If you suffer from poor brain function or chronic gut health complaints, you may benefit from performing regular coffee enemas to improve communication between the brain and the gut.
Central to communication between the brain and the gut — called the gut-brain axis — is the vagus nerve. This is a long, meandering nerve that extends from the brainstem down to the major organs.
In functional medicine, we use a variety of exercises to improve vagal nerve function and thus communication between the brain and the gut. However, one of the best is the coffee enema.
The idea of doing an enema makes some people squeamish at first. Once you learn how great they can be at improving the gut-brain axis, you may find this motivates you to give it a try.
Many people report they feel more relaxed and clearheaded afterwards. This is likely due to stimulation of the parasympathetic, or “rest and digest” arm of the autonomic nervous system.
How the brain-gut axis governs gut health
The vagus nerve meanders from the base of the brain to the major organs, serving as a communication pathway to and from the brain.
This pathway is known as the gut-brain axis or the brain-gut axis, and is bi-directional, meaning communication travels in both directions. The brain talks the gut, and the gut talks to the brain.
Through the vagus nerve, the brain plays a major role in gut health, including:
- Movement of food through the intestines (motility)
- Release of digestive enzymes to break down food
- Regulation of blood flow that carries oxygen, nutrients, and immune cells to support gut health and repair
How poor brain health leads to poor gut health
Poor brain function leads to poor gut health. When the brain ages, degenerates, is injured, or otherwise becomes impaired, total output to the vagus nerve decreases. As such, the organs do not receive enough neurological input to function properly. Think of poor water flow through a hose.
This can cause such gut health problems as:
- Difficulty digesting foods
- Constipation or irregular bowel movements
- Bloating and gas
- Abdominal distention and discomfort after meals
- Food intolerances
- Difficulty swallowing supplements or large bites of food
- A gag reflex that is either too sensitive or under active
One of the earliest signs of poor brain function is poor gut health
Frequently, the gut can be one of the first places poor brain function manifests.
Declining memory, an inability to find words, difficulty learning new things, and brain fog are often accompanied by increasing difficulty digesting foods, constant bloating and gas, or alternating constipation and diarrhea.
In fact, Parkinson’s disease has been found to affect the gut before the brain. Chronic constipation occurs years before a Parkinson’s patient develops tremors. Medicine is now acknowledging chronic constipation as a possible early warning sign of Parkinson’s.
If your gut symptoms are getting worse, you need to take your brain health seriously.
It may not be Parkinson’s disease, but it certainly suggests possible early brain degeneration and declining function of the gut-brain axis.
How poor gut health can worsen brain health
Just as poor brain health can impact the gut, so can poor gut health worsen brain function.
The gut uses chemical messengers to send messages to the brain along the vagus nerve. These chemicals influence the brain’s immune system and its neurotransmitter activity.
When the gut is healthy, these messenger proteins can enhance memory and learning. However, when the gut is inflamed and unhealthy, these messengers are linked to:
- Depression and anxiety
- Parkinson’s disease
- Memory loss
Have you ever become bloated after eating a certain food, and then noticed you’re also suddenly irritable, depressed, or brain fogged? This is an example of how your gut can affect brain chemistry.
I write more about the vagus nerve and the gut-brain axis in my brain book.
Exercise your vagus nerve with coffee enemas
In functional medicine we use a variety of exercises to make the vagus nerve stronger. Like muscles, neurons need constant stimulation to stay healthy and strong.
If you break your arm and wear a cast, those muscles shrink within a few weeks from reduced activity. Neurons are the same. Without regular “exercise” they lose function.
Vagal exercises are easy to perform at home. I commonly prescribe these exercises to my patients who have poor vagal tone and gut-brain axis failure:
- Gargling aggressively several times a day
- Stimulating the gag reflex with a tongue depressor on the back of the tongue several times a day
- Singling loudly several times a day
- Coffee enemas several times a week
The first three of these exercises activate tissues in the back of the throat that are connected to the vagus nerve.
How do coffee enemas stimulate the vagus nerve?
