Complementary and alternative medicine Friday Woo Medicine Quackery

Your Friday Dose of Woo: Coffee, the ultimate cleanser

Earlier this week, I thought that I had identified this week’s woo target. I told myself that this was it, that this was the one for this week. I even started writing it the other day, because, as much as I try to get this thing done early, somehow I always seem to be writing it at 11 PM Thursday nights. I thought this week would be different.

I was mistaken.

The reason that I was wrong was because I came across a link that was so amusing, so full of outrageously concentrated woo, that I just couldn’t restrain myself from throwing my old topic to the wayside (well, not exactly; I can always use it next week) and charging ahead. But there was a problem. You see, I’ve already covered this topic before. Well, not exactly this topic, but so close that I was worried about repeating myself. After all, there’s so much woo out there (heck, I haven’t even tackled Reiki therapy yet!) that I hesitated. Even worse, this topic is closely related to one that’s come up quite a bit because of our intrepid blog mascot. With people already wondering whether I have some sort of odd fixation, would it do to trod the same ground yet again?

Hell, yes! Surgeons are obsessed with this stuff, as you would know if you’ve ever had abdominal surgery, and all bloggers trod the same ground over and over. It’s impossible to be otherwise if you put out hundreds of posts a year. I’m like Michael Corleone in The Godfather, Part III, when he says, “Just when I thought that I was out they pull me back in.” Except, this time, being pulled back in is (hopefully) more amusing than not being pulled back in.

So, let’s take a look at s. a. Wilson’s Therapy Blend Coffee.

Regular readers will probably guess right away what sort of “therapy” Wilson is talking about when referring to “therapy blend coffee.” Even not-so-regular readers will probably figure it out fairly quickly. However, for those of you unfamiliar with the true depths to which woo will sink and yet another manifestation with the altie desire to purge and cleanse the body of undefined and unnamed “toxins,” let’s try to put it as gently as possible. The “therapy” for which this “therapy blend” coffee is intended involves putting coffee where it was never intended to be placed and where its taste is irrelevant.

Yes, as disgusting as it sounds, I’m talking about coffee enemas:

On the following pages you will find a good deal of information on coffee enemas, as well as the improved enema coffee blend developed by s.a. Wilson’s. For the first time there is an organic coffee available that has been specifically blended and roasted for enema use.

Be still my beating heart. Actually, considering that the colon can absorb lots of drugs (why do you think that some drugs are given as suppositories?) including caffeine, anyone using one of these enemas is likely to need to have his heart slowed down. He could get really hopped up on coffee, given that the volumes used in an enema tend to be quite a bit more than a cup or two. (Heck, he might even need beta blockers after that.) So, why should you start putting coffee up your butt? Let s. a. Wilson tell you (what’s with the small letters?):

The coffee enema is quite simply the best means for detoxifying the human liver. Using s.a.Wilsons Therapy Blend Coffee will make it even more effective. What does a coffee enema do, and why is it better using Wilsons coffee?

When you do a coffee retention enema the Caffeine in the coffee relaxes the smooth muscles in the body. This allows the Liver and the Gallbladder to almost immediately dump all the bile and toxins that they were holding. The Liver is then free to do its job at full capacity, removing the toxins and poisons from the body.

Also, and more importantly the coffee enema contains Palmitic Acid, this ingredient gets the liver to produce an Enzyme that cleans the blood. Tests show that while doing a coffee enema the Liver will produce up to 700% more of this Enzyme than it normally would. That, very simply, is what happens while you do a coffee enema.

Yippee. Just what I always wanted, to relax all the smooth muscles in my body while I’m tightening my anal sphincter to try to keep coffee in my colon. Where do I sign up?

