed out from the epithelial cells into blood. Digestion and absorption are almost complete by the time the chyme reaches the caecum of the large intestine. DIGESTIVE ENZYMES The pancreas secretes powerful enzymes that collectively have the capacity to reduce virtually all digestible molecules into forms that are capable of being absorbed. Four major groups of enzymes are critical for efficient digestion: 1. PROTEASES Digestion of proteins is initiated by pepsin in the stomach, but the bulk of protein digestion is due to the pancreatic proteases. Two major pancreatic proteases are trypsin and chymotrypsin, which are synthesized and packaged into secretory vesicles in their inactive forms of trypsinogen and chymotrypsinogen. Because our bodies are mainly protein, fat and water, proteases that break down proteins are dangerous enzymes to have in cells in their active state, so packaging them into an inactive form enables the cells to safely handle these enzymes, so that proteins can be digested once pancreatic secretions reach the small intestine. Proteins are broken down into peptides and enzymes secreted by the small intestine complete the process down to amino acids. 2. LIPASE Dietary fat is mainly composed of triglycerides. 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 monoglycerides to be absorbed. This means that normal digestion and absorption of dietary fat is dependent on secretions from both the pancreas and liver. 3. AMYLASE The main dietary intake is from carbohydrates such as starch. 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 – known as salivary amylase. 4. NUCLEASES Pancreatic nuclease enzymes digest nucleic acids (DNA and RNA) in the duodenum. UKHolistics/ColonicHydrotherapy/Mar13© 17 ANATOMY & PHYSIOLOGY IN RELATION TO COLONICS Endocrine (Hormonal) System Adrenal Glands The adrenal cortex produces glucocorticoids to help the body control blood sugar levels; increase the burning of protein and fat. Cushing’s Syndrome – too much cortisol is produced Addison’s Disease – too little cortisol is produced The adrenal medulla produces adrenaline, which is secreted to increase the heart rate, dilate the bronchi to increase oxygen intake and prepare the body for action. Thyroid The thyroid is situated in front of the neck, below the Adam's apple. The thyroid gland produces the hormone thyroxine, which controls metabolism, which in turn controls our energy levels plus how weight is maintained, gained or lost. Hypothyroidism (too little hormone) – lack of energy, slow heart rate, constipation, weight gain; and feeling cold Hyperthyroidism (too much hormone) – anxiety, heart beating faster than normal, diarrhoea, weight loss Lymphatic System As waste leaves the body cells, it is carried away by blood and lymph. Lymphatic vessels transport excess fluid; foreign and harmful bodies from the body’s cells. Lymphatic fluid is activated by movement, walking, stretching and exercise and encouraged to prevent lymph becoming stagnant - which would lead to increased risk of infection; phlebitis; thrombosis and poor healing of the body. Lymph vessels contain oneway valves and are lined with muscle tissue to pump the lymph through the valves. Main functions of the lymphatic system are to carry toxins away from all cells and form antibodies against infection - hence the reason lymph glands or nodes enlarge during times of illness. As much as 80% of immune response is activated from the colon. The colon is supplied with lymph material in its walls and in the small intestine groups of lymphatic cells are in Peyers Patches. There are enzymes in both the small and large intestines and these are the immune system’s first line of defence. Muscular System There are over 600 main muscles in the body, comprising skeletal; smooth and cardiac muscle that account for about a third of our body weight: Voluntary (Skeletal) muscles are attached to the bones, controlled by the Central Nervous System and are responsible for our voluntary (conscious) movements, such as running, swimming, moving Involuntary (Smooth) muscles, that line up the internal organs of the intestines, stomach, pupils of eyes and blood vessels are directly related to the Autonomic Nervous System. Their contractions assist delivery of oxygen and nutrients to body cells plus removal of wastes Cardiac muscle is the heart, responsible for pumping blood around the body UKHolistics/ColonicHydrotherapy/Mar13© 18 Nervous System The nervous system collects and sends messages to and from the brain to organs and muscles, within milliseconds. Afferent nerves carry sensory impulses from all parts of the body to the brain (A for Arrive) Efferent nerves carry motor impulses away from the brain to all parts of the body (E for Exit) The Central Nervous System (the brain and spinal cord, with protective meninges) is responsible for all conscious actions and the Peripheral Nervous System (12 pairs cranial and 31 pairs spinal nerves, plus Autonomic Nervous System) is responsible for functions outside of our control. Autonomic Nervous System The human body performs a number of activities automatically, without any conscious thoughts. It is divided into the Sympathetic Nervous System (SNS) and Parasympathetic Nervous System (PNS). Colonic Hydrotherapists need to appreciate the workings of the Autonomic Nervous system, so that they can give appropriate advice to clients that are stressed, working too hard, unable to sleep, have any digestive disorders etc. In these situations clients will be working their SNS, rather than PNS. Sympathetic Nervous System – Increase in heart rate; dilation of pupils, bronchi; increase in glucose levels; release of adrenaline; digestive system shuts down; decreased saliva production Functions – known as fight or flight, the SNS kick starts our system and prepares us for action by speeding up our metabolism. It allows the body to cool down in excess temperatures, by dilating blood vessels Parasympathetic Nervous System – Slowing of heart rate; constriction of pupil; increased peristalsis; constriction of blood vessels Functions – to lower blood pressure and all workings within the body – apart from the digestive system, whose activity is increased Skin The skin eliminates one-third of the body’s toxins, so visual observations of a person’s skin can highlight how efficient the digestive system is performing. Use the time during a colonic consultation and treatment to observe the skin. UKHolistics/ColonicHydrotherapy/Mar13© 19 DISORDERS OF THE LARGE INTESTINE Cancers and Benign Tumours Both benign and malignant tumours may occur in all portions of the bowel. Malignant tumours are more common in the large intestine than in the small intestine. Risk factors for cancers of the colon and rectum are high-fat and high-protein diets; diets high in processed foods; constipation, heredity, sedentary lifestyle and obesity. Candida Invasion of intestinal epithelium increases its permeability, then candida, its toxins, other micro-organisms and waste particles pass from the intestinal tract into the bloodstream. This creates an immune reaction as these are regarded as foreign particles. When protein particles reach the brain they cause brain allergies such as depression, irritability, sudden mood swings. Besides candida, other micro-organisms such as bacteria, viruses and fungi are able to migrate from the gastro-intestinal tract to other parts of the body, causing inflammatory conditions and infectious diseases. Micro-organisms pass into the lymph nodes, blood, liver, pancreas and spleen. In this condition the ileocaecal valve remains in the open position, which enables colonic bacteria and candida to spread up the intestinal tract to inhabit the small intestines and stomach, thereby creating nutritional and intestinal disorders. Symptoms include lethargy; flatulence; thrush; headaches; cravings and digestive pain. Coeliac Disease This damages the small intestine and affects absorption of nutrients from food due to inability to break down a gluten protein, found in wheat, rye, and barley. Eating foods or products containing gluten causes damage to villi in the small intestine. Villi allow nutrients from food to be absorbed into the bloodstream. Without healthy villi, a person becomes malnourished, regardless of how much