When the enema distends the intestines, this activates the vagus pathway.
I also tell my patients to hold the enema to the point where they have to work hard, like holding a plank, as this powerfully stimulates the vagus.
Start with a diluted mixture and gradually increase the strength of the coffee. Stronger coffee activates cholinergic receptors, nerves that the brain chemical acetylcholine activates. It also stimulates nicotinic receptors. Activating these receptors stimulates the vagus nerve and the parasympathetic nervous system.
Most people are in sympathetic dominance these days. This is the “fight or flight” arm of the nervous system. Activating the vagus nerve and hence the parasympathetic nervous system enhances not only gut health but also the ability to relax and focus.
Many people notice coffee enemas improve bowel function over time
Many people notice their bowel function improves over time and they can wean off the coffee enemas.
This is because the enemas improved their vagal system pathways.
Unfortunately, brain degeneration outpaces the ability to make permanent changes in some people. In this case, coffee enemas can be used to remedy constipation, which raises the risk for bacterial buildup, leaky gut, and toxicity.
What about the caffeine?
If you are sensitive to caffeine, coffee enemas likely won’t be a concern for you. While on rare occasions caffeine-sensitive people feel an effect, studies show that the bioavailability of caffeine during enemas is 3.5 times less than that of drinking coffee.
If you are sensitive to caffeine, start with 1/2 teaspoon of coffee grounds in the solution earlier in the day and see how your body responds.
How to perform a coffee enema to improve vagus nerve function
Timing and setting of the coffee enema
Try to do the enema when you won’t be disturbed for at least an hour.
To make it more comfortable and more effective, make sure to time it just after your daily bowel movement.
Coffee enema preparation
Make one to two cups of organic coffee (non-organic can contain toxic pesticides).
Some people can handle up to 2 TBS of coffee grounds per enema, but if you are new to enemas or highly sensitive to caffeine, start with 1/2 teaspoon and slowly increase the concentration as you’re able.
The stronger the coffee, the more stimulating it is to the vagus. Filtered or distilled water is best.
Boil the coffee for about 10 minutes and strain out the grounds.
Let the coffee cool to room temperature
Make sure the coffee is cool enough to put your entire hand in the coffee for a full five seconds comfortably.
The tissues inside the intestines are very sensitive to temperature; never use hot coffee!
Which coffee to use
- Use organic coffee to avoid exposure to pesticides.
- Avoid decaf, flavored, very oily, and light or gold roasts.
- Avoid instant coffee, as most tested showed presence of gluten. However, I have my busier patients use Starbucks instant coffee. It is the only instant brand we’re aware of that is gluten-free, although it’s not organic.
- You can find coffee online made specifically for coffee enemas.
If you can, grind your own beans right before the enema. Oils in pre-ground coffee can be oxidized and go rancid. If you use pre-ground beans, store them in the fridge to keep the oils fresher.
Instructions for performing a coffee enema
1. Lay in the tub or spill-proof the floor
As a beginner “spills” can happen, so perform your enema in the bathtub or with a towel under you to protect the floor.
2. Make sure the hose clip is closed
Make sure the enema bag’s hose clip is closed (keep it at the end near your body) and fill the bag with the cooled coffee.
3. Release air from the tube
Release any air from the tube by holding the bag over the sink with the tip slightly lower and letting liquid flow until the air bubbles are gone.
4. Hang the enema bag or bucket 2–4 feet above you
Hang the enema bag or bucket so it’s 2 to 4 feet above where you will be laying down. The end of the hose must reach your body easily. But if you hang it too high gravity may produce more pressure than is comfortable.
5. Lubricate the enema tip and insert into the rectum
Lubricate the plastic hose tip with a lubricant such as KY jelly or olive oil. Traditionally people have been instructed to lie on their right side so the coffee solution can better access the portal vein to the liver, however experiment with whichever side works best for you. Fold your knees toward your abdomen and gently insert the tube a couple inches into the rectum.
6. Use the hose clamp to slowly release the enema solution
Release the solution slowly from the tube into your body, controlling the flow with the hose clamp. You may experience some cramping and urgency to eliminate as the liquid moves up into the intestines.
