A coffee enema Dr. Max Gerson protocol is a medical procedure that was listed in the Merck Medical (the how to do it for doctors) until 1977. Some doctors now would have you believe that a coffee enema is weird alternative medicine, but this throws the baby out with the bathwater. So don’t. It’s a valuable medical technique now as it was then. Coffee enemas are a key component of the Gerson protocol, as well as later the Dr. William Kelley DDS MS protocol. It is highly effective and cheap but of course some find it challenging and cannot overcome their prudeness.
When & Why should you have coffee enemas
For good reason, Dr. Gerson MD saw coffee enemas as a key component in his cancer protocol. Next to upregulating your immune system by a bombardment with healthy nutrients, proteolytic enzymes to alter receptor sites, and boswellia sacra by mouth to induce cancer cell apoptosis, coffee enemas reduce the chance of Tumour Lysis Syndrome (TLS). TLS has been reported with virtually every type of tumour but is typically associated with high-grade haematologic malignancies such as acute leukaemia and high-grade non-Hodgkin lymphomas. TLS occurs when large numbers of neoplastic cells are killed rapidly, leading to the release of intracellular ions and metabolic byproducts into the systemic circulation. Detoxifying with very frequent coffee enemas negates the hyperuricaemia, hyperkalaemia, hyperphosphataemia and hypocalcaemia associated with TLS. By detoxifying via the liver-gallbladder-intestine route, the burden on your kidneys will be less which may help to avoid the acute renal failure associated with TLS. Coffee enemas (a maximum of four a day) are contraindicated if there’s a very real chance of bowel perforation -mostly there isn’t as a coffee enema is a low pressure procedure compared to pressure during bowel evacuation- such as in severe haemorrhoids. Rectal prolapse, anal fissures or fistulas should be resolved prior to it.
How do coffee enemas work?
The coffee enema (coffee implant & retention enema) has one and only one purpose, that of lowering serum (blood) toxins. It involves the rectal administration of a small amount of drip-ground, boiled and then lowered-to-body-temperature organic (ideally green) coffee into the sigmoideum and is left in situ for upto a maximum of 15 minutes. The palmitic acid in coffee promotes the activity of Glutathione-S-Transferase (GST) which activity is increased to some 600% (in hepar) to 700% (in duodenum) over and above the norm due to the coffee enema [National Research Council; Diet, Nutrition, and Cancer. National Academy Press; 1982:15-7,15-8]. Roasted coffee has about 50% less glutathione-S-transferase-stimulating effect than green coffee, according to research by Lam, Sparnins and Wattenberg [Cancer Res. 1982;42:1193-1198]. It is the entero-hepatic circulation that allows the palmitic acid of the coffee to reach the liver. Theobromine, theophylline and the caffeine in coffee dilate blood vessels and bile ducts, relax smooth muscles, and increase the bile flow.
The enzyme Glutathione-S-Transferase (GST) in the liver and the small intestine is responsible for the conversion and neutralisation of the four most common tissue toxins: polyamines, ammonia, toxic-bound nitrogen and electrophiles (reactive oxygen species or ‘free radicals’) all of which cause intracellular and cell membrane damage. Glutathione-S-transferases, by virtue of their capacities to bind and, in some cases, catalyze biotransformations of substances such as hormones and chemicals coming from the environment (either toxic agents or drugs), can determine whether these compounds will function or be detoxified. The range of GST substrates is quite remarkable, including a large number of xenobiotics, hepatic toxins, carcinogens, as well as endogenous prostaglandins, leukotrienes, steroids, and organic hydroperoxides including lipid hydroperoxides and lipid peroxidation products. [Listowsky I. Glutathione S-Transferases: Intracellular Binding, Detoxification, and Adaptive Responses. In: Tavoloni N and Berk PD, eds. Hepatic Transport and Bile Secretion: Physiology and Pathophysiology. NY:Raven Press Ltd.;1993.] Any backlog in the choledohepatic system causes toxaemia, so akin to lancing an abcess, accelerating the flow of bile helps to lower toxaemia.
The coffee enema should be classified as the only non-reabsorbed, effective, repeatable choleretic agent (i.e. stimulant of bile flow) that can be used safely many times a day without toxic effects. It is imperative not to confuse coffee enemas with the application of high colonic irrigation, the latter is never used in the Gerson Therapy®. Also it should be borne in mind that, since coffee enemas stimulate a hepatic detoxification pathway, there must be sufficient nutrients present to accommodate for this stimulus. Dr. Gerson MD took great care of this by giving coffee enemas within a highly contextual protocol. Kindly note that this includes stress management to alter levels of brain neuropeptides that participate in stress physiology. Patients who want to undertake a coffee enema as an isolated protocol must ensure that liver nutrients are present, consult your physician if in doubt about this. Equally patients suspected to have gallstones must pace their detox.
A Gerson patient holds the coffee enema in the colon for 12 to 15 minutes. During this time, the body’s entire blood supply passes through the liver four to five times, carrying poisons picked up from the tissues. So the enema acts as a form of dialysis of the blood across the gut wall.
