Coffee Enema: Viable Solution or Wasted Ablution?

By Katrin Geist

Contributing writer for Wake Up World

Drinking coffee in excessive amounts every day may not be the healthiest habit. But what if there was a way of regularly consuming a quart (950 ml) of coffee without detrimental effects? Not only that, but also deriving health benefits from it?

That’s right — coffee enemas. Admittedly, the way in which to consume said coffee may not seem attractive at first, but after doing a few times, you’ll be a total pro administering your coffee enema in the comfort of your own home. No, there are no take-aways for this one. And no milk and sugar, either. Just black coffee, and preferably organic, at body temperature…

Why Coffee Enema?

When it comes to coffee enemas, one observes two distinct factions: passionate proponents and equally passionate opponents. Some people swear by coffee enemas and apply them regularly for felt benefit, others herald them as meaningless or even dangerous quackery. Naturally, I wondered what it’s all about, and as so often stumbled upon a somewhat deep rabbit hole. Who would have thought that coffee taken up the rear could cause such hiccups? This article summarizes my findings of looking into the matter, inevitably involving much more than coffee enemas, as you’ll see. Of course, as always, the interested and open minded reader is invited and encouraged to draw their own conclusions upon viewing the thoughts and evidence provided here and elsewhere. And with that, let’s take a look…

What’s the (Hi)story?

Enemas are an age old therapeutic method, appearing in historical records as far back as the Dead Sea Scrolls 2000 years ago, the Essene Gospel of Peace of the 3rd century (Gerson & Walker 2006), or the Papyrus Chester Beatty Vl dating from 1305 to 1085 B.C.E. (Brandt 2008) and Mayan pottery (de Smet & Hellmuth 1986). Through the course of history, many substances, some rather dubious, served as rectal infusions to treat a variety of ailments such as lethargy, epilepsy, pneumonia, or diarrhea: water, beer, honey emollients, milk solutions, melted fat, ox brain, herbs, deer marrow, turpentine, alcohol, sulfuric acid, yogurt, opium, barium, potato-starch solution, bismuth, and others (Drummond 1914, MEH 1917, Brandt 2008).

Coffee enemas, on the other hand, are a more recent invention, discovered by accident. You may have wondered who thought up the crazy idea to deliver your favorite brew up the rear, where taste buds are absent and one couldn’t possibly derive the joy normally associated with the drink. Well…thank WW1 nurses for it. While coffee was a rare item during war times, surgeons tending to wounded soldiers always had a fresh brew at the ready to sustain them a while longer while working extremely long shifts. Sometimes, it so happened that a little coffee was left. Seeing its positive effect on surgeons, and wanting to relieve freshly operated soldiers’ pain with next to no drugs available, a nurse had the idea to add the leftover coffee to the enema solution, normally plain water. This resulted in marked pain relief in the patients. Following the war, German MDs took interest in this phenomenon and researched it further, experimentally studying the wartime clinical observations on laboratory rats. They found that rectal administration of caffeine would dilate bile ducts and promote bile flow in their test animals (in Gerson & Walker 2006).

In the 1920s, another German MD, Max Gerson, took note of above findings and later incorporated coffee enemas as an integral part of his diet based cancer therapy, mainly to support the liver’s detoxifying functions and for pain relief: “The patients reported that this was doing them good [coffee enemas]. The pain disappeared even though in order to carry through the detoxification, we had to take away all sedation. After just a few days there was very little pain, almost none. I saw that the liver plays the important role. It eliminates the toxins from the body, prepares them so they can enter into the bile ducts, and can thus be eliminated with the bile. I did not have the right as a physician to cause the body to absorb all the cancer masses [from tumor breakdown] and then not to detoxify enough. With two or three enemas they were not detoxified enough. They went into a coma hepaticum [liver coma]. Autopsies showed that the liver was poisoned. I learned from these disasters that you can’t give these patients too much detoxification” (Max Gerson lecture from 1956, published in 1978, see references).

To this day, some 80 years later, thousands of cancer patients still use the Gerson regimen in their healing journey (Weitzman 1998) and other current so-called alternative approaches to healing cancer also feature diet modifications and coffee enemas (e.g. Dr Gonzalez). Not to mention the countless websites and health professionals advocating for them as a way to support and detoxify the body for regaining and maintaining health.

Perceived benefits from coffee enemas include relief from depression, “brain fog”, confusion, general nervous tension, many allergy related symptoms, arthritic pain, liver spots on hands and face, severe pain as well as improved skin and feeling energized, among others (Hildenbrand 1986, Lechner & Hildenbrand 1994, Gonzalez & Isaacs 1999, Schuette 2015).

Coffee Enema ~ Proposed Mechanism of Action

The main purpose of a coffee enema is not irrigating the colon to alleviate constipation, as one could think. Rather, it is to support the liver in eliminating toxins and to cleanse the blood. Our most important organ to detoxify and regenerate our metabolism, the liver serves some 500 functions, including drug processing and clearing of toxic metabolites.

All of the body’s blood (c. 6l) passes through the liver c. every three minutes. While the coffee solution resides in the gut (12-15 mins), the hemorrhoidal blood vessels dilate from caffeine exposure, as do the liver’s blood vessels. Its bile ducts expand and bile flow increases. As blood streams through the caffeinated liver, the serum clears out toxins. The water retained in the bowel stimulates the visceral nervous system, promoting peristalsis. It eventually also dilutes the bile, thus causing an even greater increase in bile flow (Dr. Harold Manner, in Gerson & Walker 2006).