food is eaten. Because the body's own immune system causes damage, coeliac disease is considered an autoimmune disorder, and a disease of malabsorption because nutrients are not absorbed. Coeliac disease is a genetic disease. Colon abnormalities: Atonic - known as Lazy Bowel because it has low muscle tone or strength, so water flows in and out of the bowel without engaging the bowel itself. It may be caused by overuse of laxatives or dietary imbalances from anorexia or bulimia in earlier years; insufficient fibre or effect of medications or illegal drugs Collapsed – one or more pouches close in upon itself due to lack of muscle tones in the colon wall Hypertonic – bowel tone is too contracted and client may suffer from bouts of constipation and diarrhoea, plus gas and yeast Prolapsed – the transverse colon droops or sags, often putting excess pressure on the bladder, uterus or prostate, causing problems in those organs also Redundant – colon has become very elongated, so that a section folds back upon itself. This restricts the movement of faeces, so that faecal matter builds up in the colon Spastic - one or more pouches are in a constant state of contraction, thereby reducing the diameter size of colon Constipation and Diarrhoea Most people, even children, suffer from some sort of constipation. Chronic diarrhoea is a sign of constipation and most often due to the presence of irritation in the colon, or a stagnant condition of the bowel which is laden with harmful bacteria and parasites. Constipare is the Latin word meaning “to press together”. Old faeces may build up in pockets, coating the entire length of the colon and small intestine, so waste matter becomes hardened and does not become eliminated in normal bowel actions. UKHolistics/ColonicHydrotherapy/Mar13© 20 An overstretched or laden bowel can descend low into the pelvic cavity and cause pressure on the bladder, rectum and uterus. The longer food remains in the bowel in a putrified state, the more toxins remain in the system. An overload of toxins causes diseases. Constipation is defined as the difficult or infrequent passage of faeces and is associated with the presence of dry, hardened stools. Chronic constipation creates conditions for the development of cancer. Crohn’s Disease (Regional Enteritis) An inflammatory disease which usually affects the lower ileum and generally causes problems around the ileo-caecal valve, but may involve other parts of the gastrointestinal tract. The cause is unknown and affects both males and females equally and generally the younger age group. Diverticulosis / Diverticulitis A diverticulum is a protrusion of the mucosa and is often 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. Complications are perforations, haemorrhage, and inflammation which is referred to as diverticulitis. Problems associated with diverticulosis and diverticulitis are caused by highly refined and processed foods. The longer foods remain in the gastrointestinal tract, the more likely that harmful toxins will form and multiply. Not all the faecal matter is evacuated, so hardens on the walls of the colon. Gradually the passage inside the colon becomes smaller. Small pockets are formed as the muscles of the colon have to work harder to evacuate faeces. Eventually the pockets become infected, causing diverticulitis. Dysbiosis Dysbiosis is a state of imbalance of intestinal flora, ie an overgrowth in the intestinal tract of pathogenic organisms, such as yeasts, parasites, micro-organisms of fungi, harmful bacteria or viruses. Dysbiosis causes lethargy, lowers the immune system, upsets concentration levels and hormonal balance. It can cause anxiety, depression or mood swings. If you have dysbiosis, then you could suffer from fatigue, headaches, intestinal upsets, and some of the symptoms of Candida. Flatulence Flatulence occurs when the digestive system is not working effectively, insufficient digestive enzymes are not produced or a duct transporting the digestive enzymes is partially or completely blocked. Gas can also come from air swallowed as part of respiration. Excess of flatulence can cause headaches; skin eruptions; lethargy; aches & pains in joints. Since the encrusted faeces line the colon wall, the colon is unable to absorb nutrients from the food. Wastes from blood which should normally be drawn into the colon through colon walls are reabsorbed by the body along with other toxins resulting from the fermentation and putrefaction of incompletely digested food. Increase in flatulence occurs when consuming large quantities of foods such as beans or dairy products which leave partially undigested sugars that produce a larger than normal amount of gas. Too much dairy and meat will also cause achy joints. Haemorrhoids Haemorrhoids are the result of excess pressure and straining on the rectal veins, causing them to swell. They can be painful and may rupture, causing bleeding. Constipation causes haemorrhoids due to dry, hard, compacted stools. Poor eating habits and lack of water are other causes. UKHolistics/ColonicHydrotherapy/Mar13© 21 Hernias A badly ballooned colon creates excess pressure within the abdomen, so that part of the gastro-intestinal tract protrudes into the abdominal wall. A strangulated hernia is a shortage of blood supply to the bowel. Hiatus hernia – stomach protrudes up through opening in the diaphragm. Inguinal hernia – bulging intestines manifest as lumps in the groin, both causing considerable pain and discomfort. 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. Symptoms are frequent liquid stools, small hard stools and abdominal cramps. The condition often occurs in people who are under stress, tense, anxious and emotionally unstable. The bowel becomes over sensitive caused by emotional responses and too much adrenaline in the bloodstream. Cow’s milk and antigens can be responsible for the condition, manifesting itself as constipation; low pain; bloatedness; flatulence or diarrhoea. Nerves and muscles in the bowel are extra-sensitive, causing muscles to cramp during or shortly after eating, often followed by diarrhoea. Problem foods that cause symptoms include milk products, chocolate, alcohol, caffeine, carbonated drinks, and fatty foods. Leaky Gut Syndrome The gut lining is permeable, ie small particles of food are able to pass through into other cells. In a healthy body the holes are small enough to keep molecules contained. When the intestinal wall is weakened, toxic poisonous substances are released and collected by lymph nodes, which are numerous in the intestinal area. Liver cells keep out as much toxic waste as possible, but during times of overload, such as waste products, alcohol, food additives, preservatives, pesticides, its performance becomes compromised. Diseases such as skin eruptions arise, such as acne, psoriasis, dermatitis, urticaria, eczema, chronic fatigue. Leaky gut can be caused by exposure to anti-inflammatory drugs, lack of oxygen, chemotherapy drugs. In normal circumstances the intestinal lining generates a new lining every 3-6 days. If the gut is damaged, the body suffers from inadequate absorption of vital nutrients. No matter how many vitamins and minerals are ingested, absorption is impossible, resulting in malnutrition. Therefore, vitamin and mineral supplements should include vitamins, A, B, C and E, zinc, selenium, manganese and magnesium. Glutamine is an important amino acid that reverses gut abnormalities. Parasitic Infestations A variety of species of parasitic worms may invade the intestinal tract. The most common are round worms and tapeworms. Acute parasitic infection has symptoms of abdominal distress and diarrhoea, often urgent with burning sensations and fluid loss. Generally, there is malabsorption of nutrients, especially fatty foods. Irritable bowel syndrome, blood sugar fluctuations, sudden food cravings, and extreme emaciation or overweight are all possible symptoms of a possible parasitic infestation. Rectal Fissure An ulceration of the skin of the anal canal. An acute fissure occurs from tissue being stretched, probably as a result of evacuating hard or large faecal matter. Ulcerative Colitis Ulcerative colitis is a inflammatory disease of unknown cause characterized by passage of blood and mucous stools. It consists of congestion, oedema, and ulcerations which may develop into abscesses. The oedema may lead to extreme dryness and fragility of the mucosa. Faecal matter often contains pus, blood, mucus and could be more fluid. UKHolistics/ColonicHydrotherapy/Mar13© 22 HISTORY OF COLONIC HYDROTHERAPY Colonic hydrotherapy is an old tradition. Enemas and colon cleansing dates back to an Egyptian medical papyrus dated 1500 BC, which shows Egyptians employed purgatives, enemas, diuretics, heat, steam and leeches to treat diseases. Many tribes have used river water for cleansing. Colon cleansing therapies were an important part of Taoist and Yoga training. 