Scientifically, this is all a load of B.S., of course (or C.S.–you can guess what the “C” stands for). Glutton for punishment that I am (although not as big a glutton for punishment as coffee squirting alties), I did some PubMed searches, to see if I could find any evidence that palmitic acid does anything claimed. (I already have discussed why neither enemas nor liver “detoxification” programs are worth anything). There are a lot of articles on palmitic acid and the liver, but a perusal did reveal an interesting little paper that shows that palmitic acid activates Bax in hepatocytes (liver cells). What, you ask, is Bax? I’m happy to tell you! It’s a protein that induces apoptosis (i.e., programmed cell death). Indeed, long chain fatty acids like palmitate can induce apoptosis in the pancreas as well. I suppose it’s possible that these guys mixed up “palmitate” and “palmitoleate” (the latter actually demonstrating a protective effect against the proapoptotic effect of palmitate), but I doubt it. In fact, there is even a hypothesis that chronic exposure to free fatty acids (like palmitic acid) injures pancreatic islet cells and contributes to type II diabetes. As for the immune system, in one cell culture assay using macrophages (a type of immune cell), palmitic acid was the most toxic of the fatty acids tested. Yes, the science may not be entirely settled yet, but there’s enough evidence to suggest that pumping palmitic acid up your behind may not be such a great idea. So why on earth would these guys want to put it in the coffee?

Damned if I know. I’m still trying to figure out what “enzyme” it is that is induced by palmitic acid that “cleans the blood.” On the other hand, it’s highly unlikely that any of the palmitic acid is getting absorbed by the colon (fatty acids are not absorbed in the colon); so the end result is probably nothing, with one exception. If any significant amount of the palmitic acid is retained in the colon after the enema, the resident bacteria there can have a feast on it, generating a lot of gas, just as they do in cases of fat malabsorption, where undigested and unabsorbed fat makes it to the colon to provide a similar feast.

But wait, there’s more. Here’s another reason you should buy Starbutts–sorry, I mean s. a. Wilson’s Therapy Blend. It’s organic, maaaan:

All the coffee used for our enema coffee is 100% certified organic. It is also bird friendly [Orac’s note: Grrlscientist should be relieved about this] and shade grown. Purchased from small independent farmer co-operatives, the beans have been hand picked and the farmers have been paid far more for their product than they would have been paid if sold to the local Wolves (coffee brokers). In addition, s.a.Wilsons is one of the very few, if not the only, Certified Organic Coffee Processor. That means every single step in the production of our enema coffee and the operation of our facility has been certified to organic standards, right down to the products we use to clean the floors.

That’s certainly reassuring, isn’t it? If I’m going to squirt something up there, I certainly want to make sure that it’s all natural. Indeed, Wilson conveniently tells you why you shouldn’t use just any coffee:

The chemicals found in commercially grown coffee could damage the liver when used as a coffee enema. Use ONLY organically grown coffee!

Of course! Organic coffee good for enema; evil corporate coffee bad for enema! So bad that it will actually hurt you! And the evidence for this statement is….?


But, as if that weren’t enough:

s.a.Wilsons Therapy Blend Coffee is the first and only coffee that has been specifically blended and processed with enema use in mind. It is also the only coffee that has been clinically and lab tested to be more effective. A blend of 100% certified organic coffee beans have been selected for higher levels of those ingredients mentioned earlier. Then the coffee is put through the very special three stage process, developed by Scott Wilson after years of research. So what was accomplished with all that research? Remember earlier we mentioned the importance of the Caffeine and the Palmitic Acid in the coffee? Well, independent lab tests show that s.a.Wilsons Therapy Blend coffee is up to 48% higher in Caffeine and up to 87% higher in the more important Palmitic acid. That’s higher than any commercially available coffee, these higher levels make Wilsons coffee the most effect coffee available, without exception.

Never is it defined how “effective” is defined? Effective at what?

You know, back when I was in medical school, I might have been tempted by this stuff. Oh, no, not to use in an enema–perish the thought!–but rather to drink. When you’re a sleep-deprived medical student trying to get ready for tests, 48% higher caffeine sounds pretty good, and when you’re in your early 20’s you don’t care about little things like free fatty acids associated with glucose intolerance that might contribute to type II diabetes with chronic long term exposure. Of course, that risk would be worth it for all these benefits:

Coffee enemas rapidly help remove toxins from the liver. They often provide quick relief when one is fatigued, sleepy, has headaches, or is just feeling poorly. They also help against spasms, precordial (heart, throat, chest) pain and difficulties resulting from the sudden withdrawal of all intoxicating sedation.

A coffee enema, when done properly, causes the liver to produce more bile, opens the bile ducts and causes the bile to flow. In this process, a toxic liver can dump many of its toxins into the bile and get rid of them in just a few minutes. This often gives great relief to all parts of the body, and often makes the difference between lying down feeling miserable and feeling good and being active. Coffee enemas are also effective in relieving pain. Patients with cancer, for example, may achieve relief from pain even when drugs failed.

