Colonic lavage (or colonic irrigation) hygiene standards

Colonic lavage/colonic irrigation or colonic hydrotherapy uses water to cleanse the colon. This practice does not penetrate the skin however it is an invasive treatment which carries considerable risk if not undertaken by a trained professional who practices good infection control.

Last updated: 10 August 2011

What is colonic lavage?

Colonic lavage or colonic hydrotherapy uses water to cleanse the colon. This practice does not penetrate the skin however it does deal with other body substances able to transmit infection. For this reason therapists must have adequate knowledge about the treatment and techniques of the procedure, as well as knowledge on infection control and minimum hygiene standards. The following recommendations are made to help achieve these standards.

Premises

All colonic lavage premises must be registered with the local council. The register is to be made available for public viewing.
The premises must be in a clean and hygienic condition at all times.
A hand wash basin with hot and cold running water is required in the premises and is recommended to be in the treatment area.
Soap or other hand cleaning substance is required to be at the hand wash basin.
Paper towel or other single use hand drying equipment is required to be at the hand wash basin.
The construction of the premises should meet with local council requirements.
The finish on all surfaces within the treatment area should be made of materials that are easily cleaned.
Fittings in the treatment area such as benches should be cleaned between each client and/or a clean covering placed over the treatment surface.
Adequate lighting is recommended.
A toilet must be available in the immediate vicinity of the person undergoing treatment.

Personal Hygiene

Colonic therapists must wash their hands before and after attending a client.
A clean gown or apron must be worn while conducting a colonic lavage treatment.
If a therapist has a cut or open wound on their hands or fingers especially, they must cover it with a waterproof sealed dressing.
Single use gloves must be worn by the therapist during the procedure.

Equipment

All equipment must be cleaned between uses.
Equipment that is designed to come in contact with blood or other body substances must be sterilised before it is used and it must be maintained in a sterile and clean condition. (See fact sheet "Sterilisation information for the skin penetration industry")
If equipment is sterilised on the premises the details of the sterilisation process must be recorded.
It is recommended that the date of sterilisation be put on sterilisation packages after sterilisation is complete. Care must be taken to not puncture the bags.
Where possible use single use equipment, such as tubing and catheters. These items should be disposed immediately after use.
It is recommended to regulate the water used in the treatment so it is as close as possible to body temperature to prevent thermal shock and scalding.
All new hot water installations must deliver water at the outlet of all sanitary fixtures used primarily for personal hygiene purposes at a temperature not exceeding 50^oC.
If a thermostatic mixing valve is used to mix hot and cold water, it must be approved by the Department of Health, installed and maintained in accordance with the Public Health (Microbial Control) Regulation 2000 and the premises registered with the local authority.
The installation of the colonic treatment device must meet the requirements of the NSW Code of Practice - Plumbing and Drainage, Edition No 1 July 2006.
All toilets or wastewater disposal devices must be connected to the sewer.
All colonic irrigation systems must have a physical air gap from the water supply, which meets the specifications of the local water authority. This is to prevent backflow into the potable supply.

Procedures

A person conducting colonic lavage or colonic irrigation should have adequate knowledge about all the procedures. Knowledge of what to do should an accident occur is also recommended.
A staff training and operational manual should be provided.
All necessary equipment should be set up just prior to starting the procedure.
Single use lubricant sachets and applicators should be used to dispense lubricants.
Sterile packaging should only be opened when ready to start the procedure. (preferably in front of the client)
Sterile equipment should not be handled unless sterilised gloves are worn. Single use gloves have not been sterilised unless specified.
If the procedure is interrupted, gloves should be removed, hands washed and new gloves put on.

After Treatment

Single use gloves should be disposed immediately after the procedure.
Single use equipment must be disposed of after use.
Equipment such as benches and/or beds must be cleaned after a procedure.
Used linen must be cleaned after completion of treatment.
Any reusable equipment that comes in contact with blood or body substances must be cleaned and sterilised before it is reused.
Details of the sterilisation process must be recorded.
Other equipment used in the procedure but has not come in contact with blood or other body substances must be cleaned immediately after treatment.
All waste should be bagged appropriately and disposed daily.
Clinical/biohazard waste must be disposed by an approved waste contractor. Contact your local council for details.