An illustration of a winking butt.
Illustration: Matija Medved

Optimize Me

The Butt Is Not a Backdoor to Health and Wellness

Coffee enemas, colonics, and perineum sunning are not good ideas

Optimize Me is an Elemental column exploring (and fact-checking) the weirdest self-improvement trends. It comes out every Tuesday.

FForget about what you put into your mouth; apparently there’s a whole other hole that can be optimized for wellness through either what goes in or what comes out. Water, coffee, alcohol — all your favorite beverages can be consumed in rectal form. Some liquids are intended to be absorbed into the bloodstream, whereas others are supposed to be pushed back out, along with the rest of the contents of your colon. These health claims of these practices include increased vitality, energy, and detoxification — except in the case of alcohol where the goal is enhanced intoxication. It should be noted that while there is little to no scientific evidence backing up these purported benefits, there are several cases of people becoming injured and even dying after receiving a beverage enema.

The most common colon health practice is colonics, the popularity of which has waxed and waned over the years. The treatment involves sending large volumes — up to 16 gallons — of warm water up the anus and into the colon to clean out your insides. According to the Association of Registered Colon Hydrotherapists, a colonic “firstly cleans out waste matter in the colon, and secondly it stimulates the natural nerve and muscle action of the bowels to encourage proper bowel function.” They say this can give people “a sensation of overall well-being and energy.”

Since the time of ancient Egyptians, humans have pursued colon cleansing out of concern that toxins are not fully flushed from the intestines the natural way. The belief goes that the remaining stool becomes putrefied and byproducts from the feces are absorbed back into the bloodstream where they poison the body — a process called autointoxication. This theory has been thoroughly debunked in modern medicine. Your body does a perfectly fine job of flushing and expelling on its own, and if things really do get backed up, there are much easier ways to loosen things up and speed it along, such as fiber, good hydration, and over-the-counter laxatives.

“I don’t prescribe colonics. I don’t give colonics,” says Martin Poleski, a gastroenterologist at Duke University. “The rare time I see people who use colonics, it’s usually that they’ve had a problem — sometimes they get hemorrhoids or irritation in the rear end.”

Occasionally, if a patient has severe chronic constipation, Poleski will recommend an enema — the colonic’s tamer cousin where a much smaller volume of liquid is used. Enemas with steroidal anti-inflammatory medications are also sometimes prescribed for people who have irritable bowel disease or colitis. But in general, he says, “The best thing for colon health is fiber and fluids.”

Taking it one step further, some people have started flushing their colons with coffee. The practice was first performed as part of ancient Chinese medicine, again due to concerns of autointoxication. It was reintroduced to medicine by physician Max Gerson in the 1930s as part of an alternative cancer treatment regimen focused on nutrition. The goal is to boost the liver’s detoxification abilities by stimulating it with caffeine, carried by blood vessels that travel from the colon to the liver. However, the Gerson method is highly controversial and has come under fire as being based on poor, 90-year-old knowledge of how cancer biology works.

“The explanations justifying the use of coffee enemas and ‘low sodium, high potassium, poison free diets’ as a treatment for cancer, published first by Gerson and now by his proponents, are not supported by the established tenets of cancer immunology, biochemistry, or nutrition,” wrote cancer researcher Saul Green in 1992. “[It] is based on the beliefs of German physicians who practiced 60 to 90 years ago and whose knowledge of the cause of cancer was rudimentary.”

Coffee enemas were repopularized more recently as another detoxification practice by Gwyneth Paltrow’s company Goop (of course). However, the practice can be highly risky, and there have been reports of people developing rectal burns, tears, and inflammation as a result of squirting coffee into their nether regions.

It should go without saying, but please do not do this.

If that wasn’t dangerous enough, college students have been known to consume alcohol through their anuses via a funnel, a pastime known as “butt chugging” or “boofing.” The alcohol is absorbed directly into the bloodstream from the colon instead of first being broken down and metabolized in the stomach and then entering the bloodstream from the small intestines. This backdoor route means higher amounts of alcohol can reach the brain and other organs than through the conventional method of consumption.

It should go without saying, but please do not do this. Pouring vodka into a beer bong in your butt can cause alcohol poisoning, and in several cases, it has resulted in death, not to mention severe irritation of the colon.

Finally comes perhaps the most bizarre rectal wellness trend: perineum sunning. In a viral Instagram post from November, influencer Metaphysical Meagan posted a picture of herself lying naked on her back, legs up in the air in what’s known in yoga as the “happy baby pose” receiving sun, well, where the sun don’t shine. In the caption, she claimed absorbing vitamin D into this particular body part resulted in better sleep, energy, creativity, and focus. There is absolutely no research or commonsense rationale to back up these claims.

Dermatologists in particular were quick to denounce the fad because the region is particularly sensitive to UV rays and can burn quickly since it isn’t used to getting sun exposure. But perhaps actor Josh Brolin did the best job of quashing the trend, posting on his own Instagram account that after trying to tan his taint, his “pucker hole is crazy burned.”

Duly noted.

Health and science writer • PhD in 🧠 • Words in Scientific American, STAT, The Atlantic, The Guardian • Award-winning Covid-19 coverage for Elemental

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