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 the USA, colon hydrotherapy equipment was used by doctors practising in health spas and hospitals. From the 1920s to the 1960s, the regular use of enemas was standard practice amongst most medical practitioners and they were implemented as common treatment in many hospitals. Colonics versus Enemas Enemas: Have been used for the relief of constipation, flatulence and intestinal discomfort They are often self-administered They empty the lower part of the large intestine Water has to be held within the bowel for a long time, then evacuated. The process often has to be repeated several times Colonics: Are administered by a person with professional training Can hydrate and empty the whole of the large intestine Are a series of small holds, never beyond the uncomfortable threshold Is a 45-minute treatment using a special piece of equipment to control the water flow Colonic Equipment Always use equipment recommended by your colonic hydrotherapy organizations, which meets local water authority’s standards. 1. Make sure your equipment is installed and tested by a qualified installer 2. Always follow equipment manufacturer’s instructions in performing the cleansing procedure 3. Always use the cleansing solution recommended by the manufacturer 4. Maintain your equipment and change all necessary parts as per the instructions contained in the equipment manual, especially the filters Disposables 1. 2. 3. Use disposable kits only No part of the disposable kits (speculum, obturator, inlet & outlet pipes, disposable underpants or gown) must ever be re-used It is recommended to use paper towels or flannels in your washroom The Room 1. 2. 3. 4. The floors must be fully washable. Carpet floor is not allowed The room must have its own adjoining toilet, washing facilities and have an extraction system There must be a water fountain/supply of drinking water on the premises UK regulations require a separate sink for therapist’s use only Personal appearance 1. Professional appearance must be maintained at all times 2. Ensure hands are sanitised and free from cooking smells 3. No heavily scented perfumes should be used UKHolistics/ColonicHydrotherapy/Mar13© 23 Hygiene 1. All surfaces touched by the customer: the toilet, the door handles, the bed must be sanitised with a disinfectant solution between all treatments 2. 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 3. Hands must be scrubbed between treatments 4. All disposables, paper etc must be stored and removed in accordance with local by-laws Water temperature and pressure Always follow manufacturers’ instructions. Generally water temperature must be reasonably close to body o temperature (36.8 C). Treatment duration The average treatment duration is around 45 minutes. Treatment preparation 1. Always check contra-indications 2. Check the consultation has been signed and dated by the client 3. Do not treat clients with severe hyper or hypotension 4. Never treat anyone who appears to be under the influence of alcohol or drugs or behaves erratically 5. Clients will often arrive for their first colonic treatment feeling apprehensive, nervous and curious about what will happen during the treatment. A good colonic hydrotherapist will be prepared and do all they can to offer reassurance before and during the treatment 6. In closed systems, insertion is carried out when the client is lying on their side. Give a thorough explanation to the client and ensure the client is at ease. Some discomfort may be experienced 7. In open systems, the client sits on a protruding tube and self-inserts. No colonic hydrotherapist assistance is needed throughout the treatment 8. When using lubricant, use disposable spatulas to avoid cross-contamination Comments from clients It was much better than I expected I feel so motivated to eat healthier now I feel cleansed I’m amazed at how much came out of my body I wish I’d done this years ago I can’t wait for my next treatment How soon can I have my next treatment? How many treatments would you recommend? I’ve got so much relief from Irritable Bowel Syndrome UKHolistics/ColonicHydrotherapy/Mar13© 24 CLIENT REACTIONS AND EXPERIENCES DURING TREATMENT Caecum Flush The caecum is the first part of the large intestine. A caecum flush can be observed in the waste pipe, which will be full of a dark green soup-like consistency. Once the caecum flush has started, the pipe will be full several times as it is all evacuated. This means that the water has been able to travel around the whole bowel and represents a good release. If, however, the caecum flush is at the beginning of a treatment, this could indicate that the walls of the large intestine are much narrower than they should be and are possibly covered in mucous faecal matter. As water is unable to soak off the faecal matter so early on in the treatment, it quickly travels round the bowel to the caecum area. Erratic Breathing Clients can experience more discomfort if they aren’t able to relax during the treatment and hold their breath. Oxygen is needed. As more oxygen is inhaled, more carbon dioxide (waste product) is released. Clients might hold their breath at some point in the treatment and it is the job of the therapist to work with the client to ensure the breathing rate is flowing, at ease and encouraged to be deep and slow. Lack of Oxygen As water is released from the bowel, together with faecal matter, the body sees the bowel as a site of emergency, so blood and endorphins immediately go to that area. As blood contains nutrients and oxygen, this blood supply increases, so other parts of the body stop receiving their full share of oxygen. Low Sugar Levels Caused if the client has not had sufficient food during the day. Client can feel slightly dizzy or disorientated and this can be overcome by offering them a sugar lolly or mini box of raisins, which needs to be eaten straight away to increase glucose levels. Weight loss? Faecal matter and toxins will be lost, but one of the main aims of the treatment is to rehydrate the colon. If a client has previously been dehydrated, then water will be absorbed. Getting weighed on the scales before and after the treatment could even result in some slight weight gain, albeit temporary. The main benefits are that soaking occurs in the large intestine, which helps to release any hardened faeces. Clients will have better absorption of nutrients through the walls of the intestine, which will in turn contribute towards better health and wellbeing, and less impacted faecal matter building up. Better absorption of nutrients will contribute towards weight loss. How many treatments are recommended? A course of 3 treatments is beneficial for every single person. Often clients book their first treatment and seek guidance from the therapist as to future treatments required. Many clients will rehydrate on their first colonic treatment. Subsequent treatments should be recommended until the client has started to release. If the client has suffered with digestive disorders for several years, then it will take more than a few treatments to bring the body back to balance and restore harmony to the large intestine. Lifestyle and nutritional advice are very important to complete the holistic treatment. UKHolistics/ColonicHydrotherapy/Mar13© 25 AFTERCARE ADVICE Clients need to receive an aftercare advice sheet, with recommendations for nutritional and lifestyle support. Clients should refrain from eating spicy or rich foods, alcohol and generally excess food for 24 hours after the treatment. Light food with plentiful vegetables would be beneficial, introducing whole