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Coffee Enema Instructions, Benefits & Dangers

Written by Carlos Tello, PhD (Molecular Biology) | Reviewed by Ana Aleksic, MSc (Pharmacy) | Last updated:
Ognjen Milicevic
Medically reviewed by
Ognjen Milicevic, MD, PhD | Written by Carlos Tello, PhD (Molecular Biology) | Reviewed by Ana Aleksic, MSc (Pharmacy) | Last updated:

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Coffee enema
Coffee enemas would probably remain on the fringes if natural health blogs and celebrities such as Gwyneth Paltrow didn’t popularize them. Nowadays, they are claimed to improve a long list of health conditions by helping your body detox. Does science back up their benefits? Are they worth the potential dangers? Read below to find out.

What is a Coffee Enema?

An enema is the insertion of liquids into the large bowel to relieve constipation, prepare for surgery, or “detox.” A coffee enema is exactly what it sounds like: an enema with brewed coffee. Theoretically, coffee should add specific benefits to those of enemas in general.

Snapshot

PROS

  • May help cleanse the bowels before medical procedures
  • May relieve constipation

CONS

  • Most health claims are not backed by science
  • The benefits from coffee’s active compounds are more effectively (and pleasantly) achieved by drinking it
  • Used as part of fraudulent and expensive cancer therapies
  • May cause digestive issues, bowel injuries, and electrolyte imbalances

Use through History

The first documented uses of coffee enemas for poisoning and post-operative care date back to the 19th century. According to an anecdote, their popularity picked up during World War I. The water supply shortage forced a nurse to use the surgeon’s coffee as a preparatory enema in a soldier. Supposedly, he experienced immediate pain relief [1].

However, it wasn’t until German doctor Max Gerson developed his anticancer therapy that coffee enemas became known worldwide. Gerson died in 1959 but his therapy has lived to our days [2+].

The popularity of coffee enemas declined during the 20th century and their citation as a folk medical practice was removed from the best-selling textbook Merck Manual in 1972.

However, these enemas have revived in recent years. Despite the lack of scientific evidence, advocates of coffee enemas propose their use for:

  • Removing toxins
  • Losing weight
  • Relieving constipation and digestive issues
  • Boosting mood
  • Removing intestinal parasites and yeasts
  • Improving various chronic disorders
  • Flushing kidney and gallstones

In the next section, we’ll break down the scientific evidence for each claimed health benefit.

Coffee Enema Benefits Breakdown

1) Detox

Theory of Autointoxication

The purported detox power of enemas relies on the pseudoscientific theory of “autointoxication.” Supposedly, undigested food waste and toxins build up in the bowel and pass into the bloodstream, causing a number of diseases [3].

Over 2000 years ago, the Egyptians and Romans already washed out their bowels to flush substances that supposedly caused disease. Bowel cleansing reached its peak of popularity in the early 20th century, after English surgeon William Arbuthnot Lane claimed that autointoxication was responsible for most chronic conditions [4+].

During this time, enemas, laxatives, and even surgical procedures to shorten the large bowel and speed bowel waste removal were common. The popularity of these practices started declining after the American Medical Association published a paper in 1919 condemning them [3+].

While the theory of autointoxication lacks scientific evidence, the bacteria in the bowel do have a role in toxic waste production and breakdown. Some help break down toxins while other types form protein byproducts associated with colon cancer. Rather than flushing this “food waste” with enemas, it’s better to eat a diet that promotes a healthy gut microbiome [5+, 6].

However, the autointoxication theory is often used today to explain the purported benefits of all types of enemas.

Gallbladder Stimulation

Coffee enemas are often claimed to open the bile ducts and help eliminate toxins with bile acids. In a clinical trial on 6 men, drinking coffee (165-400 mL/day) increased gallbladder contractions and the levels of the hormone that stimulates bile release (cholecystokinin) [2, 7].

However, it’s very unlikely that an increased bile flow removes toxins from blood: over 95% of the bile released into the small bowel reenters the liver and is recycled [8+].

Antioxidant Activity

Glutathione is the main antioxidant of the body and is mostly produced in the liver. It protects cells from free radical damage. Plus, it binds to and helps remove toxic chemicals, drugs, and pesticides [9].

The same paper is often cited by coffee enema proponents. In the study, “coffee enemas” increased the activity of an enzyme that helps glutathione bind to toxins (GST) by up to 700%. However, it suffers from a glaring issue: mice in this study were not given coffee enemas but fed green coffee beans! [10+]

Other animal and cell-based studies found that certain coffee components (kahweol and cafestol palmitates) increase the activity and production of GST and glutathione. But water extracts of roasted beans (the closest to brewed coffee) had the lowest antioxidant activity [10, 11, 12, 13].

Indeed, neither moderate coffee intake (2 cups/day) nor coffee enemas (3x/week) showed any antioxidant-enhancing effects in a clinical trial on 11 healthy men [14].

