Colonic lavage (or colon irrigation) hygiene standards

Last updated: 01 October 2003

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 or colonic irrigation 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 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 basin.
• Paper towel or other single use hand drying equipment is required to be at the hand 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 using an open system, while the toilet must be in close proximity to the room where the treatment is undertaken using a closed system.

Personal Hygiene

• Colonic therapists must wash their hands before and after attending a client.
• A clean gown or apron must be worn while conducting treatment using an open system.
• A clean gown or apron made of water proof material must be worn by therapists conducting treatment using a closed system.
• If a therapist has a cut or open wound on their hands or fingers especially, they must cover it with a waterproof 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.
• 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 autoclave bags 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 2 July 1999.
• 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

• Although not a legal requirement it is recommended that a person under the age of 18 years have parental or guardian approval prior to undergoing treatment.
• 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.
• 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.
• Sterile equipment should not be handled unless sterilised gloves are to be 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 has come, and is designed to come 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.

Related links

• Guidelines for skin penetration  http://www.health.nsw.gov.au/resources/publichealth/environment/general/guidelines_skin_pen.asp
• Skin penetration code of best practice  http://www.health.nsw.gov.au/resources/publichealth/environment/general/code_of_practice.asp