grains such as brown rice, barley, oats and buckwheat. Clients often have problems with constipation and digestive disorders due to the lack of fibre. Aim for more soluble fibre, rather than insoluble, as this will be less harsh on the wall of the colon. Artificial sweeteners should be avoided, as well as carbonated drinks, which will only make clients more bloated and feeling gassy. After a treatment clients will feel lighter, brighter and less bloated, due to excess gas being eliminated during the colonic treatment. If there has been a long-standing condition of constipation or several health problems, a slight headache or fatigue may be experienced with the first and/or second colonic. This will only last 24-48 hours. The liver is the main organ of detoxification, so it can sometimes undergo a healing response as a result of receiving a colonic. If clients experience a healing response, then they should be advised to book in for another colonic treatment as soon as possible, as it means that excess toxins are travelling around the bloodstream looking for an escape route. A second colonic treatment will give those toxins that escape route. Some water has been absorbed through the colon walls during the colonic and clients may feel the need to urinate for a few hours afterwards. This is a normal response and clients should be encouraged to include more water intake in their diet, to further promote the cleansing effect on the kidneys. Normal bowel movements may take 1-4 days to resume, due the colon being emptied of solid matter. Clients should only be offered one or two lifestyle/aftercare advice tips, so as to avoid overloading them. Encourage clients to avoid ice cold water with meals. The most optimum temperature for water is at body temperature, ie luke warm. Advise clients to chew food slowly. If clients suffer with flatulence then, whenever possible, talking should also be avoided when they are eating, to avoid air getting into the digestive system. It is a good idea to develop your own Aftercare Sheet, which is given to clients at the end of the treatment. Often clients do not fully listen to everything being explained, but would read the leaflet later on at their own convenience. Supplements Clients receiving colonic treatments will often have digestive disorders, which can be relieved through the intake of supplements. Innahealth is a range of herbs, vitamins and minerals to repair the intestinal walls and offer comfort with conditions such as candida; bloatedness; aches & pains; lethargy; indigestion; detoxing; food intolerances; leaky gut, and many more. A full business day is offered to colonic therapists on Innahealth, so that they are able to offer advice to clients towards better health and wellbeing. During the consultation it is beneficial to discover whether clients are taking medication and/or supplements. Medication is often prescribed and clients have virtually no control over what is to be taken. Discovering what supplements clients take will highlight what priority they have over their own wellbeing. Sometimes clients do not disclose what conditions or disorders they are suffering from. Discovering information about what supplements are being taken will give you clues about their priorities. UKHolistics/ColonicHydrotherapy/Mar13© 26 CAUSES OF DIFFERENT BOWEL MOVEMENTS 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. Evacuation 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, will not eliminate as much. However, those people will accumulate just as much waste, but without the fibre, as it is not able to get rid of it as quickly if at all. The need for acidic colon The main acid in the colon is acetic acid – originating from fats and sweets. This acidity protects the body against bacteria. Antibiotics, all pain killing drugs and steroids have a disastrous effect on the bowel, destroying all active bacteria, leaving more waste in the bowel. The intestine likes fibre as it absorbs water, bulking out the intestines and encouraging evacuation from the bowels. Friendly bacteria produce lactic acid, acetic acid, digestive enzymes and vitamins. How constipation develops If it takes longer than 10 minutes to complete a bowel movement, then that represents constipation. The residues of digested food move from the small intestine into the large intestine in liquid form. Peristalsis, ie muscular contractions, moves the contents through the colon before evacuating them. Walls of the colon are absorbing both moisture and waste material from the body into the colon. The longer material remains in the colon, the more moisture is absorbed from it, with the result that it is drier and pressed together. During a bowel movement powerful contractions, called mass movements, force the contents of the rectum and lower colon through the anus. Faecal matter will be of different consistencies:Watery matter will be eliminated quite quickly Slimy matter will be eliminated more slowly Slimy matter has a longer transit time through the colon, so more moisture will be absorbed from it, causing it to become sticky, coating the sides of the colon as it passes through. As layers of sticky faecal matter build up, they often form tough, rubbery, really dark stools. The slimy matter is due to the levels of mucoid material present in the colon. A nonmucoid stool can be fully formed as it passes out of the body, but soon crumbles when it hits water, or will break up when gently agitated. Nonmucoid stools pass through the body quicker. A mucoid stool has the appearance of lumps pressed together. The more mucoid the stools are, then the longer the transmit time and often more straining is required. A borderline mucoid stool requires little or no straining to be passed from the body, breaking up partially when the toilet is flushed. Laxatives These stimulate the bowels to move. Most work by irritating the colon sufficiently to expel contents in the colon. Laxatives however do not eliminate anything older than the laxative itself. Once the laxative has passed through the colon, the bowels will still be as sluggish. Laxatives cannot be used for colon cleansing. Chronic diarrhoea Clients will have several bowel movements a day and will not consider themselves to be constipated. The reason for chronic diarrhoea is the presence of irritation in the colon, which the colon attempts to expel as soon as it can. Stagnant mucoid will be laden with parasites and harmful bacteria and adheres to the walls of the colon and cannot be expelled. Colonic treatments are extremely beneficial to these clients. UKHolistics/ColonicHydrotherapy/Mar13© 27 Autointoxication This is the process whereby the body poisons itself by holding onto decaying matter in the colon, which contains high concentrations of harmful bacteria. The toxins released by the decay process get into the bloodstream and travel all around the body. Every cell in the body is affected and many forms of sickness can result. Putrefaction - this is the cause of autointoxication within the intestinal tract. It is a process of decay in which foul odours and toxic substances are generated. The amount of putrefaction present in the body depends upon how long the food undergoing putrefaction has been in the body; also the efficiency of the digestive processes and upon what kind of food is undergoing putrefaction. The length of time food stays in the body depends upon two factors - stagnation and transit time. Stagnation - this is the result of matter becoming lodged in the alimentary tract, thereby not moving, causing it to putrefy and release toxins for weeks. The main aim of colonics is to remove the stagnant material from the colon. THE TRANSIT TIME This is how long is takes after food is eaten until its residues are expelled through the anus. The shorter the transit time, the less it will putrefy before being expelled. The average transit time is 65 to 100 hours. It takes about 8 hours for food to travel through the stomach and small intestines and the remainder of the transit time is spent in the colon. Longer transit times may be associated with low energy levels, bad skin, congested blood, decreased immunity and degenerative diseases, including colon cancer. Colonics can help reduce the transit time down to 24 to 48 hours, provided a nutritional programme is also followed and there is a healthy ratio of good bacteria in the colon. Composition of faeces? 