The blood cleaning (dialysis) function mentioned above has important implications – and applications – in healing or curbing degenerative diseases. If the medium that services all cells and tissues is contaminated, it invariably impairs the quality of service. Healthy blood, on the other hand, bears more oxygen and more effectively carries away cellular waste. The entire organism benefits from cleaning the bloodstream. A coffee enema lowers the blood serum’s toxic load, contributing to improved physiological function. It also lowers a cell’s challenge resulting from low oxygen levels, malnutrition, and toxins (Gerson & Walker 2006).

Rectal coffee turns out a very effective choleretic (bile flow stimulant). Its advantageous effect on bile: instead of being reabsorbed from the small intestine up to ten times before leaving through the feces, it passes through the gut and exits through the colon straight away, expelling all carried toxins in the process, thereby easing the body’s toxic burden quicker (Gerson & Walker 2006). This proves especially beneficial in the presence of endogenous* serum toxins, which may arise from bacteria, damaged cells, and cancer cells. *[endogenous: self-generated, originating from the body’s own metabolism vs exogenous: originating from external sources; this includes xenobiotics, see below]

In essence, a coffee enema is thought to 1) support the liver’s detoxification function by removing toxins from the bloodstream and binding them to bile, and 2) increase bile flow from the liver, thus flushing out bound toxins along the intestines into the rectum.

What’s the Evidence?

Evidence of coffee enema use and its favorable effects comes from various sources:

• medical history
• animal studies
• human studies
• clinical experience of doctors applying them with their patients & patient feedback
• liver autopsies
• anecdotal evidence – healing stories from countless people testifying to the usefulness of coffee enemas in their healing process/ maintenance of wellbeing
• therapists walking their talk and regularly using coffee enemas themselves, in healing and prevention

Evidence against coffee enemas comes from medical case reports and opinion pieces in the scientific literature. While no direct evidence, many point out the scarcity of clinical trials to show efficacy – the standard clinicians look to when evaluating the appropriateness of a method.

Evidence of Coffee Enema Use from Medical History

Despite the nice story of WW1 nurses (re-?) discovering coffee enemas, older records of their use exist. Coffee enemas appear in the literature as early as 1862, and perhaps prior to that. Searching the archives of Nature – arguably the worlds’ most prestigious science journal, with digital availability of all papers since its inception in 1869 – returned such curious titles as “The Resuscitation of the Drowned” from 1882 (apparently involving “hot coffee or brandy given by enema”) or “Case of Resuscitation and Recovery after Apparent Death by Hanging” from 1885, also involving coffee, possibly in enema form. The details of their intended purpose remain unclear, however, and it also does not take away from the WW1 nurses easing their patient’s pain and spurring research into coffee enemas in Germany. Curiously, Franz Torek, like Max Gerson a New York based MD of German origin, and his contemporary, who performed the first ever successful thoracic esophagectomy for cancer in 1913, incorporated a variation of coffee enema in his treatment: “At the end of the operation, a hot coffee enema with whiskey and strychnine was applied” (Dubecz & Schwartz 2008). Likewise, other American surgeons in the early 20th century used coffee enemas in treating acute adrenal insufficiency, shock from postoperative bleeding, and peptic ulcers (Beeson 1980, Ward 1988).

Today, mainstream medical use of coffee enema seems reduced to featuring only in bowel preparation for video capsule endoscopy (Kim et al. 2014). In this context, “coffee enema was safe and feasible” (Chun et al. 2010).

Evidence from Research & Clinical Observations

Detoxification and GST (not a tax…)

As far back as the 1920s, animal experiments have shown that coffee enemas result in dilated bile ducts and increased bile flow, physiological effects also observed in humans as a result of rectal fluid instillations (Garbat & Jacobs 1929). Max Gerson interpreted these findings to reflect an increase in liver detoxification. Was he correct?

Enzyme systems in the liver and small bowel convert and neutralize the most common tissue toxins (poly-amines, ammonia, toxic bound nitrogen, free radicals), all of which potentially cause cellular damage (Hildenbrand 1986). One of these systems involves a group of enzymes called glutathione S-transferases (GSTs). GSTs facilitate the binding of a vast variety of free radicals (highly reactive molecules that can damage cells) in the blood stream to the glutathione (GSH) protein. In particular, GSTs have been extensively studied for their ability to remove endogenously produced free radicals, their capacity to bind toxic reaction products of lipid peroxidation (a process that causes cell membrane damage), and their catalytic role in binding and eliminating compounds foreign to the body (xenobiotics*), including anti-cancer drugs (Board & Menon 2013). In other words: GSTs metabolize toxic to non-toxic molecules, thus protecting the liver by averting potentially severe damage to cells (their membranes, DNA, organelles). A very important function! Many toxic degradation products provide substrates for GSTs, including those of environmental pollutants and drugs (Ketterer 2001). GSTs scavenge free radicals which then leave the liver and gallbladder as bile salts flowing through the small and large intestines to the rectum. Other functional properties of GSTs include binding bilirubin (break down product of red blood cells) so liver cells can clear it, blocking and detoxifying carcinogens (Schilter et al. 1996), and clearing tumor breakdown products (Gerson 1978). * [xenobiotic: foreign to the body, e.g. antibiotics, pollutants, pesticides]

Rat, mouse and human GSTs show considerable similarity. One reason why some view rodents as human analogues when it comes to GSTs (meaning results obtained from studying mice and rats readily transfer and apply to humans) (Coles & Ketterer 1990), and others point out that things may not be as straight forward as that (Schilter et al. 1996, Board & Menon 2013). Either way, in all three species, liver cells provide the richest source of GSTs (Ketterer et al. 1990). GST inducers are generally considered beneficial against cancer (Schilter et al. 1996, Lee et al. 2007).

