A salt water flush is a traditional cleanse that washes material through the digestive system. It can be useful when constipation is a problem and may help to loosen impacted feces in the colon. In my view it also seems promising as a way to help combat SIBO when used in concert with intermittent fasting and gut rest. The idea is that it would help to flush out excess bacteria during a period when food is not being consumed. It will also complement the body’s natural migrating motor complex – a periodic peristaltic action that strips leftover material and bacteria from the gut.
The idea of the salt water flush is to create a solution of salty water which has the same concentration of salt as the body’s normal plasma. When this is consumed it is in osmotic balance with the blood, and so the water is not drawn in either direction across the gut wall but remains in the lumen. The salty water remains inside the gut where it mechanically pushes through the length of the intestinal tract until it is expelled in a bowel movement, taking residual digested material along too.
We are often warned about the dangers of salt. It may seem that doing this flush means that a person is over-consuming salt, but in fact the salt solution used has the same concentration as normal saline which is given to people intravenously for hydration purposes at the hospital. Ideally the salt water flush is not absorbed but travels through the whole length of the gut and is expelled. In addition, this is not chronic salt consumption but an occasional procedure.
In many ways a salt water flush is healthier than taking osmotic laxatives such as milk of magnesia, polyethylene glycol, or stool softeners. These laxatives work by disturbing the osmotic balance and drawing fluid through the gut wall. This can lead to dehydration and loss of electrolytes because fluids and ions from the blood are dumped into the colon and expelled. However the downside of a salt water flush is that it can be uncomfortable and requires quite a lot of preparation for good results.
Here is the procedure:
- The first important step is to refrain from eating for some considerable time before doing the flush. Ideally you should fast for around 8-12 hours. The gut must be fairly empty in order to avoid retaining the salt water. It is a mistake to try to do a salt water flush to clear out some food, blockage, or bloating in the upper gut. What will happen is that the salt water will sit for hours making you feel very uncomfortable. I have personally made this mistake and retained the water for up to 12 hours. Eventually it may be absorbed in this situation which is not ideal. Therefore make sure that you haven’t eaten for quite some time before the procedure and are hungry. A good formula is to have an evening meal, skip breakfast the next morning, and then do the salt water flush in the afternoon.
- Get a mason jar with a screw top lid that holds one quart (1 liter) of water. Fill this full with warm, but not hot water. Warming the water makes it easier to drink and helps to dissolve the salt more rapidly.
- Add 9 grams of salt (about one teaspoon). Adding a little more salt gives a more aggressive action but the amount specified here is the right weight to make an isotonic solution that matches the saltiness of blood plasma. The type of salt is not critical, but I prefer a good quality sea salt over table salt. If you powder the salt it will dissolve more rapidly.
- Put on the lid and shake the salt solution strongly until it has all dissolved. Make sure to shake the mason jar before consuming it because otherwise the saltiest region will tend to stay at the bottom and so you will get an uneven concentration.
- Drink all the salt water over a period of about 30 minutes. It’s important not to consume it too fast otherwise severe discomfort can ensue. Take medium mouthfuls every few minutes as you feel like your body can take it, but try to consume it all within the allotted time otherwise the mechanical pushing action will be ineffective.
- Once you have consumed this solution you will feel it gurgling through your belly. It is advisable at this point to stay still and rest for up to an hour. Do not engage in strenuous activity. A friend of mine drank the salt water and then went out for a jog. Not surprisingly he vomited it up fairly quickly. Do not do this.
- After about 1 to 2 hours you should start to get bowel movements as the liquid is expelled. If the process takes longer do not worry. If you are unfortunate it can be retained for a number of hours, or overnight, but this is less likely if you have not eaten recently. Good luck!