Do we really need to gut cleanse?

Gut issues have become more common in recent years and people are often looking for ways to gut cleanse. Life has got so busy that people feel very limited with their time. This leads to stress, a lack of activity and looking for fast foods (that are typically highly processed and fatty). This can wreak havoc on our gut health. Our mood can be affected on days when we are having issues with our gut. Most people will tell you that they have suffered with problems like cramps, wind, diarrhoea and constipation at some point or another. In a world where digestive problems are very common, many people are searching for a digestive system cleanser or regime to help with these issues. But do any of them actually work?

In this article we will look at some of the most commonly tried alternative remedies and see if they are really worth the hype?

Types of gut cleanse

Colonic Irrigation

Claim: Thought by alternative health advocates to cleanse the colon naturally, the colon is flushed with large amounts of water using a tube inserted into the rectum to “detoxify” the gut (1, 2). The contents removed during treatment are assessed to see if there are any issues present. For example, if undigested particles are removed it indicates a “sluggish digestive system”.

Fact: The digestive system already removes waste material and bacteria from the body and doesn’t require any outside help (this is why you produce stools)! Undigested particles should be present, considering that some fibre is insoluble and cannot be digested. Several unpleasant side effects can occur after colonic irrigation such as nausea, vomiting, dehydration and cramping (3). Some evidence suggests that regular use of colonic irrigation could be helpful to maintain gut bacteria in people with serious problems with their digestive muscles (4). Despite this, any new treatment or procedure needs to be supported by a lot of scientific evidence before it can be recommended as a treatment for the general public. At present, this is not the case for colonic irrigation (5). 

Turmeric to cleanse the gut

Claim: Curcumin, a chemical found in turmeric is believed to support digestion by relaxing the muscles in the walls of the intestines, pushing food through. 

Fact: Early animal studies have shown the potential for curcumin to have a positive effect on gastrointestinal health and function, such as improving intestinal wall permeability (6a). However, there may be limited effects in humans due to the poor bioavailability of curcumin. The curcumin content of turmeric is only around 3% by weight (6) and curcumin is poorly absorbed by the gut (7). Many studies have shown low to undetectable levels of curcumin in the blood (6a). Animal studies have shown curcumin’s potential to treat gastrointestinal diseases, however this has not translated successfully into human clinical trials. The dose of turmeric required to have an effect is not specified and in other studies on spices, the dose required to have any impact is so large that a typical serving would have insignificant consequences. This too is likely the case with turmeric.

Apple cider vinegar (ACV)

Claim: One theory for using this as a colon cleanse drink is that it contains an enzyme that helps break down food and prevent gas being produced.

Fact: There is little scientific evidence to support this claim. The body naturally produces enzymes that breakdown food. If the body did not make enough digestive enzymes, then it is medically diagnosed (usually a problem with the pancreases) and medication containing digestive enzymes would need to be taken. Enzymes are also extremely sensitive and can be destroyed by high temperatures or acid in the stomach. Medical enzyme products contain a special coating to prevent them from being destroyed in the stomach. It is unlikely that if there were any enzymes present in ACV they would survive long enough to reach the gut (8). ACV can also erode your teeth, cause heartburn and reflux (9). 

Activated charcoal cleanse

Claim: Another at home colon cleansing suggestion, believed to detoxify. There are also claims that it reduces indigestion, gas and bloating, by binding to gases produced during digestion and then flushing them from your system.  

Fact: Activated charcoal is used in medicine to bind accidental poison consumption or an overdose of medication in the gut to prevent it from entering the bloodstream (10). It is not surprising that there are claims it can detoxify the body. Unfortunately, it is likely that activated charcoal is more a hindrance than a help. It slows down your gut, often resulting in nausea and constipation, it binds to some medications making them less effective and also with vitamins and minerals, blocking them from being absorbed (11). 

The Microbiome diet

Claim: The idea of the microbiome diet is to promote healthy bacteria in your gut. This gut cleansing diet is split into three stages. The first stage involves avoiding gluten, dairy, corn, corn-starch, eggs, trans saturated fats, dried fruit, soy, processed meats, potato, sweet potato, beans and alcohol. Unprocessed meats like chicken, fish and lamb, fruits and vegetables are allowed. The microbiome diet recommends taking a wide range of nutritional supplements to help the gut during these stages. Stage one lasts twenty-one days after which the second stage involves the reintroduction of eggs, potato, legumes and gluten free grains. After a further nine days, you enter the final or “maintenance stage” whereby the foods currently consumed should make up 70% of the diet and “processed and packaged foods should be avoided”.

Fact: This diet is unnecessarily restrictive and will lead to nutrient deficiencies (such as calcium, in the absence of any dairy or calcium-containing alternatives). The supplements are expensive and most have little scientific evidence for their use (12).

The bottom line: should we use a gut cleanse or digestive system cleanser?

There is not enough scientific evidence to support any of the gut cleanse remedies mentioned above. Some of the remedies can be dangerous or waste your money. Dietitians and nutritionists don’t recommend a specific gut cleanse diet, but will advise on ways to increase the health of your gut that is tailored to you.

How to keep your gut healthy

You don’t need expensive supplement or fancy diets to keep your gut healthy, there are a few simple steps that can help to keep your gut healthy.

Below are ways which can help to keep your gut healthy:

  1. Ensure you are having enough fibre everyday.

    Aiming for 30g of fibre per day. Most of the UK population are not meeting fibre recommendations (13) so aim to make small sustainable changes to your diet to increase your fibre intake.

  2. Include wholegrain versions of foods such as cereal, pasta, bread and rice.

    Ways to increase fibre includes using wholegrain, brown, seeded versions of starchy carbohydrate foods.

  3. Increase the amount of veg and fruit you have in your diet.

    Aiming for at least 5 different vegetables or fruit per day. Try to include at least 2 different vegetables with meals and fruit snacks. Check out some great ideas from guest writer Harpreet Sohal.

  4. Try to limit fizzy drinks and rich or fatty foods

    such as chips, fast food, pizza, creamy sauces cake, biscuits, processed meats such as sausages and deli meats.

  5. Drink plenty of water

    aim for about 8-10 x 200ml glasses/day

  6. Keep up with your physical activity

    aim for a total of 150 minutes of activity every week (either in 30 minute or 1 hour blocks)

Interested in learning more?

Below is information from trusted sources, but for tailored nutritional advice please consult a dietitian or registered nutritionist.

  • The Gut Stuff is a website focused on all things gut related and run by an expert team of GPS, scientists, nutritionists and dietitians 

Final Thoughts

There will always be people and websites that are trying to sell you remedies to fix your gut, but often these are not needed and unsupported by the evidence. Always check the qualifications of the people you are getting your nutritional advice from. Dietitians are the only nutritional professionals to be regulated by law (via the HCPC) and registered nutritionists (RNutr) sign up to a voluntary register with the Association of Nutrition in the UK.

Disclaimer: The information in this article is for information only, for tailored nutritional or medical advice then please speak to a dietitian or other health professional.

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With thanks to dietitian Maebh Williams for putting this comprehensive review together for Dietitian’s Life.

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