CONTRAINDICATIONS FOR COLON HYDROTHERAPY TREATMENT 

RICTAT Contraindications 24.05.24 ©

ABSOLUTE CONTRAINDICATIONS

 Abdominal Hernia including inguinal and umbilical
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.
 Inflammatory Bowel Disorders – Ulcerative Colitis, Crohn's, Colitis and
Diverticulitis, Diverticulosis
Risk of bleeding, tissue damage and may exacerbate symptoms. However, if
medicated with drugs, for example Sulfasalazine and Azathioprine.
Exception – current clients of therapist before 24-5-24 who are fully in remission and
have been treated without problem.
 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.
 Atrial Fibrillation- Do not treat due to sudden changes in heart rate
 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 – http://www.bnf.nice.org.uk/

 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.
 Prolapse of colon
Do not treat
 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.
 Tachycardia or AF- Do not treat due to inconsistent heart rate pattern
 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
Professional.

 Recent bowel biopsy – 3 months.
 Recent prostate biopsy made through the bowel – 3 months.
 Recent abdominal surgery, laparoscopic or open – 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 fully discharged
 Recent Gastric Band, Sleeve or Bypass Surgery – 6 months fully discharged
 Recent Gastric Band Removal – 6 months full discharged no problems.

RELATIVE CONTRAINDICATIONS 

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.

 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, General infections /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. If digestive in nature or
similar await results.

Reference – http://www.bnf.nice.org.uk/

RICTAT Contraindications 25.05.24©