Enter: Coffee Constituents and Their Effects

Coffee contains a cocktail of plant chemicals, among them antioxidants, polyphenols, terpenes, and – of course – caffeine. Two compounds especially, cafestol palmitate and kahweol palmitate, isolated from green coffee beans, exhibit anti-carcinogenic properties in rats and hamsters (Schilter et al. 1996, Cavin et al. 2002, Huber et al. 2008), and in human cancer cell lines (Choi et al. 2011). Kahweol and cafestol strongly induce GST. In mice, for example, coffee beans enhance the GST system by 600% in the liver and 700% in the bowel (Teekachunhatean et al. 2012), an effect also observed from other compounds, to a lesser degree (78-182%) (Lam et al. 1982). Lee et al. (2007), examining liver toxicity in mice wrote: “The hepatic [liver] GSH levels and GST activities were increased by a treatment with kahweol or cafestol alone. […]. In line with these observations […] the chemoprotective effects of kahweol and cafestol have been known to relate to the enhanced detoxification, e.g. via […] GST.” All these results were obtained from feeding mice, not through enema. Still, they speak for a positive effect of coffee against carcinogens by protecting the liver through increased antioxidant enzyme activity.

Interestingly, regular (daily) dietary supply of cafestol and kahweol increased the GST system in mice c. 4 and 5 times above the norm, compared to a one time supply that did not evoke as much change (Lam et al. 1982).

Lechner & Hildenbrand (1994) isolated c. 1g of cafetsol diacetate from 1l of coffee enema solution prepared after Dr Gerson. Cafestol applied rectally to Wistar rats significantly increased their bile output by 28%. “Because the Wistar rat’s GST system is a direct human analogue, these results apply to humans and cafestol may be understood to be (along with kahweol) a putative human choleretic” (Hildenbrand 2001).

Thus, coffee, as feed, drink, and enema, enhances bile flow and the GST system in animal models (e.g. Lam et al. 1982, Hildenbrand 1986, Cole & Ketterer 1990, Lechner & Hildenbrand 1994, Lee et al. 2007).

Clinical Observations in Humans

In 1862, at the Royal Free Hospital in London, a seven year old boy presented with mushroom poisoning, rendering him severely ill, in a state of collapse. His doctor

“directed three ounces of very strong warm coffee to be used as an enema every fifteen minutes. After the administration of the second enema the vomiting was less, the pulse more perceptible, and the patient gradually improved. In the course of the night the sickness had altogether ceased […]. The boy […] left the hospital completely recovered.” (Royal Free Hospital, 1862/ The Lancet 2013).

This was the oldest medical document on coffee enemas that I could find – well before WW1.

Some hundred years later, in 1984, Dr. Peter Lechner, of the Landeskrankenhaus of Graz, Austria, reported:

Coffee enemas have a definite effect on the colon which can be observed with an endoscope. Wattenberg and coworkers were able to prove in 1981 that the palmitic acid found in coffee promotes the activity of glutathione S-transferase and other ligands by many fold times above the norm. It is this enzyme group which is responsible primarily for the conjugation of free electrophile radicals which the gall bladder will then release (in Hildenbrand 1986).

Lechner also reported that two coffee enemas daily reduced the need for pain medication by 71.3%, 59% and 22% in cancer patients with WHO cancer pain levels 1, 2, and 3, respectively (Lechner & Hildenbrand 1994), results echoed by Gonzalez & Isaacs (1999) who commonly observed symptomatic relief in their patients from coffee enemas – as did Max Gerson and the WW1 nurses so many decades earlier.

Journal editors at Physiological Chemistry and Physics acknowlegded Max Gerson 20 years after his death with publishing “The cure of advanced cancer by diet therapy: a summary of 30 years of clinical experimentation” (Gerson 1978) and stating in the abstract: “Caffeine enemas cause dilation of bile ducts, which facilitates excretion of toxic cancer breakdown products by the liver and dialysis of toxic products from blood across the colonic wall.”

In 1990, visiting British oncologists to the Gerson clinic in Mexico observed its patient’s marked reduced pain levels from regular coffee enemas: “Particularly intriguing were the low pain scores and analgesic requirements for all the patients, despite the presence of extensive metastatic disease in many and the fact that several had been on opioid medication previously” (Reed et al. 1990).

Although Gerson used caffeine enemas primarily to facilitate excretion of toxic wastes, especially from necrosing tumors, we now realize that these enemas also promoted the absorption of vitamin A, a process requiring the action of bile acids. Thus the enemas that brought ridicule from Gerson’s enemies actually enabled his patients to use the enormous amounts of vitamin A which his diet provided” (Ward 1988).