Physiological benefit of coffee enemas:
- coffee enemas dilute the portal vein and due to their choleretics they dilute the bile.
- theophylline and theobromine, major nutraceutical consitutents of coffee dilate blood vessels and thus counter inflammation of the intestine.
- palmitates of the coffee (cafestol palmitate & kahweol palmitate) enhance/intensify GST which is responsible for the removal of many toxic radicals from the bloodstream due to increased binding of reactive oxygen species to the sulfhydryl group of Glutathione. The increased activity of those enzymes ensures that free radical activity is greatly diminished and that the pathology-producing actions of carcinogens are blocked.
- the fluid of the enema itself stimulates the visceral nervous system, promoting peristalsis and the transit of diluted toxic bile from the duodenum out the rectum.
- because the stimulating enema is retained for upto 15 minutes, and because all the blood in the body passes through the liver nearly every three minutes, coffee enemas represent a form of dialysis of blood across the gut wall.
- the empirical finding that coffee enemas have an analgesic effect dates back to the First World War and this was reported upon by Prof. Meyer MD and Prof. Heubner MD at the University of Göttingen’s College of Medicine. A clinical study performed by Dr. Peter Lechner and colleagues showed that coffee enemas, performed twice a day, “reduced the need for pain medications by 71.3%, 59%, and 22%- respectively in cancer patients with WHO cancer pain level 1 (n = 91, P < 0.001), level 2 (n = 68, P < 0.05) and level 3 (n= 19 not significant due to small sample)”.
How does one do these coffee enemas?
Drop 3 rounded tablespoons of ground organic coffee into just over 1 quart / 0.96 litre of distilled or properly filtered water; let the solution boil for 3 minutes and subsequently simmer for 15 minutes more whilst covered; strain this solution and completely fill a glass container with the strained solution and let it cool to body temperature; use this solution for the purpose of a bowel infusion. Preferably the patient should lie on his/her right side to receive the coffee enema with the legs pulled up in a relaxed position (pillow in between knees); with the enema bag some 18 inches / 50 cm above the tube’s end, gravity forces the fluid into the sigmoid. Once fully infused (to tolerance) the enema ideally should be held for 12-15 minutes. Afterwards the patient gets up and simply evacuates the coffee enema into a toilet. Do not confuse the GST effect of a coffee enema with the assumed lithiasis evacuation of a liver flush which is definitely not a part of the Dr. Max Gerson MD protocol.
The single biggest worry of patients contemplating the coffee enema procedure is “will I make a mess”
The concise answer to that is “no”. Nonetheless it is a good idea to do this very private procedure with somebody loving as a helper. Not just in case there is a slight slip-up, it simply is handy and comforting.
- You need “a bucket, a hose and a plug”, an open invitation to the DIY enthusiasts perhaps. There are warm-water-bottle type of enema kits but none are as durable as the stainless steel irrigator vessels. Use a PVC clear plastic tube in favour of latex ones if latex sensitivity is suspected. Make sure the rectal catheter can fit the tube. Such items are available on the internet.
- You have bought organic, ground (ideally green i.e. non-roasted) coffee, one source for this is www.realcoffee.co.uk. Your helper puts 3 heaped table spoons into 1 litre of distilled or properly filtered (a Britta filter is OK) boiling water, leaving it to boil for another 3 minutes without a lid on the pan. Next let it simmer for another 15 minutes with a lid on the pan, this stops further evaporation.
- To strain the coffee broth, it is easiest to pour it through any manual coffee filter e.g. a Melitta coffee filter device lined with unbleached filter paper. Both can be bought from most kitchenware shops. Top-up the filtered coffee with lukewarm distilled/filtered water to come to 1 litre again. Straining also can be done with an ordinary straining cloth of course. The purpose is to make sure the enema fluid does not contain any ground coffee.
- Whilst your helper is doing the coffee stuff in the kitchen you are getting yourself ready. On the floor within short walking distance of a toilet you put a comfy, thick layer of foam (summer chaise cushion perhaps) on top of which you put a plastic sheet and on top of that a bath towel.
- You undress your bottom half and lie on your right hand side with your knees pulled up towards your chest. It is very comfortable to put a pillow in between your knees. Your head is on your regular pillow. Have another towel ready to keep your legs warm.
- In the meantime down in the kitchen your helper checks the now-filtered-coffee in the jug for body temperature by stirring it with a clean index finger – a sure way to find out. Our enema kit is a stainless steel bucket which has a 1.5 metre hospital quality rubber hose attached to it with a stop-cock + a small rectal tip. Quite frankly that stop-cock is a pain in the posterior (no pun intended) for twisting whilst that tip is inserted in your anus. It is much easier simply to bend the hose double to stop the flow.
