I see a lot of environmental illness, chemical sensitivity, and GI symptoms in my practice. Most of the time in cases of suspected or proven solvent toxicity, my recommendations for detoxification include sauna, castor oil packs, constitutional hydrotherapy, and colon hydrotherapy. The latter is performed with water only, though there are some cases where coffee enemas can be helpful.

The Theory Behind Coffee Enemas

Coffee enemas were popularized in the 1930s by Dr Max Gerson, as part of Gerson Therapy. In an enema, the coffee gets absorbed through the colon and goes directly to the liver, via the portal venous system. This is called First Pass Metabolism, and it happens in regular digestion too: since many toxins enter the body through the digestive tract, the first stop after the intestines is the liver, to make sure there’s nothing toxic that you don’t want circulating throughout the rest of the body. However, about 3.5 times less caffeine gets absorbed in circulation via an enema as compared to oral coffee consumption.

Coffee, consumed orally, has been shown to increase glutathione production—the most powerful antioxidant in the body. Gerson therapy proponents claim that taking coffee rectally increases glutathione S-transferase (the enzyme that makes glutathione) by 600-700%, though I could not find a reference for this. If true, though, this would greatly assist in detoxification, at least through the glutathione transferase pathway.

Another primary argument for coffee enemas is that coffee contains theophylline and theobromine, both of which act as vasodilators. The increased blood flow direct from the colon to the liver would theoretically increase liver filtration. If true, this would increase liver detoxification efficiency overall (more blood filtered per unit time).

Since theophylline also acts as a bronchodilator (in fact it is sometimes used as a treatment for asthma), another theory is that it and its chemical cousin have a similar effect on the bile ducts (muscle dilation is muscle dilation, after all, whether in the blood vessels, the bronchioles, or the bile ducts). Why this might matter: bile helps with fat absorption generally, which can work for or against you. If you want to absorb fat and fat-soluble vitamins, it’s great. But if you want to excrete fat-soluble toxins, bile recycling (which is about 95% under normal conditions, and closer to 99% in cases of constipation) will definitely work against you. Bile duct dilation would, in theory, increase bile excretion—and if you’re trying to get rid of fat-soluble toxins, that means the dumped bile will take those bound toxins with it, right out of the body.

The Evidence, and Upshot

But this is pretty much all just theory, even though it makes sense, and clinical experience backs it up.

Unfortunately there is very little research on coffee enemas. Most of what I could find made much of a small handful of adverse cases, but it doesn’t appear that large scale studies have really been done. In most cases, I recommend either colonics or regular water based enemas as part of a detoxification protocol. But in some stubborn cases of toxicity or parasitic infections, coffee enemas have been a very helpful addition. I’d love to see some larger scale studies back this up.

A few cautions: coffee beans can often be grown with pesticides when not organic, so I’d definitely recommend that anyone doing a coffee enema use organic coffee to avoid this. If you’re caffeine sensitive, even though caffeine absorption is much lower rectally, start low and gradually increase the amount of coffee used.

Any kind of enema or colonic can potentially deplete electrolytes, in much the same way that chronic diarrhea can do. Repletion with electrolyte packets, Pedialyte, or a fresh green juice is ideal. (I’m less a fan of sport drinks for this, as they are typically quite high in sugar.)