In another Austrian study, “a modified Gerson therapy was offered to adult cancer patients in a surgical clinic. The controls (NGPs), were matched patients who refused the therapy. As the authors acknowledged, this was a basically flawed control group. However, the Gerson patients (GPs) showed markedly better tolerance of radiotherapy, and especially chemotherapy, since nausea, vomiting, loss of appetite and loss of hair occurred 3 times as frequently in the NGPs. In some groups the length of survival appeared better in the GPs, particularly those with liver metastases, and pain control appeared to be better, possibly due to the caffeine enemas. According to Lerner, the authors found significant advantage for the GPs: some lived longer, others were healthier, had better responses to conventional therapies and fewer side effects, less pain and a better quality of life” (Weitzman 1998).

Human Enema Studies

Two recent studies looked into coffee enemas in humans: one examined the fate of a single caffeine dose delivered via coffee enema compared to coffee drinking and also evaluated the safety profile of a single caffeine administration via these routes by measuring blood pressure and heart rate (Teekachunhatean et al. 2013, discussed further on). The other looked at blood serum antioxidant effects resulting from oral versus rectal coffee intake in single and multiple installments (Teekachunhatean et al. 2012). Both examined these dynamics in a small group of 11 healthy Thai male volunteers.

The antioxidant study found single or multiple coffee enemas neither beneficial nor harmful in terms of their modulating markers of blood serum antioxidant status (GSH and others), electrolyte balance, and cardiovascular parameters. A single dose of coffee via either route showed no differences in GSH levels. Multiple coffee doses over a 12 day period did not markedly alter GSH levels, even though a not statistically significant trend towards raised GSH (c. 16 – 25%) was observed on days 6 and 12 for both oral and rectal uptake routes. Blood electrolytes and cardiovascular parameters before and after multiple coffee enemas were not clinically significant.

So in this study, the coffee delivery route made no difference in terms of exerting (little) influence on blood serum GSH levels. Quite a surprising result. The researchers concluded: “Although beneficial effects from coffee enemas have not been clearly demonstrated, the procedure in the routine practice is unlikely to produce any adverse effects on the cardiovascular system or an electrolyte balance. The coffee enema could therefore be employed according to personal preference, unless specific contraindications […] dictate otherwise” (Teekachunhatean et al. 2012). (See discussion section for thoughts on these results.)

Anecdotal Evidence from People the World Over

Every coffee enema user has a story to tell, it seems. Of the c. 679.000 google hits for “coffee enema”, most experience reports I viewed spoke positively and some mentioned unwanted effects (see “Contraindications” paragraph below). Since this information is easily accessed, I decided for the sake of brevity (…) to not include it here, and to solely focus on the technical literature instead.

Why Not Drink Coffee to the Same Effect?

While simply drinking coffee also offers liver protective effects (Muriel & Arauz 2010) and stimulates gallbladder contraction (Douglas et al. 1990), the therapeutic dose of one quart (950ml), especially when used regularly or even multiple times a day, would probably negatively affect the upper digestive tract (Lechner 1990 in Lechner & Hildenbrand 1994). Teekachunhatean et al. (2013) also showed that caffeine absorption from enema is c. 3.5 times less than that from orally taken coffee.

I’m not sure whether drinking coffee increases the GST system and stimulates bile flow as much as an enema does. The two effects working together make the process. Some say that drinking coffee suppresses the liver, while enemas enhance it by stimulating different parts of the nervous system, resulting in different physiological outcomes (Gonzalez interview 2012).

A rectal infusion increases bile flow from the liver and increases the activity of one of the most important detoxifying mechanisms we have. GST scavenges free radicals and renders toxins non-toxic. All of these compounds end up in the bile, which then flows along the digestive tract into the rectum, with less recycling of bile than usual, thanks to the enema liquid stimulating bile flow. Enemas trigger bile release from the liver within 3 -12 minutes and for up to an hour later (Garbat & Jacobs 1929).

Are Coffee Enemas Dangerous?

When running searches for papers on online science search engines, one notices a number of them reporting adverse effects from coffee enemas. While case reports definitely have value, they do not lend themselves to generalization. Compared to people taking regular enemas, some multiple times a day for years, without encountering true complications (Gerson & Walker 2006, Dr Isaacs website & other websites), reports of singular mishaps weigh in less. Of course, the enema needs to be done correctly (see below), especially in a therapeutic setting with regular, multiple applications. And if one uses hot water (Sashiyama et al. 2008), well…what do you expect…? As Brandt stated so aptly in his commentary in response to Sashiyama et al. (2008) above: “In the first century C.E., Celsus warned not to use enemas that were too hot or too cold – advice this patient should have heeded.”

Perforating the colon wall is certainly a serious accident and has been reported as a spontaneous knock-on effect of a hot water coffee enema (Kim et al. 2012). However, this may be a singular event. In other words, it’s rare. Care must also be taken when inserting the enema nozzle. Yet, I find it hard to fathom how one could hurt oneself this way, as I imagine it would take quite some force to poke a blunt plastic object through the colon wall. But yes, definitely take care when inserting the nozzle – getting instructions from a qualified healthcare professional when first starting with this is always a good idea.