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, and are then converted into bilirubin, which is the main component of bile, which gives the faeces their rusty-brown colour Dead bowel flora, parasites and other gut buddies that make their home in the large intestine UKHolistics/ColonicHydrotherapy/Mar13© 28 Healthy and Unhealthy Faeces The size and shape of the stools indicate the transit time through the digestive tract. The colour, shape and texture can tell you how good your digestion is and alert you to other changes concerning your wellness. Examples: Eating grains – slightly looser faeces, sausage will break in the middle, leaving a rough edge Eating lots of leafy green vegetables - dark faeces Eating beetroot – faeces will be burgundy Charcoal – faeces will be dark Iron supplements - stools harder and darker Stools that are very yeasty –possible dysbiosis Undigested pieces of food – although sweetcorn, nuts and seeds are harder to fully process Dark blood or fresh blood in stools Too much mucus Variety of colours within stools Dehydrated stools, despite client drinking copious amounts of water 3 Stages of Bowel Movements 1. Segmentation 2. Peristalsis 3. Mass movements BOWEL DISORDERS Anal Itching Most adults experience anal itching, the soreness around the anus and the irresistible desire to scratch at some point in their life. Itching is a sign of malfunction in the body, perhaps from wearing clothes that are too tight; dry skin or too much moisture; sweating or using shower gels that can cause a skin reaction. Occasionally the causes are found in overusing laxative preparations; antibiotics; psoriasis or eczema. Itching could also be caused by dysbiosis - excessive yeast production in the bowel, commonly known as thrush or candida albicans; or from infections; worms or other parasites. Dietary causes can be coffee and other drinks containing caffeine, nuts, popcorn, tomatoes, chocolates and sometimes fruit. UKHolistics/ColonicHydrotherapy/Mar13© 29 Blood in Stools Fresh blood in the bowels could mean that the stools are too dry and have scratched the bowel wall, causing it to bleed. Small capillaries line the intestinal wall, so some faecal matter could have been trapped and the pressure of water caused faecal matter to come away from the wall, at the same time rupturing small blood vessels. A haemorrhoid can also bleed causing discomfort and pain. If fresh blood continues to appear in the stools, then referral should be made to their doctor. Dark blood in the stools means that there could be a haemorrhage higher up – in the small intestine or stomach. Dark blood could be more serious and definitely needs to be investigated. Gassy/Smelly Stools Often gassy, smelly stools are the evidence of lactose intolerance (lactose 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 overloading one type of food, especially high-fibre vegetables, such as onions, beans or pulses. Gas can also be caused by excessive consumption of fatty animal foods combined with stomach acid or bile deficiency. 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 your client takes fatblocking tablets, the toilet water will have orange-slick puddles, because they pass the fat straight into the colon. Whilst soft faeces are evacuated, they also greatly upset the intestinal flora. Mucus in Stools Can be caused by agents that the body is intolerant to, and the bowel lining has secreted more mucus to try to eliminate it. Or a client could be eating a disproportionate amount of proteins and fats, especially of animal origin, including meat, milk, yoghurts, fromage frais and cheeses. Some people can tolerate dairy and others struggle. 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. However, most people 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 coat and help eliminate undesirable wastes. It could be caused by dysbiosis, bacterial infections, and obstructions in the bowel, parasites or haemorrhoids. Blood-containing mucus in the stools is a good reason to have stools checked professionally. Pale or Grey 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 bile insufficiency in the body. Rabbit Droppings Normally a sign of constipation caused by dehydration. Lack of fibre (bulking agent) plus lack of liquid (increases weight of waste) creates stools that are small and very compacted. Adrenal exhaustion, of an emotional blockage or of high levels of suppressed stress and anxiety that increase acidity in the body. Skid Marks Skid marks are often present after an alcoholic evening, and leave a slightly burning sensation when passing soft stools. 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 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 affecting digestion of proteins in the stomach. UKHolistics/ColonicHydrotherapy/Mar13© 30 Straining Straining is a sign of constipation. If you have less than one bowel movement a day, then you are almost certainly suffering from constipation. It means that dead stuff is not being eliminated. Straining means that the stools are too dry or dehydrated to come out on their own. They irritate 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. Appropriate lifestyle advice should help alleviate the problems. Undigested Food Coloured pieces of food in stools could mean that food is not being chewed properly, and/or bacterial colonies living in the gut are not very effective. It could also mean that not enough enzymes in the small intestine, the stomach or the pancreas are being produced, causing inadequate food assimilation by the body. Some foods are much harder to digest than others. Common examples are tomato, potato and apple skins, seeds or nuts, sweet corn and popcorn. Peeling fruit and vegetables and not eating their skins. Sweetcorn or popcorn being chewed properly and grinding seeds and nuts before eating should benefit the digestive system and assist in nutrient absorption and assimilation. White Chalk-like Stools White chalk-like stools may result from a combination of factors: low-fibre diet high in fat and processed foods, anaemia and severe dysbiosis (imbalance of bacteria), often caused by excessive or long-term use of prescription drugs, appetite suppressants, drugs and laxatives, which grind the colon to a standstill. IMPROVING THE QUALITY OF BOWEL ELIMINATIONS Clients may have a history of being unable to release and will need emotional support to allow them to release partially or fully, both from the mind and also the bowel. Some examples are holidays in confined areas, eg caravans sharing accommodation with strangers parents’ attitude and training group visits to public toilets fear of using school toilets Advice to clients: Beneficial relaxation exercises Eat food not under stress, as digestive system shuts down in that state Use a toilet privately, where and when nobody can overhear Allow time for bowel movements Encourage more hydration of the bowel by drinking water or other alkaline beverages Use a footstool to tilt the pelvis backwards and straighten the rectum and to relax skeletal muscles of the abdominal cavity In many countries, disposable toilet seat covers are provided or can be bought in a pharmacy. UKHolistics/ColonicHydrotherapy/Mar13© 31 Reasons for Dehydration Insufficient water intake - a minimum of 2 litres a day Change in nutritional habits. More processed foods are easily accessible such as pizzas, pastas, breads or potatoes Less time to eat meals, so more bulky food with less hydration Chemically enhanced foods, so less chewing is required to unlock the senses. Chewing contributes to the hydration of foods. Fast chewers are often more dehydrated Stress, adrenal fatigue, air conditioning, sedentary jobs and lifestyles, inhaling petrol fumes and pollution Excessive exercise Eating animal proteins Drinking excessive amounts of alcohol Drinking sweet and fizzy drinks instead of water Bodies are 70% water. As cells in the body need water to create energy, it is important for clients to hydrate their bodies, so colonic treatments will ensure the bowel receives adequate hydration. Water re-absorption from the bowel Fat and stools are not totally dependent upon water. Physical