- Whilst holding the rectal tip higher than the bucket your helper pours the body-warm coffee into the enema bucket. Next a dollop of K-Y Jelly is spread everywhere over the tip. Now he or she holds the tip lower than the bucket to let the coffee flow (into the toilet or a sink). When it does (i.e. no more air in the hose) the hose is bent double immediately to arrest the flow. Everything is now ready for the enema infusion.
- It is often easiest for the recipient to insert (1″ – 1.5″) the tip into his/her anus, it is no different from the old thermometer routine when you were a child. Of course there is nothing against your helper doing it. Gently does it of course and the K-Y Jelly makes it very easy. Be especially gentle with people who are known to have haemorrhoids (or are suspected to have them) and people with anal prolapses.
- The tip inserted into the anus may be held in place by the recipient of the enema or by the helper. It may be asking for trouble if you don’t. Next the helper takes the kink out of the hose and coffee should start to flow providing the bucket is at least 50cm higher than the tip. It is not always easy to feel so you can either hold the bucket higher (max 75cm) to increase the pressure or move the tip a little, its opening may be against something.
- You will feel several things: a) your anal sphincter (that circular muscle in your bottom holding your bowel content inside) contracts occasionally and this is perfectly normal b) the enema infusion may give you the feeling as if you want to fart; actually this is the last thing you want to do as otherwise you’ll be mopping up for hours c) you’ll gradually feel pressure building up in your tummy and this you must communicate to your helper who must stop the flow if the pressure is uncomfortable. Relax and restart infusing when you are ready for it.
- At all times the enema must be comfortable, so infuse as quickly or as slowly as feels comfortable. Because of the little height difference (50-75cm), the small opening in the rectal tip and the only 1 litre of coffee, there never is an issue of putting too much pressure on the bowel wall. This is one of the criticisms of high colonics that does not apply to coffee enemas.
- You ingest as much of the 1 litre as you are comfortable with. Let it happen, consciously relax your tummy, just don’t relax your anal sphincter. I make it sound as if you should worry about this. Don’t, your ‘sub’conscious remains focussed on that sphincter. So there is no stress.
- Once you have achieved full infusion (over several sessions build up to the 1 litre if you cannot take all in the first session) your helper slowly & gently pulls out the rectal tip. Whilst he or she does this you will naturally pay a little more attention to that sphincter. Now you rest on your side for 12-15 minutes. It is useful to read something or, if you have a chatty helper, chat the time away. In the absence of a chatty helper there is music that relaxes you.
- Time is up and you need to get up. The easiest way is to get onto hands and knees first (this position is like the cat in yoga) and then to rise further. It truly comes naturally to be aware of your sphincter at this time. There is unlikely to be desperate urgency for bowel evacuation. So you have time to walk to the loo, sit yourself down and then relax.
- Explosive evacuation is what will happen. My strong advice to you is to take ample time for the evacuation phase. Massage your tummy firmly in circles from the lower-right-side to the top-middle and then down to the lower-left-side. Massage also firmly from your sides to your tummy button. Also simply prod your tummy in places. All this activates the intestines and you will notice that, just when you thought it all done, there will be a little more to evacuate. But you also will know when the coast is clear. If you don’t skimp on time for evacuation then you are unlikely to have dribbles afterwards. So take your time.
- How will you feel afterwards? The awkward answer is that it completely depends on how you felt before. Often pain relief for those in pain, patients with a high level of blood toxicity may notice a temporary reaction like headache or a slight fever and all those temporary symptoms are to be welcomed. Perhaps you may feel something in the liver area itself. What is clear is this, GST cleanses the blood through the conjugation of at least four common blood toxins: polyamines, ammonia, toxic-bound nitrogen and free radicals all of which cause intracellular and cell membrane damage. Repeated coffee enemas aid markedly in healing people who are unwell. Do not draw a conclusion after just one coffee enema, do seven in a row and then review your symptoms. Gerson Institutes may do 4 daily within the context of their protocol, many of my patients do only 1 a month. Frequency depends on clinical status.
- From both books on the Dr. Max Gerson MD Therapy it is clear that the coffee enema is part of a package, one aspect of which is optimal nutrition. A coffee enema makes Glutathione-S-Transferase (GST) some 600-700% more effective. The biochemistry behind it however demands as a minimum the in-ratio presence of L-glutathione (100-200mg daily), L-methionine and cysteine (NAC 50-350mg daily), ample selenium (200-400 mcg of selenomethionine) and vitamin C (6,000-10,000mg/day of ascorbic acid providing this does not cause osmotic diarrhoea!) and a good high dosage vitamin B Complex. Just to name a few. Dr. Gerson achieved this by a diet bombarding the body with readily assimilable nutrients.
- It must be obvious that detoxification must at least go hand in hand with the elimination or very much reduced intake of anything that your body cannot handle i.e. that what constitutes a toxin for it.
Neither the author Han van de Braak BSc LicAc MCSP MBAcC (Retd) nor anybody working for or on behalf of Santé Franglais Ltd. can be held liable for any ill effects suffered as a result of incorrect execution or inappropriate application of the coffee enema or inappropriate application of the advice mentioned in this web page.