Keum et al. (2009) report a case of proctolitis [inflammation of the rectum & colon] resulting from coffee enema. While their assessment may well be correct, I cannot help questioning it – perhaps the enema triggered a reaction, rather than causing the discomfort in the patient? This patient presented with scar tissues from ulcers and suffered from chronic constipation, the reason she used the enema. To me, that seems a more likely causative of her troubles, rather than the enema itself? Who knows.

Death by enema? Two authors thought coffee enemas possibly responsible for the death of two patients, one with metastatic cancer and one with chronic abdominal pain for 20 years. Reading their account it became apparent that in one case enemas were administered as frequently as 3-4 times per hour, adding up to 10 – 12 enemas for one night and then hourly for about 2 days, with a volume of just under a liter (950ml) every time. One can imagine this could indeed cause some unintended effects such as an electrolyte imbalance (despite coffee containing quite a few minerals), as reported and presumed by the authors as cause of death. Interestingly, despite the large coffee doses, not enough caffeine was absorbed to cause substantial toxicity. The cancer patient used enemas less frequently, four times a day, for about 8 weeks. Death was attributed not to metastatic cancer, but to a fluid and electrolyte imbalance possibly caused by frequent enemas, and maybe that is correct. However, in the experience of most accounts I read, people rarely reported this as problematic, and dietary protocols often supply minerals to balance electrolytes. Above authors concluded: “With the current wave of popularity of naturopathic medicine, one would expect an increase in this therapy [meaning coffee enemas] and consequent morbidity and mortality“ (Eisele & Reay 1980). Going from the literature, however, this prediction did not eventuate, and thousands of happy coffee enema users world wide say otherwise.

Bacterial infection was also mentioned as a possible hazard (Margolin & Green 1984), and I would probably see this as the most relevant argument. Yet again, when done properly, with clean equipment, this should be a none-issue, neither in the clinic nor at home.

All up, in my perception and experience (and that of many others), a correctly administered coffee enema usually poses no danger in healthy people.

Let’s see what research says in terms of caffeine intake: Teekachunhatean et al. (2013) compared the fate and effect of coffee taken rectally and orally in healthy male subjects. Regarding coffee enemas, they concluded:

These findings confirm that a single administration of coffee enema [4 g of coffee boiled in 100 ml of water; then filtered and made up to 500 ml volume] should not produce deleterious effects on the hemodynamics [blood pressure & heart rate] in healthy subjects. Nevertheless, since most of the caffeine in systemic circulation is normally eliminated within […] approximately 24h, it could be postulated that even multiple doses of coffee enemas (e.g. once a day or once every other day) would not result in the accumulation of caffeine in the body and hence should not adversely affect hemodynamic parameters. This postulation is in accordance with the results from our previous study demonstrating that multiple doses of a coffee enema (3 times weekly for 6 visits) do not adversely affect either the hemodynamic parameters or the electrolyte balance in healthy male subjects.

Contraindications

Bar above case reports, apparently none for healthy people, except for pregnant and nursing women, who should not use coffee enemas. Also, some people online reported unpleasant effects, including increased heart rate, wobbly legs, breathing difficulty, stomach cramps, nausea, hives, dizziness, fatigue, watery eyes, swollen lips, faintness, palpitations, and others. While I do not know their specific context (e.g. healthy or ill), and while I never experienced any difficulty or complications myself, it shows that unwanted reactions may occur. Therefore, it is strongly recommended to discuss the appropriateness and frequency of coffee enemas with your healthcare professional first, especially if you would like to include this with an already ongoing healing regimen. Possible synergies with any medication should also be considered.

A number of people reported finding relief from unwanted effects through doing another coffee enema (or even two), which may seem counter-intuitive, but worked for them.

The technical literature discouraged coffee enema use for the following: hemorrhoids, gut obstruction, diverticulitis, ulcerative colitis, Crohn’s disease, IBS, colostomy, recent bowel surgery, and colorectal cancer. However, proponents would argue for the benefit of enemas for at least some of these conditions, so carefully evaluating your particular situation is highly recommended.

Frequency of Coffee Enemas ~ How Often Should I Take One?

Some practitioners and proponents of coffee enemas routinely use them daily as a preventive measure (e.g. Gonzalez 2011 and many websites). There’s no hard and fast rule. Simply apply them as needed. Your body gives you feedback to figure out your personal enema interval – just notice how you feel afterwards. I usually do them on weekends and don’t feel a need for daily infusions. That said, if I felt unwell and thought that enemas might help, I would increase their frequency and see what difference it makes. The literature points in favor of regular enemas, as effects seem dose-dependent, with thresholds reached after a few days, rather than through a single application (more on this below).

Going from the literature, very ill people can take an enema as frequently as every four hours in support of their liver. When already undergoing other therapies, discuss with your competent healthcare provider first.

Discussion

Sifting Through the Literature

Enemas are conspicuously absent from the extensive current coffee literature, even from reviews that one would expect to include them, such as those pertaining to caffeine and pain reduction (Tavares & Sakata 2012), coffee and health (Higdon & Frei 2006), or coffee and liver function (Muriel & Arauz 2010).