exercise over a period of time allows fat in the body to release water. The large intestine receives digested wet wastes from the small intestine to convert them further into stools, absorbing most of the water from the bowel, leaving some water in the faeces for a smooth evacuation. It means that the body will re-absorb water from the bowel when dehydrated, hence hard, dried stools are formed. Fibre, which helps bulk up the wastes, retains water in the stools, which stay hydrated. Dehydration and colonics Often a client’s first colonic hydrotherapy has no wastes coming out for the majority of the treatment. The usual symptoms of the body trying to get rid of wastes are present – cramping; discomfort; the urge to release – but the wastes are not coming out or coming out randomly. One reason for this is dehydration. The bowel needs to absorb water before starting to release the wastes so that they become bulky and wet enough to be evacuated. In a situation of severe dehydration, it is recommended to have a course of 3 treatments within 10 days, with nutritional and lifestyle advice, plus supplementation. The second brain The intestine works with the nervous system to send signals during hunger, overeating or the need for elimination. About 95% of serotonin, the neurotransmitter known as the mood regulator, is stored in the gut. The bowel is known as the second brain or enteric nervous system because it directs the digestive system. There are many circumstances that cause a breakdown in the nervous system connection between the bowel and the brain, some of which are: Emotional eating Reluctance to empty the bowels, due to inappropriate timing or locations Overeating Insufficient chewing Dehydration UKHolistics/ColonicHydrotherapy/Mar13© 32 Initial Assessment of Anal Area Ensure client is lying on their left hand side, with legs bent, which helps to straighten out the back passage. Men generally have tighter anuses, whereas women, especially child-bearing women, generally have looser anuses. Age tends to create sphincter muscles that are looser. Digital examinations mean that the anus is lubricated, either with gloved finger or with the speculum. Lubrication enables you to gauge the client’s sensitivity; check if there are fissures or haemorrhoids or any other obstacle that might prevent insertion of the speculum. The glove on that hand should always be thrown away straight after the examination. Re-insertion If the speculum is released at any stage of the treatment, re-insertion should take place, as if starting the treatment from the beginning. Never try to re-insert the speculum without first inserting the obturator back into the speculum, then re-lubricating the area. Re-connect the water lines and treatment recommences. Insertion Difficulties Pain or problems with insertion could result from either a raised vein or an internal haemorrhoid close to the entry point, which should be observed in the following ways: a. Lift the external sphincter muscle slightly more, allowing more room for the speculum to be inserted b. Use your finger to press down on the external sphincter muscle, rest for a few seconds to allow the brain the process the message being sent, then slowly insert speculum Questions for the client Have you ever had a colonic before? Have you been recommended to have a treatment? Do you have any aims of the treatment? Why a colonic? Benefits of the Chi Machine Helps to oxygenate every cell of the body Improves evacuation of wastes Switches off the nervous system Encourages relaxation Re-aligns all the major chakras in the body Allows the client to “switch off” Strengthens and tones muscles Switches on the parasympathetic nervous system Clients will benefit from resting their ankles onto the Chi Machine for about 5 minutes at the start of the colonic treatment. Nervous, apprehensive clients will especially find their Nervous System responds very quickly to the Chi Machine. UKHolistics/ColonicHydrotherapy/Mar13© 33 COLONIC TREATMENT 1. Using extra water pipe, run warm water to desired temperature within the green zone 2. Welcome client and discuss the treatment 3. Complete consultation, check contra-indications and discuss any changes since the last visit 4. Ask client to change into the gown and disposable pants, using the toilet before the treatment 5. Place client on the Chi Machine for 5 minutes, then raise height of the couch 6. Ensure all equipment is to hand - ie lubricant; forceps; waste bin; plastic containers and spatulas 7. Put on gloves and remove speculum out of plastic bag 8. Connect hoses to the machine and water pipe onto the speculum 9. Move Chi Machine away from couch 10. Ask client to turn onto their left, and draw knees up 11. Lubricate speculum and let client know you are going to insert it into the anal passage 12. Lubricate anal area with lubricant and insert speculum 13. Remove the obturator and put into plastic bag in beaker 14. Put small amount of lubricant inside the waste pipe and connect it onto the speculum 15. Start water flow gently and watch the pressure and temperature gauges 16. Begin treatment with short fills to gauge reaction and break up any initial gas in the back passage 17. Increase fill duration and, using the callipers, release when the client feels the pressure 18. When faecal matter is released, increase outflow but turn down flow rate when on inflow 19. After approx 5 minutes stop water flow and turn client onto the back, remembering to support the speculum. However do not roll client onto back if client is still releasing on their side. Never change anything that is “working” 20. Massage the client’s abdominal area 21. Vary the water inflow from fast to slow; reposition the pipe by adjusting slightly; and complete variety of techniques to encourage release of waste matter 22. Ask client to roll back onto their left side and finish treatment with 2-3 last fills 23. Stop water flow and allow natural draining before unplugging pipes 24. Use a tissue to hold over the end of speculum, once it has been removed from the client 25. Help client to sit on edge of couch and, when confident client is okay, ask them to go to the toilet and get changed 26. Disconnect hoses from machine, wipe all surfaces with surgical spirit 27. Advise appropriate aftercare advice, especially taking Probiotics to boost the immune system 28. Clean toilet once the client has left 29. Complete the treatment card for client Observations during the treatment As water starts to be introduced into the client, ensure it is introduced gradually on a slower inflow, with no long fills initially. When callipers are used to break up the gas, ask the client to say NOW or RELEASE when the pressure has built up sufficiently for the client to release. If the client says NOW quite quickly and frequently, then it indicates that there is some blockage or gas that is preventing the water to go more fully into the colon area. Ask the client if they are able to hold the water and pressure for just a little bit longer to the point of mild discomfort. It is usual for a client to take a few minutes to become adjusted to the colonic treatment. The client might ask if they should be holding for longer, to which you can answer yes as long as it is not too uncomfortable. It is more beneficial to do several short fills rather than long fills if the client has discomfort, and there are signs of gas. UKHolistics/ColonicHydrotherapy/Mar13© 34 IBS Sufferers These people are far more sensitive to temperature changes, possibly due to a higher number of nerve endings in the digestive system. These clients are a lot more aware of the changes in their digestive system. Special attention should be given to ensure that the water temperature is kept as close to the body temperature (36.80C) as possible, with gentle fills. No hot fills, just tepid warm to cool fills, as the intestinal area will be irritated, sensitive, raw and angry. Lifestyle Changes The treatment gives opportunities to educate the client about a healthy lifestyle; refer clients onto other therapists for supportive treatments; gives clients a block of time for emotional release and also time for clients to ask questions. Massage Routine Always massage in the direction of the bowel, which is often beneficial to clients for