Bottom Line

To sum it up, evidence is lacking to suggest that coffee enemas improve detox or antioxidant defense. Claims about their superiority – such as delivering more active compounds to the liver faster and with fewer adverse effects – remain unproven.

2) Weight Loss

Autointoxication is claimed to block metabolism and cause weight gain. Hence, proponents think it can be prevented by cleansing the bowel with enemas. Similar to the case of waste management, the activity of the gut microbiota rather than blood poisoning with bowel toxins seems to play a role here  [3].

Your gut bacteria can create various byproducts, depending on the bacteria type and the foods you eat. Some waste products – especially those from protein digestion – can “rot” and worsen bowel inflammation. They’re associated with obesity and its health complications. Research has not proven that enemas will get rid of these waste products, though [15, 16].  

Enemas can, however, promote weight loss through their laxative effect. This is an unsafe weight loss method; in fact, it is frequently used among people with eating disorders such as bulimia [17].

12 clinical trials attest to a weight-loss mechanism at hand. You may have guessed it: the fat-burning action of caffeine. However, taking coffee by mouth may be safer and more effective: blood caffeine levels were 3.5x higher after drinking coffee than after an enema in a trial on 11 people [18+, 19, 20, 21, 22, 23, 24, 25, 26, 27].

All in all, enemas are not a smart or safe way to lose weight. Coffee enemas are no exception.

3) Clearing Parasites & Other

Coffee enemas are often advertised to help remove and kill parasites, although the scientific research backing this claim is nonexistent.

While the laxative effect of coffee enemas may increase their elimination, some worms will remain in your gut and continue reproducing. Coffee seems unlikely to kill them, since it was even beneficial to a tiny roundworm commonly used in the lab. Infections will most likely remain unresolved if you don’t take antiparasitic medication [28].

A combination of enemas and medication may, however, be effective when the bowels are blocked by large roundworms. This procedure helped in 5 clinical trials on over 600 children and prevented the need for surgery in most cases. In any case, balanced or concentrated salt enemas may remove the parasites more effectively [29, 30, 31, 32, 33].

Proponents of coffee enemas also claim that they improve yeast (Candida) overgrowth. Although no human studies have been carried out, coffee extract killed Candida in antimicrobial tests [34].

4) Improving Digestion

Coffee may improve fat digestion by stimulating the release of bile acids and keeping your gallbladder healthy. Two studies on almost 100k people associated drinking coffee (2-6 cups/day) with reduced the risk of gallbladder stones in women and of gallbladder cancer in all genders. None of them tested enemas [7, 35, 36].

Enemas are mostly used to relieve severe constipation. In 3 clinical trials on over 350 constipated adults, they improved 47% of all cases and up to 87% of those due to nerve damage [37, 38, 39].

Enemas were also effective in 5 trials on over 250 children, but didn’t have any added benefits to laxatives in another one on 100 children [40, 41, 42, 43, 44, 45].

Coffee’s composition may also contribute to the laxative effect of coffee enemas. Drinking coffee, especially caffeinated, promoted bowel movements in 2 trials on over 100 people [46, 47].

It’s not clear how coffee enemas affect gut microbiota. While drinking coffee increased the growth of beneficial bacteria in humans and rats, frequent enemas may reduce their number by washing them off and prevent their regrowth due to the acidity of coffee [48, 49].

5) Preparation for Bowel Endoscopy

Bowel endoscopy is a common examination procedure that requires cleaning the bowel. It’s either used to diagnose a condition or as a therapeutic intervention.

Stool particles are the main contaminants in the large bowel. Enemas are approved for this procedure by the FDA and worked in 25 out of 26 people in a clinical trial. However, drinking solutions such as GoLytely and Pico-salax are more commonly used [50+, 51, 52].

Warm water enemas facilitated large bowel endoscopy through an alternative mechanism – preventing intestinal cramps – in a clinical trial on 69 people [53].

Bile darkens the small bowel and reduces visibility. In a clinical trial on 34 people preparing for an endoscopy, 2 L of an enema with a laxative (polyethylene glycol) flushed more bile when it contained coffee [54].

6) As Part of Gerson Therapy

Gerson Therapy is an unproven alternative cancer “treatment” developed by German doctor Max Gerson. Gerson started using a low-salt diet rich in fruit and vegetable juices to relieve his migraines, later recommended it for tuberculosis, and started applying it to cancer in 1928 [55].

According to Gerson’s theory, cancer develops when toxins build up and overwhelm the liver’s capacity to break them down. By killing cancer cells, chemotherapy would release more of these toxins into the bloodstream and damage the liver [56, 55].

Gerson also claimed that people with cancer have too much sodium and too little potassium in their cells, which weakens the organs by damaging their tissues [56, 55].