While the evidence section reports about all I could find within a five week online search period and without access to an extended physical archive of medical literature, it does show that coffee enemas were not unknown to orthodox medicine. Indeed, “coffee enemas have been discussed in the orthodox medical literature for the better part of this [20th] century. Many nursing texts [up until the 1960s and 1970s] routinely recommended coffee enemas, and the Merck Manual* advocated coffee enemas as a stimulant in all editions from the first in 1898 through 1977. During the 1920s and 1930s, coffee enemas were prescribed for a variety of conditions” (Gonzalez & Isaacs 1999, Gonzalez 2012). Curiously, modern science data bases return comparatively little when running searches for “coffee enema” – Web of Science, a database indexing papers dating back to 1864, returned a mere 58 hits and Science Direct came up with 1496 results, most of which, however, did not relate to coffee enemas – these did not feature past the first 25 results. PubMed returned 26 hits. *[The Merck Manual of Diagnosis and Therapy, the world’s best-selling medical textbook, according to Wikipedia.]

Adding to this, not all peer reviewed articles are readily available, including older publications and select abstracts. This introduces some bias as to what papers form the basis for assessing the merit of coffee enemas. Many an article I would have liked to read and could not access.

Contrary to above meagre results from the peer reviewed literature on science search engines, a Google search for “coffee enema” yielded c. 679.000 hits. Interesting discrepancy. Taking into account the many (useless) articles without references and the undiscerning copying and pasting that’s rampant online, it still leaves a huge gap between the world of academia with its peer reviewed rigor and that of Google which includes anything and everything from anywhere, leaving it to the reader to discern quality from nonesense. Do we really know as little as science search engines return? Do we really know as much as Google shows? Neither seems correct. Or, partially correct. Are the hundreds of thousands of websites and the people behind them all wrong and misled when recommending coffee enemas? Or is the establishment ignorant of a simple method that works?

Mainstream Medicine vs Other Approaches to Cancer and Healthcare

One reason why the medical literature offers comparatively little about the efficacy of coffee enemas is the limited availability of appropriate and assessable patient data, scarce follow up data, and too little research funding allocated to these types of regimens (Reed et al. 1990, Molassiotis & Peat 2007, in reference to the Gerson Therapy). Not to mention a negative, often arrogant attitude within the medical community, where many readily discredit alternate approaches without giving them a second thought (and without much knowledge of the value they may indeed offer) (Burke & Sikora 1993, Mackereth & Stringer 2005). While this may be warranted in some instances, the Gerson approach was developed by an MD who first resolved his own health issues (migraines) with it and then let patients participate in his carefully developed protocol (Hildenbrand et al. 1996), initially applied to migraines, then tuberculosis, and later to cancer (Gerson & Walker 2006). Gerson was a highly regarded (Watson 1930), very observant and well published scholar who collaborated with some of the medical greats of his time (Ward 1988) – surely not someone easily associated with the label “quack”. Also, Gerson’s sincerity was acknowledged by his opponents (McCarty 1981). And why would it be so surprising when a detoxifying, whole foods based therapy actually translates into a whole biology? Isn’t this just common sense? Is it not bio-logic?

While this article is not necessarily intended as a piece about Dr Gerson’s approach, anyone researching coffee enemas won’t escape his name and the ongoing discussion between orthodox and “alternative” cancer treatments. As the “Godfather of coffee enemas”, it was Dr Max Gerson who first recognized, from his clinical experience with very ill patients, the relevance and value of coffee enemas in healing. Thus they formed such a crucial element of his protocol. Given the many success stories known from the Gerson Therapy and others like it, wouldn’t it behove researchers to at least look into this? One would think so. Despite their combined success of helping 1000s of people experience improvement, including complete regression and healing of major illness (Hildenbrand et al. 1995, Molassiotis & Peat 2007, Gonzalez 2014), mainstream medicine views dietary approaches to cancer and other degenerative illness still as dubious, clinically non-proven, and not only not recommendable but also as outright dangerous (Moss 2005, Huebner, Loeser & Stoll 2013). And just to put things into perspective, a medical historian says: “It is one of the least edifying facts of recent American medical history that the profession’s leadership so long rejected as quackish the idea that nutrition affects health” (Ward 1988). I think many MDs would agree today that what we eat affects our biology.

Enema Study Results

Going from animal experiments, one would have expected a positive effect of coffee on GSH levels, as indeed has been shown for Italian coffee drinkers who exhibited a 16% GSH increase after prolonged oral coffee consumption (5 cups of moka or espresso daily for 1 week) (Esposito et al. 2003), and for Austrian coffee drinkers consuming 1l of ground coffee daily for 5 days, thereby increasing their GSTP* levels three-fold (Steinkellner et al. 2005). Consuming cruciferous vegetables also increases GST levels in humans (Lampe et al. 2000). While showing an elevated trend twice within 12 days, the enema versus oral consumption study did not reach statistical significance in this respect (Teekachunhatean et al. 2012). *[GSTP is a specific variety of GST; general GST levels were also induced, although to a much lesser degree]

A few thoughts come to mind when looking at these results:

All up, the investigations by Teekachunhatean et al. (2012 & 2013) are the only two recent studies I could find to address and look into the effect of coffee enemas (apart from some Korean papers with unfortunately too little information in their English abstracts to include here). As far as I’m aware, for the first time, someone contrasted coffee enemas with oral coffee intake. A repeat with a larger group (including more ethnicities), enema variations, and stronger coffee concentrations (excluding instant coffee) reflecting therapeutic doses would be desirable. Estimating bile flow as a consequence of oral versus rectal coffee intake would also be interesting.