dispersing any trapped gas. A portable massager with infra-red and vibrational head are very beneficial, activating the enteric nervous system, and can often be much more effective than strong manual massage in the abdominal area, promoting better elimination. The infra-red heat has the effect of calming and relaxing the client. Water temperature An important aspect during the treatment is the control and changes of water temperature. Cooler temperature will mobilise and contract the bowel Warmer temperature will relax the bowel The process of alternating cooler and warmer temperatures will normally achieve a significantly deeper release than otherwise. Caution – IBS clients do not respond to changes of temperature unless the changes are significant, but caution about raising the temperature too much above body temperature. Working with the whole person – Holistic Approach During the treatment observe the body language of the person: Are they breathing sufficiently or holding their breath Watch the clients’ facial expressions Observe whether they are flexing or clenching their toes or fists, which would mean that the client is in discomfort Is the client getting fidgety and moving arms in agitated way Is client having a hot flush, or alternatively suddenly has a cold shiver Many organs do not give out warning signs when under stress - ie the liver, kidneys or brain. However the heart, stomach, bowels and bladder react when in an emotional turmoil. The heart beats furiously; stomach makes people feel sick or nauseous; bowels cause us to rush to toilets; and bladder causes more frequent trips to expel urine. Feeling nauseous can be a sign of the body eliminating excess toxins. All activity in the body requires energy. Stagnation results in a decline in energy. The solar plexus, which is a collection of nerves behind the stomach wall, is an area where tension and stress is held. If the colon loses its ability to have a regular and peristaltic flow, then over a period of time nerve signals stop functioning and large deposits of waste line the muscular wall of the colon, gradually invading the many pockets and convolutions. This waste paralyses the ileo-caecal valve, backs up the small intestine and a toxic condition is reabsorbed into the bloodstream. Almost every chronic disease is directly or indirectly due to the influence of bacterial poisons absorbed from the intestines. These poisons gravitate to weakened spots in the body - perhaps a genetic weakness; accident resulting in injury to an organ or structure; patterns of childhood illness such as allergies, asthma, or stomach upsets. UKHolistics/ColonicHydrotherapy/Mar13© 35 Toilet Break Clients will release faecal matter at different stages in treatments. If it is a first treatment it could possibly be more about hydration of the colon. If client experiences continual discomfort, yet nothing is being released, then it would be beneficial for a toilet break. Switch off water, remove the speculum and ask client to release on the toilet. Sometimes faecal matter is too big to come down the waste pipe and may have got lodged near the entrance, therefore blocking water going into the intestinal area If client has a toilet break quite soon into the treatment, then ask client if they would like to carry on with the treatment, and re-insert the speculum If client has already had majority of the treatment, perhaps 30 minutes or more of water hydration, then it is probably best to finish the treatment, and book another treatment quite soon after Always ask the client what their preferences are. Never re-insert if the client feels they have had sufficient, as this will not achieve anything Visual observation of the client gives time to ask questions, as sometimes client hold onto their discomfort. Establish whether client’s level of discomfort is bearable, continuous or occasional. Explain to the client that it frequently happens that clients need a toilet break due to the size of faecal matter needing to be released Release Techniques A variety of techniques are used to encourage release of faecal matter and gas, plus optimum hydration of the bowel. Most people will have some problem with either gas, bloating, constipation or diarrhoea, hence their need for a colonic treatment. Soaking technique is excellent for those clients with atonic constipation and no discomfort related to bloating or gas at any stage of the treatment, as their bowel is reacting mechanically rather than using any peristaltic movement. You can only use this technique when the client is lying on their back. Make a towel roll and slide it under the waste line to raise it by a few inches. Reduce the flow considerably and let the water sit in the waste line to help soak up the wastes, at the same time massaging the client’s abdominal area. Burping the waste line is beneficial if the client has a lot of gas as this will break it down causing it to be released. Use callipers to quickly hold and release several times. Teasing is used when large faecal matter does not fit into the speculum, causing discomfort. Hold the waste line close to the speculum and move it up and down, also circling round, as if you were “teasing” the bowel. This helps engage the bowel muscles and the nerve endings, helping contractile activity and breaking up any stubborn matter releasing it into the waste line. When to close the treatment After observing release of faecel matter and then a caecum flush results well into the treatment, it means that water has reached as far as the ileo-caecal valve and gone round the whole of the large intestine. Do a couple more long fills and possible massage before drawing treatment to a close. If client is experiencing discomfort, and has been doing so for some time, then a toilet break may be necessary. If the treatment has been less than 30 minutes, then give the client the option of continuing the treatment after the toilet break. If longer than 30 minutes, then the client will have received sufficient hydration and the treatment should not be continued. UKHolistics/ColonicHydrotherapy/Mar13© 36 Requirements for Colonics Business Basic requirements for opening a colonics business are as follows: Recognised training qualifications Public liability insurance Products liability insurance Employers’ liability insurance if employing any staff Professional indemnity insurance Premises with preferably en-suite toilet facilities Appropriate equipment, plus boiler capacity for continual colonics Supply of consumables and disposables Supply of supplements and other supportive products Paperwork of factsheets, consultation sheets, aftercare advice, nutritional support Training and insurable qualifications: The minimum requirements for becoming a colonic hydrotherapist are: 40 hours of supervised colonic hydrotherapy training 40 hours of prerequisite requirements (Anatomy & Physiology or Diet & Nutrition) 10 colonic hydrotherapy treatments Accredited Prior Learning taken into account for individuals Completion of Pre-Study materials before the course Being involved in either giving or observing a minimum of twenty colonic hydrotherapy treatments performed during the training Satisfactory completion of written and practical examinations Purchasing equipment Initial budget Plumbing requirements Purchase of colonic equipment - prices range from a few hundred pounds to set up with a gravity system, to several thousand for a modern colonic hydrotherapy machine Cost of disposables and consumables Maintenance of the equipment Reputable plumber and engineer to fix and service the equipment Available working space Purchase of electric couch, rather than portable one Gloves A supply of disposable gloves will always need to be on hand. Only order a box of each time to start with, until you establish what gloves you prefer to use. They range from vinyl to latex, both powdered and unpowdered, some with aloe-vera, some white, blue or green. Record-keeping Therapists have a legal requirement to keep all details of clients confidential and filed in a locked cabinet. Write any aftercare advice and points of reference straight after the treatment, ie reactions during the treatment; supplements given; any emotional release. Remember clients can ask to see their records at any time, so