I wonder what my colleagues in medical oncology would say if I suggested using coffee enemas intead of, say, Oxycontin in their terminally ill patients in severe pain. Best not to think of it.

Of course, no benefit is without its potential downside:

At the start of the treatment and during “flare-ups”, the bile contains poisons, produces spasms in the duodenum and small intestines, and causes some overflow into the stomach. This may cause feelings of nausea, which could result in the vomiting of the bile. If this happens, drinking a good quantity of strong peppermint tea will help was out the bile from the stomach and bring relief.

Or it could be that expanding the colon with an enema simply causes nausea and vomiting by stretching the smooth muscle of the colon, not to mention the peritoneal lining of the bowels.

Of course, these guys have even thought of an answer to the usual retort:

It is interesting to note that drinking a cup of coffee has an entirely different effect from that of using it as a cleansing enema. Drinking coffee causes the following problems: increases reflex response, lowers blood pressure, increases heart rate, causes insomnia and heart palpitations, over stimulates the adrenals, irritates the stomach, and leaves a toxic residue in the body. A coffee enema, when done properly will not produce these effects.


Dr. Gerson found that all the caffeine is absorbed from the fluid within 12 minutes. The caffeine goes through the hemorrhoidal veins directly into the portal veins and into the liver.

Of course, they don’t bother to explain how, physiologically and pharmacologically, absorbing caffeine directly into the hemorrhoidal veins (which drain blood from the rectum and the sigmoid colon) to the inferior mesenteric vein and thence to the portal vein is any different than absorbing the caffeine from the proximal small intestine, into the intestinal arcade to the superior mesenteric vein and then to–you guessed it!–the portal vein. It’s a different different set of veins in the beginning, but it all ends up in the portal vein in the end heading to the liver, as all the gut vasculature is. True, there is some communication between the hemorroidal veins that go to the systemic (body) venous system rather than the portal (liver) circulation, but that would mean any small proportion of the caffeine that gets into the systemic circulation via the hemorrhoidal veins that way would bypass the liver! And what is the big claim for the “advantage” of this particular means of caffeine administration? That it goes straight to the liver to cause relaxation of smooth muscle and increased bile secretion!! Never mind that absorption through the rectum probably shunts a significant fraction of the absorbed caffeine away from a first pass through the liver. You probably get more caffeine going “straight to the liver” just by drinking coffee.

No one ever said that altie claims had to be consistent, either logically or with anatomy and physiology.

In any case there really is no good physiological reason to suspect that it would make any difference whether the caffeine is administered orally or by enema. As Harriet Hall once put it:

Please tell me: after the caffeine is absorbed, how does it remember where it came in, and how does it talk the various organs into not doing the side effect thing?

It doesn’t. (Or maybe it’s “homeopathic” somehow.) Whatever the case, the good feeling people report after getting coffee enemas is almost certainly due to nothing more than an old-fashioned caffeine rush.

Finally, you may ask, is there anything to the claim, made on the website, that the Merck Medical Manual , which, according to the website, is the “Bible” of physicians (some “Bible”–I never owned a copy), included coffee enemas as an accepted means of detoxification and constipation relief until 1977? Quite honestly, I have no idea. For one thing, no quotation is provided. For another thing, it may be that the Merck Medical Manual simply mentioned it as a folk remedy that some people believed in. Maybe it was in there for decades and no one bothered to remove it until 1977. Why did Wilson put this claim on the website? Even if true, on the one hand s. a. Wilson is trying to boost its credibility by mentioning this, but at the same time it’s saying that conventional medicine has rejected it.

Finally, no article about coffee enemas is complete without a list of potential product names for such coffee products designed for this purpose. Thankfully, Harriet already thought of some (or at least collected a bunch) so that I don’t have to:

Starbutts (yes, I know that’s one of the oldest jokes about this)
Seattle’s Butts Coffee
100% mountain grown Colon-bean coffee
Laxwell House
Nuts Chock Full O’Coffee
Marijuana blend (for a truly high colonic)
Innuendo (new Italian brand)

I leave it to the creativity of my readers to come up with even more fine suggestions for names for coffee made for the express purpose of being put where coffee was never meant to be put. I trust that you won’t let me down, and I’ll publish a complete list after enough time has been allowed for everyone to get a–if you’ll excuse the term–crack at it.

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By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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