Scarcity of Clinical Trials ~ The Enema Enigma

Despite the decades long strong opposition and ridicule from mainstream medicine, I am not aware of a single paper – bar case reports – showing a detrimental effect of coffee enemas. While there still is no definite clinical trial showing efficacy, the Gerson method (with its multiple coffee enemas a day) has never been disproved, either (Molassiotis & Peat 2007). As far back as 1945, physicians “urged a widespread trial” of the Gerson regimen in a Senate hearing on cancer research, for example (McCarty 1981). To my knowledge, it has not eventuated yet, and “the call for more rigorous research [of alternative cancer therapies] is loud and clear” still (Ernst 1995, Molassiotis & Peat 2007).

Part of not having a robust clinical trial to date may be their prohibitive cost of millions of dollars (Moss 2005, Ji 2015). As far back as 1990 (in Lechner & Hildenbrand 1994), Dr Lechner wrote in regards to results from animal experiments with rectally infused cafestol:

However, the continuation of these investigations is beyond our scope and should be reserved for the pharmaceutical industry, together with a possible clinical test. As long as the substances under discussion, which in our view could make a highly effective drug for protecting the liver, are not produced industrially and no relevant studies are planned, we have to continue administering them in the awkward form of enemas. All the more so because patients cannot be expected to consume the therapeutically necessary daily amount of at least one litre of coffee by drinking it, without risking side effects in the upper alimentary tract.

As far as I’m aware, this call reverberates through the mists of time, unheard. And it may be one of the few shared sentiments between the worlds of orthodox and “alternative” medicine: a desire for more clarity as to the efficacy of methods other than mainstream medicine.

One clinical trial that held much promise (Chabot et al. 2010) unfortunately turned out a total disaster (Isaacs 2016 & 2015, Gonzalez 2011), with much time and money ($1.4 mio) wasted. For the first time, this trial directly compared conventional treatment to an “alternative” treatment of pancreatic cancer (which includes daily coffee enemas) (Burton 2012). Carried out properly, it possibly could have been a mile stone in the peer reviewed literature. As it stands, it concludes that the conventional treatment works better than the alternative. Only funny that the real “alternative” treatment creates long term survivors of pancreatic cancer (Gonzalez & Isaacs 1999 & 2007), whereas the conventional treatment does not (Chabot et al. 2010). I’ll detail this interesting case in a following article.

Regardless of a positive or negative outcome, the information from a properly run clinical trial would offer great value to patients, furthering their decision making, their safety, their options. These data would simply provide much required clarity and potentially increase people’s choices and survival chances.

Coffee Enema as Agent of Health ~ No Panacea, but a Viable Solution

There now is a molecular basis to believe that coffee benefits the liver, as a growing body of evidence supports its favorable effects on liver function and disease. Coffee components such as caffeine, kahweol, cafestol, and antioxidants exert positive, chemopreventive and detoxifying effects (Cavin et al. 2002, Lee et al. 2007, Muriel & Arauz 2010).

Dr Gonzalez (2011) believed that one can clear tissue toxins accumulated over many years by applying a coffee enema each day for about two years. If that’s correct, it’s terrific. The environmental burden of toxins certainly seems on the rise, rather than in decline. Lam et al. (1982) reported that regular intake of cafestol and kahweol produced a greater GST increase than a single administration, a reversible dose-dependent relationship also observed by others (Cavin et al. 2002) – could this underlie the benefit of regularly applied coffee enemas, as prescribed by Dr Gerson, Dr Gonzalez, and others? The relief from mushroom poisoning described earlier resulted from coffee enemas given every 15 minutes, with easing of symptoms noticed after the second infusion and subsequent patient recovery over night. The quick symptom relief here is interesting – the coffee enema definitely did something. Another very similar experience involved a 22 months old child with severe poisoning and loss of vital signs. It recovered within an hour of receiving a single enema of strong coffee, a last resort approach after other remedies had failed (Cachot 1866). Certainly, in these instances, coffee enemas made all the difference, as they did to the WW1 soldiers and Gerson’s cancer patients.

Whether the underlying mechanism is correctly explained or not, people derive a felt benefit from using coffee enemas, from mood improvements to feeling rejuvenated and energized, from simply feeling well to headaches gone, staying focused, pain eased, skin cleared, candida cleared, liver and gall stones expelled and gallbladder restored, insomnia, nausea & balance problems eased, anxiety lessened, or gut parasites expelled (examples gathered from around the world wide web). The clinical experience of those applying coffee enemas with their patients definitely points in favor of their usefulness (Gerson, Gonzales/ Kelley, Group 2010), as do the countless positive anecdotal stories online. Maybe it just comes down to trying this for oneself and noticing the possible difference that it makes?

As a side thought, when a method exists for decades without huge advertising and publicity (as many of the so-called Tijuana Clinics do (Moss 2005)) – wouldn’t you think there’s something to it? In my mind, things that spread by word of mouth (because they work) enjoy more credibility than something that’s heavily advertised. Does success not naturally speak for itself, without the need to push it on TV and billboards? Aren’t healing stories of people given up by the convention who then heal completely and happily live on for decades (vs counting 5 years of being cancer free as cured) worth looking into? Especially when they aren’t one-offs but seem to occur regularly (e.g. methods after Gerson, Gonzalez/ Kelley, Bursynksi), including advanced stages of illness? If someone survives pancreatic cancer for 34 years (Gonzalez & Isaacs 2007), I’m definitely interested to hear how they succeeded, clinical trial or not.