only note professional comments. UKHolistics/ColonicHydrotherapy/Mar13© 37 Supportive Treatments Clients interested in receiving colonic treatments may also be interested in massage; reflexology; body wraps; fat burning treatments such as iLIPO; universal slimming contour wraps; lymphatic drainage; separate nutritional consultations. Body Wraps, such as mud or seaweed wraps, engage skin which is the largest organ of the body. They nourish and detoxify the skin and internal organs by combining heat, hydration and active agents in the body wraps, which 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. iLIPO is a treatment using a laser machine. Pads are placed on the body on appropriate places where fat needs to be reduced. The laser penetrates through to the fat cells, bursts them and the fat needs to be released through exercise, which stimulates the lymphatic system. Lymphatic Drainage enhances the detoxification effect of colonic hydrotherapy by speeding up removal of toxins from the system, especially if carried out both before the colonic treatment, to promote more thorough cleansing, and after the colonic treatment, to promote speedier recovery. Massage, especially incorporating lymphatic drainage, is very beneficial before and after colonic treatments. Massage movements can be used on the abdomen to encourage any trapped gas to be released. Reflexology can assist elimination, by working on appropriate reflex areas on the hands and/or feet. The web between the thumb and forefinger can be pressed to encourage the colon to release. UKHolistics/ColonicHydrotherapy/Mar13© 38 DIET AND NUTRITION Diet = what we eat Nutrition = what the cells and tissues receive There are 3 types of food that are eaten:1. bioacidic - foods that deplete energy levels 2. biostatic - neutral foods 3. biogenic - those that improve energy levels Each cell performs many tasks such as respiration, growth and repair - taking in oxygen and glucose and excreting acidic metabolic wastes. The body needs to neutralize and detoxify these acids before they travel round the body as poisons. Eating natural, organic foods that form an alkaline residue in the body help to 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. Acid forming foods are proteins (meat and fish), concentrated carbohydrates (grains, potatoes, rice) and highly refined foods (junk food and sugar). Acid foods have a contracting, constipating effect on the body. If a diet is high in acid forming foods, the mineral reserves become depleted as they are used to buffer the excess acids, then begins to take electrolytes from various organs and systems of the body to maintain the pH level. Blood and tissue alkalinity is maintained by abstracting calcium salts from bones and teeth and by abstracting potassium from muscles. This results in weakened bones and teeth, and causes muscles to become acid contracted. Alkaline forming foods are most vegetables and fruit; honey; almonds; quinoa and herbal drinks. The alkaline residue in the body is its store of alkaline forming minerals of potassium, calcium, magnesium and naturally occurring sodium. These are vital to the metabolic functions of our body systems. When there is a reserve of these minerals, the buffering process (cushioning and removing of unwanted acids from systems) is not a problem as there is a ready store. Alkaline foods have a relaxing, expanding, laxative effect on the body. A diet rich in alkaline forming foods is more nutritious, keeps the excretory systems in good order and maintains blood sugar levels, plus providing the optimum pH of tissue fluids for the body to function well. 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. Alkalizing foods – 75% of diet Acidifying foods – 25% of diet Burning Fat Oxygen burns fat. If clients cannot hold a conversation whilst exercising then they are not burning fat. In order to burn fat Vitamin E is needed. Anti-oxidants need to be increased as the breakdown of adipose tissue causes free radical release - as does exercise as well. 1KG Muscle = 90 KCal. Smoking One cigarette represents 25mg Vitamin C used. UKHolistics/ColonicHydrotherapy/Mar13© 39 Food intolerances & Food Allergies Not all food that is eaten is beneficial. Food is also coated in fertilisers, pesticides, additives, bacteria, chemicals and preservatives. Many foods cause reactions in the body, ie itching, sweating, thirst, digestive disorders. Some of these foods are gluten; wheat; oats; cows’ milk; dairy produce; coffee; shellfish, therefore the body tries to eliminate those offending substances through the bowel (designed for storage and elimination of wastes). When we try to eliminate excessive amounts of toxins through the skin, the skin erupts. Elimination through the lungs gives us bad breath and acid reflux. Vitamins Bind messages between cells. Vitamin deficiency can result in glaucoma; fatigue; immune deficiency. Minerals Transfer energy - for example iron in cells; or chromium to balance sugar levels. Essential Fatty Acids Cell membranes need good fats. EFA deficiency represents nerve damage; chronic inflammation; pain and immune deficiency. Cells without healthy membranes lose their ability to hold water and vital ingredients; lose communication with other cells and will represent more inflammation. Carbohydrates storage as Glycogen The simplest form of carbohydrates is glucose. Glucose cannot be stored as glucose, but can only be stored as glycogen, or used instead as energy. The liver stores 100g glycogen which represents 400 KCals. The muscles store 275g glycogen, representing 1100 KCals. Glycogen = 1 part carbohydrates + 3 parts water (H2O) Functions and Repair of Cells Every hour millions of cells replace others that have died. Skin replaces every 28 days Skeletal system replaces every 5 years Gut epithelial cells replace every 4 days Intestinal cells replace every 3-6 days Every cell experiences 10,000 free radical attacks every hour UKHolistics/ColonicHydrotherapy/Mar13© 40 Glossary 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 – “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 – Follows absorption, when nutrients enter human cells and turn into components to be used Autointoxication – Re-absorption of gut toxins back into the bloodstream, also known as Leaky Gut Syndrome Bowel – The large intestine or Colon Candida – Yeast-like fungus that is naturally present everywhere. 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, malnutrition, low emotional and immune states Colon – Another name for the large intestine or bowel 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 Dysbiosis – An imbalance of micro-organisms 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. Removal of wastes and non-nutrients that are incompatible with our living cells and therefore cannot 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 enema clears only a small section of the large intestine, whereas the colonic hydrotherapy treatment can clear most of it Enteric Nervous System – Located in the intestines, the ‘brain’ that the 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 Putrefaction Gut – The 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: 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 Gut permeability – A condition characterised by absorption of undesirable contents of the intestines into the bloodstream, caused by 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 – Taking food into the mouth, to initiate digestion UKHolistics/ColonicHydrotherapy/Mar13© 41 Intestinal flora – Gut bacteria Large Intestine – The part 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 bloodstream. 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 Parasite – Organisms that live inside the host, use the host and negatively affect the hosts’ function. Humans suffer mostly from single-cell parasites (microparasites) and worms. Parasites mainly live in the digestive tract, but sometimes they can also invade muscles or connective tissue Putrefaction – Decomposition, decay of proteins 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 moods, but also the quality of digestion. 95% of 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 UKHolistics/ColonicHydrotherapy/Mar13© 42 DIGESTIVE SYSTEM UKHolistics/ColonicHydrotherapy/Mar13© 43