None of these were proven. What’s more, Gerson Therapy can be dangerous, especially in cancer patients. In a nutshell, it consists of [55, 57]:

  • A diet of organic fruit and vegetable juices, grains, and supplements to boost immunity and body function
  • Liver and pancreatic enzymes to support liver function and digestion
  • Coffee enemas to widen the bile ducts and increase toxin flushing

Gerson Therapy was banned by the FDA and today is only applied in two clinics in Tijuana (Mexico) and Budapest (Hungary). According to their official website, the therapy lasts 2-3 weeks and costs $5500 per week.

Clinical Studies

Gerson himself and an advocate of his therapy (Dr. Freeman W. Cope) reported several alleged cases of cancer cure without providing any clinical records [58+, 56+, 59+].

An observational study from the Gerson Foundation on over 150 people with skin cancer reported better survival rates compared to conventional therapies. However, unmatched control populations and an unofficial classification of tumor stages bring bias to its results [60].

In another study on 6 people with advanced skin cancer, 5 survived longer than expected. However, 4 used conventional chemotherapy together with Gerson’s regimen [61].

The National Cancer Institute has analyzed case reports presented by Gerson’s proponents on 3 occasions (last time in 1990) without finding any proof that the diet improves cancer [62+, 55].

Dr. Nicholas Gonzalez tested his method, which is similar to Gerson’s and also includes coffee enemas. He reported good results in an uncontrolled study on 11 people with pancreatic cancer. However, a study on 55 people found that those taking chemotherapy (gemcitabine) had better quality of life and survived 3x longer than those following the Gonzalez Regimen [63, 64].

7) Flushing Kidney Stones

Some proponents of coffee enemas claim that they help flush kidney stones. Supposedly, the increased toxin elimination protects kidney function and facilitates stone flushing. As previously described, there is no evidence that bowel toxins pass into blood nor that colon cleansing is required to prevent this [3+].

Coffee enemas may, however, help prevent kidney stones, since caffeine intake was associated with a reduced risk of this condition in a study on over 200k people. As was the case of weight loss, this benefit is easier to achieve by drinking coffee [65, 27].

8) Balancing Mood

Supposedly, the buildup of toxins in the bloodstream causes mood disorders such as depression, sluggishness, irritability, low energy, brain fog, and changes in appetite. Coffee enemas are claimed to remove toxins and prevent these conditions.

As previously described, there is no evidence that waste products pass into blood from the large bowel nor that they cause any health conditions.

A woman with bipolar disorder, psychosis, and suicidal tendencies improved with a lifestyle intervention that included a detox diet, meditation, and coffee enemas. However, meditation alone could have been responsible for this effect since it reduced stress and improved well-being in a meta-analysis of 47 studies [66+, 67].

9) Other Chronic Health Issues

Although their proponents rarely describe how coffee enemas may help in these cases, they are often recommended for chronic conditions such as:

  • Fibromyalgia
  • Chronic fatigue
  • Rheumatoid arthritis

However, all the evidence comes from anecdotal stories.

Multi-herbal enemas are commonly employed for rheumatoid arthritis in Ayurvedic medicine. A therapy including enemas improved the symptoms in 2 studies, but they lacked controls and included only 13 people [68, 69].

Coffee Enema Dangers & Side Effects

“Detox Symptoms”

Frequent enema use may cause the following adverse effects [70+]:

  • Cramping, stomach pain, bloating, and diarrhea
  • Bowel stretching leading to constipation
  • Nausea and vomiting
  • Headaches, dizziness, and fatigue
  • Bowel injuries and irritation
  • Kidney, heart, and liver failure
  • Infections from improperly sterilized kits

While proponents often claim some of them (particularly nausea, headache, dizziness, and fatigue) are “detox symptoms,” these side effects are most likely caused by bowel stretching and electrolyte imbalances.

People at Risk

The risk of adverse effects is especially high in people with [70+]:

  • Digestive conditions (Crohn’s disease, ulcerative colitis, diverticulitis)
  • A history of bowel surgery
  • Severe hemorrhoids
  • Kidney, heart, and liver disease
  • Allergy to coffee

The FDA only approves colon cleansing to prepare for medical procedures and has issued several letters warning about unapproved uses.

Health Complications

Because boiling water is necessary to brew coffee, a risk of these enemas is that they may cause burns in the bowel if the water is still too hot. This was the case of 3 women, one of whom even developed holes in the bowel (perforation) [71+, 72+, 73+].

Additionally, coffee contains irritating compounds that caused colon inflammation, pain, and bloody stools in 3 women [74, 75+, 76+].

In 2 women who used them very frequently (up to 3x-4x/hour), coffee enemas caused severe electrolyte imbalances that resulted in death [77+].

A woman on Gerson Therapy died from blood poisoning (septicemia). 10 people following a similar therapy also suffered from this complication but most likely due to the intake of raw calf liver [78+, 79+].

