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On Good Bacteria, Enemas, And Your Health

In certain cultures, like middle class Jews growing up in Hyde Park in the 1950s, everyone remembers being chased through their home by a well-meaning mom armed with an enema bag. “Dr. Nachman said you needed this for a poopy!”

I am tearful, dressed only in whity-tighties until caught in the steel grip of my father, probably grateful he wasn’t next on the list.  I lose the battle, but since I’m right at Sigmund Freud’s anal stage of development, I probably lay still and rather enjoyed the experience. I simply don’t remember, which is just what Freud expected.

Decades later, when I was establishing what would ultimately become WholeHealth Chicago, I sampled just about every form of alternative therapy available at the time. During my encounter with colon therapy, comfortably lying on my side, a hose snaking upward from an irrigating pump, my tummy being gently massaged by my therapist, I thought…of mom.

Probiotic enemas
When I first encountered the research into using enemas containing probiotics, the whole thing made a lot of sense. With an enema, you’re simply inserting water into your rectum to clean it. A probiotic enema adds a small amount of powdered probiotic to the water. There are a lot of DIYs online, but here’s a good one.

Until recently, conventional medicine paid virtually no attention to the concept of good bacteria—probiotics—focusing its narrow-minded thinking solely on bad bacteria as the cause of most illnesses, battling them with the single tool in its arsenal: antibiotics.

Good-guy probiotics were highly suspect by MDs, since they were found in health food stores and the offices of clinical nutritionists, chiropractors, and naturopaths. Imbalances of intestinal bacteria (called intestinal dysbiosis) were so foreign to the conventional health care system that to this day, if a physician orders a test looking specifically for dysbiosis many health insurance providers will deny coverage, claiming it’s an unproven condition.

Our understanding of intestinal dysbiosis has changed dramatically over the past decade despite the deliberate reluctance of the insurance industry to keep abreast with the times. Read this piece for a solid overview. Scientists ultimately calculated the following, which still feels a little sci-fi to many of us:

  • There are 100 trillion bacteria (approximately 3 pounds!) in our intestines.
  • Bacteria represent from 1% to 3% of our entire body mass.
  • In terms of numbers, we carry ten times as many bacterial cells as human cells, each with its own genetics and metabolic system.

They named this living creature the gut microbiome. And when scientists recognized how many areas of the body were affected by it, they began to consider it a nearly separate functioning organ within the body.

Microbiome bacterial mix
A poor mix of bacteria in your microbiome can increase your risk for a diverse selection of conditions, including:

  • Autoimmune disorders such as rheumatoid arthritis, Type 1 diabetes, and multiple sclerosis.
  • Susceptibility to intestinal inflammation (irritable bowel syndrome, ulcers, ulcerative colitis, Crohn’s) and colon cancer. Some gastroenterologists are treating these conditions by giving enemas containing stool material from a healthy donor, a process called a fecal transplant. If your doc recommends one, consider a DIY approach to save yourself $10K.
  • Lyme Disease.  Our physicians recommend a low-volume retention enema using an extremely high-potency, prescription-only probiotic containing nearly a trillion bacteria.

Testing the status of your gut microbiome
Currently the best test available (and at least partially covered by most insurance companies) is the GI Effects Comprehensive Stool Profile by Genova Diagnostics. WholeHealth Chicago patients can discuss this test with their physician, chiropractor, or any of our nutritionists and we can order the kit for you. If you’re not a WHC patient, your doctor can order it or you can contact Genova directly.

If your test results show that your gut microbiome is a train wreck, our nutritionists will guide you through the process of making it healthful again. We can even teach you how to self-administer your own probiotic enema so you won’t have to call your mother. My mother is, well, unavailable.

Be well,
David Edelberg, MD




Leave a Comment

  1. Deb S says:

    You are absolutely correct. I recently had the Genova GI Effects test which showed gut dysbiosis, a low level of short chain fatty acids, etc. I have started on a program to heal this and have made great strides. However, the insurance company refused to pay for the Genova lab test. I know they would have happily paid for a colonscopy, lower GI, and CT scan, all of which I had done seven years prior for the same (lingering symptoms) and would have had to repeat if I didn’t opt for the Genova test. The insurance companies are so short sighted, preferring to spend more in the long run.

