IMPORTANT MUST READ  – The below conditions are contraindications – medical advice is needed in order to proceed if these conditions apply to you as the treatment cannot be carried out.  Please discuss with your therapist and your doctor before proceeding.  In many instances a doctors note will be needed to perform the treatment.



RICTAT Contraindications 09.01.24 ©


 Abdominal Hernia
Defect in abdominal wall, risk of strangulation of the bowel.

 Active Fissure
Tear or crack in the anus, usually very painful when active. Varies from small crack to
open fissure that requires surgery.

 Active Inflammatory Bowel Disorders – Ulcerative Colitis, Crohn’s, Colitis and
Diverticulitis.Risk of bleeding, tissue damage and may exacerbate symptoms. However, if
medicated with drugs, for example Sulfasalazine and Azathioprine, and if controlled
and not having flare ups then you can treat.

 Active Rectal Fistula
Caused by an abscess ‘tunnelling into the rectum’ sometimes requiring surgery.

 Anti-Coagulants
Warfarin is administered to artificially affect and reduce blood clotting time. If the client
is on Warfarin, or a treatment dose of an injectable anti-coagulant (e.g., Daltaparin,
Tinzaparin,) then it is contraindicated. However, if they are on low dose prophylactic
anti-coagulant and not being monitored by medical staff, then fine to treat.

 Autonomic Dysreflexia (occurs in spinal injuries at or above T6)
Danger of general body spasm, particularly related to insertion of speculum.

 Bowel Obstruction – e.g., adhesions, volvulus, tumour, etc.
With a bowel obstruction no gas is passed and client would be requiring medical
attention. (Not to be confused with faecal impaction – caused by chronic constipation.)

 Bowel Prolapse or Rectal Prolapse
Due to weakened tissues not supporting the organs properly. Risk of making the
condition worse.

 Carcinoma of the colon or rectum
Risk of perforation, bleeding, bowel is diseased and may be damaged.

 Chemotherapy
No-one to be treated whilst receiving chemotherapy. High risk of infection due to no, or
low immune response (neutropenia). Minimum of 3 months once bloods levels to return
to normal. Reference –

 Diabetes – Uncontrolled/Unbalanced.
Risk of hypoglycaemia during a treatment.

 Epilepsy
No treatment if the client does not have a driving license without medical approval

 Heart Failure
Requiring care of medical professional, ongoing monitoring, and medication. Do not
treat. (On advice from Cardiac consultant, St Bartholomew Hospital. April 2021.)

 Hypertension –severe or uncontrolled.
Risk of stroke or heart attack.

 Inflamed Haemorrhoids (Piles)
May exacerbate symptoms and cause pain and bleeding.

 Intussusception
Do not treat as the bowel ‘telescopes’ on itself.

 Liver function
Any condition that affects the liver and decreases its function needs to be assessed
and if the client is under the care of a medical professional.

 Neutropenic
Low or no immune system. Severe risk of infection. Do not treat.

 Pregnancy
Risk of miscarriage.

 Radiotherapy of abdominal area not discharged from medical care
Radiotherapy burns and damages other tissues as well as the tumour, risk of
perforation. Do not treat for 2 years.

 Rectal Bleeding
All rectal bleeding needs investigation by GP, unless a small speck of blood on the
tissue after straining to pass a large stool.

 Reduced kidney function
Renal insufficiency which requires reduced fluid intake under the supervision of
medical professional. Kidney function must be a minimum of 50% with two kidneys and
100% with only one kidney and not fluid restricted.

 Tight Sphincter
Unable to insert speculum without pain.

 Undiagnosed Persistent Diarrhoea
Needs professional medical investigation.
Under medical Investigations/awaiting medical results – do not treat – depending

The following timelines given post-surgery/treatment are deliberately
conservative and could be less with the written support of a Medical

 Recent bowel biopsy – 3 months.
 Recent prostate biopsy made through the bowel – 3 months.
 Recent abdominal surgery, laparoscopic or open – 3-6 months depending on severity
of surgery and on medical discharge with no complications,
 Recent laparoscopic investigation – 6 weeks and on medical discharge
 Recent surgery of colon or rectum – 6 months.
 Recent Gastric Band, Sleeve or Bypass Surgery – 6 months
 Recent Gastric Band Removal – 3-6 months full discharged no problems.


The following are industry agreed relative contraindications. The suitability of the
treatment remains specific to the individual and must be assessed by a professional
Colonic Hydrotherapist.

 Recurring inflammatory bowel disease episodes.
Generally, more than 3 episodes in a year or within 3 months of a flare up.

 Highly anxious, stressed or emotional client.

 Fainting (vaso-vagal attack).

 Joint Replacement (hip, shoulder, knee.)
Awareness of positioning on couch and as pain allows. NB. Hips – knees no higher
than 90 degrees when they’re on their side and pillow between legs during treatment if
on side, awareness of possible dislocation.

 Severe underweight or eating disorders.
Aware of not using colonics for further weight loss.

 Severe anaemia.
Risk of fainting during a treatment.

 UTI – Urinary Tract Infection/Antibiotic Treatment – do not treat until the
course of antibiotics for the infection has been completed.

 Under medical Investigations/awaiting medical results – consider the
nature of the conditions that the client is having tests for e.g., bowel,
gynaecological, liver, pancreas, digestive, heart.

Reference –

RICTAT Contraindications 09.01.24©