Because caffeine is also absorbed through the bowel, coffee enemas are not recommended in susceptible people such as children and pregnant women.

A major risk of coffee enemas is using them to replace conventional anticancer therapies. Cancer is a serious, life-threatening condition. Consult your doctor before trying unproven therapies.

Limitations and Caveats

Most health benefits proposed for coffee enemas are based on pseudoscientific theories such as autointoxication. The clinical evidence of these benefits is usually nonexistent or based on anecdotes and uncontrolled cases.

The effects of coffee on gallbladder contractions, weight loss, and preventing kidney stones have only been tested with oral coffee but not enemas.

Although coffee is often claimed to increase glutathione levels and GST activity, positive effects were only found in animals and cells. In the only clinical trial, neither oral coffee nor coffee enemas had any benefits [14].

Some studies showing benefits of coffee enemas also included lifestyle changes (such as special diets and meditation), making it difficult to estimate the contribution of the enemas.

The benefits of enemas on rheumatoid arthritis and cancer have mostly been tested in small, uncontrolled studies, one of which also used chemotherapy; one study had several flaws (unmatched controls, unclear cancer stage classification), while the best-designed one had negative results [68, 69, 61, 63, 64].

How to Do a Coffee Enema

If you still wish to do a coffee enema, have in mind that research is lacking to suggest a safe and effective DIY protocol. Consult a doctor before trying this out. If you experience side effects or discomfort during the procedure, seek medical help immediately.

Recipe

Natural health blogs recommend using lightly roasted, organic, caffeinated coffee beans (to increase antioxidants and avoid pesticides) and distilled or filtered water (to avoid the chlorine of tap water). After grinding, brew as follows:

  • Bring 4 cups (1 L) of water to boil.
  • Add 4 tablespoons of coffee to a French press or a pot. Don’t use aluminum pots because this metal may leach into the coffee.
  • Add the water and let steep for 15-20 minutes
  • Press down the French press or strain with a very fine strainer. Don’t use paper filters because they may retain the active compound (cafestol palmitate).
  • You can add one teaspoon of blackstrap molasses to help retain the enema
  • Let cool at room temperature or by adding cold water

Kits

In addition to brewing the coffee, you will need to buy an enema kit in health food stores, drug stores, or online. They normally consist of:

  • A bag or bucket
  • A flexible tube
  • A nozzle

Instructions

  • Put some towels on the floor.
  • Clamp the tube and attach it to the bag/bucket and to the nozzle.
  • Fill with brewed coffee and place at ~45 cm high so gravity will help it flow.
  • Apply a lubricant (e.g., coconut oil) to the tip of the nozzle and your anus.
  • Lie down on one side and insert the hose ~15 cm into the rectum.
  • Unclamp the tube and let half of the coffee flow in.
  • Hold it in the bowel for 10-15 minutes and release into the toilet.
  • Repeat with the rest of the coffee.

How Often Should You Do It?

Proponents recommend doing coffee enemas 1x-2x/day for 4-8 weeks before shifting to one maintenance enema every 2 months.

In people healing from a digestive disorder, they recommend up to 1x/day.

Several enemas per day are generally discouraged. Proponents make exceptions for severely ill people (such as those with cancer), claiming that they need to get rid of many toxins. We discourage this dangerous practice.

Reviews

The internet is full of testimonies of people who regularly use coffee enemas. Most users believe in the claimed enema benefits, so it’s not surprising that they tend to report great health improvements. A lot of them describe adverse effects such as nausea or dizziness, but attribute them to “detox symptoms.”

People buying kits were seeking the same benefits and were satisfied with the results. Most reviews evaluated the kits based on practical features such as ease of use and cleaning, quality of the materials, or price. The reviews were generally positive and dissatisfied users often complained that their kit leaked or was uncomfortable to use.

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Takeaway

Proponents claim that coffee enemas will help you detox and cure chronic diseases, but science-based evidence says otherwise.

Research is lacking to support the use of coffee enemas for anything but constipation and cleaning the bowels before a medical procedure. For most of the claimed benefits, moderate coffee consumption and a healthy diet work much better.

If you do decide to try out a coffee enema, consult a medical professional first. Using enemas at home can be dangerous. If you experience side effects, seek medical help immediately. Frequent use can cause severe electrolyte imbalances and even death.

About the Author

Carlos Tello

Carlos Tello

PhD (Molecular Biology)
Carlos received his PhD and MS from the Universidad de Sevilla.
Carlos spent 9 years in the laboratory investigating mineral transport in plants. He then started working as a freelancer, mainly in science writing, editing, and consulting. Carlos is passionate about learning the mechanisms behind biological processes and communicating science to both academic and non-academic audiences. He strongly believes that scientific literacy is crucial to maintain a healthy lifestyle and avoid falling for scams.

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