How to Take a Coffee Enema after Dr Max Gerson

The right preparation matters, as brews differ in their coffee constituents. Interestingly, research now shows that preparing coffee after Gerson’s method (boiled coffee) has the second highest yield of cafestol and kahweol, compared to Turkish coffee (highest yield), instant & drip coffee (lowest yield), and espresso varieties (intermediate amounts) (Gross et al. 1997). Below is what the Gerson Therapy recommends (Gerson & Walker 2006):

The Brew:

• Add 3 rounded tablespoons of organic drip-grind coffee (not instant) to
• 1 quart (950 ml) of distilled or filtered (fluoride free) water.
• Boil for 3 mins uncovered; then cover and simmer for another 15 mins. Strain and allow to cool. Add distilled water back to make a full quart. Use at body temperature.

The Application:

• Pick a spot to lie down on a towel (clean bathroom floor or bath tub work).
• Hang enema bag or bucket filled with coffee c. 50 cm above your buttocks; let out the air through the nozzle.
• Lie down on your right side with knees pulled toward your belly.
• Slowly and carefully insert nozzle into anus and reassume fetal position.
• Allow all coffee to infuse, then hold for 12 – 15 minutes.
• Retract nozzle, get up, use the toilet, clean equipment – all done. =)

Variation: Dr Gonzales (2011) recommends to split the quart into two pints and to run two enemas back to back, holding each for 10 mins.

The enema feels more comfortable after a bowel movement. You can also retract the nozzle after infusion is complete, instead of waiting until the 12-15 mins are up.

Conclusion

After reading extensively for the past five weeks, I found nothing substantial that would speak against using coffee enemas. On the contrary, from the literature and combined practitioner and coffee enema user experience, it seems clear that:

1. Enemas increase bile flow from the liver in humans.
2. Coffee constituents induce the GST detoxification system many fold above the norm in rodents, with similar effect in humans (more enema data would be desirable).
3. Coffee exhibits chemopreventive, anti-carcinogenic effects, especially in liver & colon.
4. People experience symptom relief and feel better after coffee enemas.
5. Correctly taken coffee enemas are usually safe and tolerated well, even in regular, multiple applications.

Regrettably, too few clinical trials exist to date showing definite efficacy (or non-efficacy) of coffee enemas, either as stand alone or part of a wider regimen, and one wonders why. Yet, does this render all other existing experimental evidence, clinical and patient experience, and working dietary approaches tweaked and fine-tuned over decades meaningless, and thousands of happy coffee enema users delusional? I think not. All these data certainly provide ample grounds for a long overdue, thorough and sincere investigation, along the lines of Teekachunhatean et al. (2012 & 2013) and Gonzalez & Isaacs (1999).

Meanwhile, people continue to use coffee enemas for reported benefits such as pain and symptom relief, feeling energized, and systemic detoxification. Patients experiencing degenerative illness neither have the time nor patience to wait around for the funding and results of clinical trials. Since it has been shown that coffee enemas are likely harmless when administered correctly, even repeatedly, and potentially make a big difference, why not give them the benefit of the doubt and try them? In the end, a felt improvement in oneself may be all the evidence required. Anyone who has ever experienced pain relief from coffee enemas certainly speaks in their favor.

Of course, one needn’t wait until illness strikes. An occasional or regular coffee enema, depending on your situation and preference, may be a great way to maintain your health and aid the body in retaining optimal function. Given the amount of pesticides, plastics, industry waste and other such environmental burdens that eventually end up in the food chain and in us, supporting the body in its effort to maintain its functionality seems a sensible idea. If you deal with a degenerative disease, adding regular coffee enemas into the mix may be an excellent strategy, especially with any pain present.

So to enema or not to enema? It’s up to you. And with that, I leave you. Thanks for reading. My weekly enema brew happens to be ready just….about….now. =)

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About the author:

Katrin Geist loves exploring the mysteries of life. Initially doing so as a biologist, she now devotes her time to helping people regain and maintain their wellbeing through Reconnective Healing and wellbeing coaching. Biophysics taught her the importance and far reaching implications of a truly holistic approach to wellbeing, and to life at large. More and more, she begins to understand how energy, frequency, and information shape our lives – knowingly or not.

Katrin holds a BA from the University of Montana, U.S.A. and an MSc in biology from Berlin University (FU). This science background enables her to communicate scientific subjects in an accessible way, so that everyone can benefit from information otherwise often confined to technical experts.

Katrin has held international wellbeing clinics in several countries and currently works from her New Zealand office in Dunedin. She feel privileged to serve in this capacity and invites you to experience something different. Take back the reins of your health and discover more!

To contact Katrin for personal or remote sessions and to invite her for a seminar or presentation, please call or email her. You can contact Katrin via Facebook • Email • Website • or telephone 0064 (0)21 026 95 806 (NZ mobile).

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http://www.drlindai.com/detox

http://tv.greenmedinfo.com/do-coffee-enemas-work/

http://www.gesundheitsfundament.de/blog/2014/11/01/der-kaffeeeinlauf-ein-fast-in-vergessenheit-geratenes-detoxmittel/

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