  2. Evie says:

    Maybe it was because I grew up Catholic, in a large family of nine children, we were lined up and given Fletcher’s Castoria. It was only when mom (an R.N.) brought out the pan of boiling water to sterilize the needle for our annual flu shots, did we all run and hide. We actually got to like the taste of that castor oil!
    Great columns that you write, Dr. Edelberg. I still say you are brilliant! A genius!

  3. Tara Drolma says:

    This is a very timely article and I applaud your open mindedness. I have Chronic Fatigue Syndrome and Irritable bowel. My stomach problems became so intense over the past few months that I have completely given up all grains and gone on a low carb/ketogenic diet. I no longer have problems with my stomach. Dr. Myhill, an English physician suggests a “paleo” or stone age diet for her CFS patients. She has a good explanation of how our gut works on her website. She claims, “the upper gut is a near-sterile, digesting carnivorous gut (like a dog’s or a cat’s) evolved to deal with meat and fat, whilst the lower gut (large bowel or colon) is full of bacteria and is a fermenting, vegetarian gut (like a horse’s or cow’s) evolved to digest vegetables and fibre.” I am not sure if this is true and I have never been tested for gut disbiosis, but my stomach problems are gone as long as I follow this diet. The CFS seems a bit better, but it is still a problem. You can find more info at her website under Fermentation of the gut and CFS.

  4. Sandy Kurtz says:

    What do you think of Optimum Health Institute in San Diego?

    I go and get colonics with wheat grass implants.
    I found your comments on probiotics very informative.
    My best,
    Sandy Kurtz

  5. Dr E says:

    Hi Evie
    I am sure you’ll be delighted to learn that Fletcher’s is still available, renamed as Fletcher’s Laxative for Kids. You can get it on amazon
    Hi Sandy
    Optimum Health is an excellent SanDiego resource for you

  6. sara says:

    Am interested in learning how to give myself probiotic enema.

    Do you provide this service. If so, I will schedule an appointment. Although I live in Virginia.



  7. cliffmaurer says:

    Hi Sara – Dr. Kelley tends to be our office expert on this subject. She can help you decide what probiotic would be appropriate based on your health concerns. If you’re able to travel to us, feel free to call our front desk at 773-296-6700 to schedule a visit.

    All the best,
    Dr M

  8. Colette says:

    My son is struggling with Crohn’s and would like to try the probiotic enemas if they will help. Any guidance is greatly appreciated! Thank you!

  9. Dr E says:

    Hi Collette
    Probiotic enemas would not be dangerous and may be useful for a Crohns patient
    You can read plenty of articles online about fecal transplants and Crohns

  10. Gator says:

    I recently started doing basic probiotic enemas as rec. by my M.D. This is to address inflammation/autoimmune disease NOT constipation, as I go 2-3 times per day already. I am having trouble getting much of the soluion to go in even after having 1 or more BMs for the day. What can I do to improve this and help with retention when more does go in?

  11. Dr. R says:

    Gator. It is probably best to perform your probiotic enema in the morning. Mix the probiotic solution the night before and let it remain at room temperature. Hold the enema for 15 minutes, if possible. You may feel an intense need to evacuate your bowels before the 15 minutes is up. Pay attention to your body’s signals and evacuate when it feels appropriate. Warnings: Speak with your doctor before performing a probiotic enema, especially if you have a digestive or intestinal condition. Do not perform an enema if you have a ulcerative colon or gallstones.

  12. Nema Nyar says:

    Hi Gator:

    I was not able to get my first enemas in until I shifted my position (laying on the left side, I shifted my right hip more forward). For some reason, that did the trick

  13. Paul lancor says:

    Very helpful explains alot thank you

  14. Shannon Smith says:

    Can you recommend a place where I can get a probiotic enema?

  15. cliffmaurer says:

    Hi Shannon – Typically we teach patients to administer these to themselves as they are easy to do on your own. Are you in the Chicagoland area?
    -Dr M

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