NOTE: This is a précis of an important lecture given at the Association & Register of Colonic Hydrotherapists at their 18th Annual General Meeting held in April 2005
Colonic Hydrotherapy Survey conducted by Peter McDonald MS MBBS FRCS Consultant Surgeon at Northwick Park and St Mark's and Senior Lecturer Imperial College London. Member of the Association of Colonproctology. Honorary Editor Royal Society of Medicine, Sub-Dean at St. Mark's Trained in London and the USA
Author of 60 Scientific papers and the " Oxford Dictionary of Medical Quotations" as well as 600 scientific columns in both scientific and non-scientific journals et. al. from St Marks Hospital, Harrow HA1 3UJ.
Correspondence to Peter McDonald (e-mail: firstname.lastname@example.org
Colonic Hydrotherapy is practised as an alternative treatment by at least 80 practitioners in the United Kingdom . No adequate survey has been conducted to date. We sent a questionnaire to all known practitioners and another 380 to their clients. One third of practitioners had a clinical background. The clients had undergone an average 3-5 treatments and were predominantly female (84%).
There were no complications reported and a high level of satisfaction amongst clients, particularly when compared with their experiences of traditional medicine. Colonic Hydrotherapy is a safe treatment that may benefit some patients with functional bowel disorders .
There has never been a survey in the UK of commercial colonic hydrotherapy and this is the first report of its kind in the world literature . There is wide spread scepticism of the benefits amongst colorectal specialist. Practitioners who were registered with the Association & Register of Colon Hydrotherapists were circulated with a questionnaire and 38/80 (48%) replied. Their average age was 50 years (range 22-78) and 85% were practising single-handedly.
They had all trained for a minimum period of one year with a Hydrotherapist and had passed a written and practical examination. This training included undergoing hydrotherapy themselves and mean number of sessions that the practitioner had undergone was 4 - 5 (range 3-300). The average time in practice was 6 years. 12/38 (32%) had a clinical background (doctor, dentist, nurse) and over a quarter of the whole group were originally nurses.
The mean number of hydrotherapy sessions they had conducted was self-estimated as 3200 (range140-10, 000) sessions with 68 (range 4-200) being performed monthly. An average of 56L (range 9-132) of warm filtered water is administered under gravity through a proctoscope by means of an inflow/outflow intermittent flush-out method and the treatments take between 30 and 60 minutes to perform.
The questionnaire to the clients were returned by 242/380 (64%) and 84% were female. Clients were aged between 18 and 82 years of age (mean 44). Individually they had undergone 35 (range 1-2500) treatments with a frequency of 10 per annum (range 1-96) 73% anticipated needing regular and lifelong hydrotherapy.
None reported any adverse effects from a total of 8,470 treatments. Traditional medicine was rated twice for the males) or three (for the females) times less effective for treating their various complaints. 24% of the clients complained of constipation and 29% had been diagnosed as irritable bowel syndrome. On self-assessment 78% of the clients rated themselves as having no psychiatric problems although 19% admitted depression and a very few had bipolar and eating disorders.
This was in contrast with SF-36 scores where clients scored significantly lower than the UK norm for all criteria (Figure 1) When the clients were asked how they thought hydrotherapy works their responses included that it "detoxifies", "cleans", "unblocks", "tones bowel" "relieves constipation" "clears skin", helps headaches and arthritis" and "energises. Clients reported a high level of satisfaction with hydrotherapy and a low level of satisfaction with traditional treatments for their symptoms (Figure 2).
" The conclusion from our survey we conclude that it is a safe technique with no clients in our study reporting any adverse effects. In the UK at least it appears to be performed by experienced and trained practitioners if they are registered with the Association & Register of Colon Hydrotherapists. However, it is not know how many are practising outside this umbrella.
Although the clients are a self-selected group with some psychological morbidity their satisfaction with hydrotherapy is high and this appears to fill the gap in conventional treatments for functional colon disorders. A truly randomised study would be hard to conduct but there may be a place for more detailed research which might benefit some patients with functional bowel disorders"
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