If you cramp, close the clamp to stop the flow, and take some deep breaths. Cramping typically passes quickly. Once the cramp is gone, gently open the clamp again.
The presence of gas is the main reason some people have trouble holding a coffee enema. If you have gas that is making it difficult to hold the enema, you can leave the enema tip inserted — the gas will flow out the tube and this makes it easier to hold the enema.
4. Hold for 5 to 15 minutes — working to hold it in activates the vagus
You may have urges to have a bowel movement, but relax and hold the enema for 5 to 15 minutes. Working to hold in the liquid is what most benefits the vagus nerve. Don’t be discouraged if you can’t hold the liquid for long in the beginning and experience leaks. It’s quite common and you will get better at it.
For some, leaving the plastic enema tip in the rectum assists in preventing leaks.
If it is easy to hold in, this means you can strengthen the concentration of coffee next time.
Take in as much of the liquid as your body will allow. Two cups is an average, everyone is different, and your ability to hold more will improve with practice.
Once the time has passed, move to the toilet and release the liquid.
5. Post-enema cleanup and care
Separate the enema bag and hose, rinse them thoroughly, and wash the plastic tube tip with hot water and soap.
If you use a stainless steel enema bucket, wash it with soap and water to prevent the acidity of the coffee from degrading the metal.
Some people like to run some hydrogen peroxide through the bag and hose after washing it. If you do so, make sure to rinse it well with water afterward so no peroxide goes into your intestines the next time.
Hang the hose and bag/bucket in a warm dry place until they are completely dry. Store in a dry location.
Tips and common issues with coffee enemas
To best activate the vagus nerve, the enema should be very difficult to hold so that you suppress the urge as long as you can.
If you are sensitive to coffee, use weaker coffee so you can hold it longer.
As you become more experienced with enemas, use stronger coffee so that it is still challenging.
Clearing the bowels first with a water enema
Some people prefer to start with a water enema to clear the intestines so they can hold the coffee longer.
A mild saline solution of 1 tsp salt to 2 cups water is ideal. However, you can also use filtered or distilled water. It is best to avoid tap water.
Learn more about vagus nerve health in my brain book and food sensitivity course
I write in more depth about vagal nerve function in my brain book, Why Isn’t My Brain Working? In addition, I invite you to check out my online brain health course, Save Your Brain — the Six Week Rescue Plan. The course guides you step-by-step through the same brain health strategies that I use with my patients.
If you are on an elimination diet for chronic illness, have leaky gut, or suffer from unexplained food intolerances, I invite you to take my self-paced online course, The 3D Immune Tolerance Program: Steps to Restoring Oral Tolerance. In the course you will learn what oral tolerance is, what causes its loss, and the role it plays in recovering from or managing chronic illness. You will then learn how to improve your oral tolerance so you can eat a wider variety of foods, and what factors can thwart attempts to recover oral tolerance.
Hi Doctor, very effective and encouraging article. Thank you so much
Thank you for the feedback. We’re glad you found it useful.
What is the temperature range of the coffee water for an enema? How frequent can/should a coffee enema be done? Thank you.
We don’t have a numbered range, but in the article it does state: “Let the coffee cool to room temperature. It’s very important that it be cool enough to put your entire hand in the coffee for a full five seconds comfortably; the tissues inside the intestines are very sensitive to temperature.”
Test it with your entire hand, not just a fingertip – it must be comfortable on the tender parts such as the inner side of the wrist.
Frequency of coffee enemas depend on the patient’s needs. Some do multiple enemas daily (such as cancer patients), some daily, some weekly, etc. In Dr. Kharrazian’s brain health course, a lot of the members start with daily and see how they feel. It’s more important to do a relaxed, quality time span less frequently than a rushed, inefficient time span daily.
Can you use coffee that doesn’t say “organic”?
Can you follow with a water enema after a few hours to restore ph balance in the gut?
How often can you do an enema?
You can use any coffee you choose, but it’s strongly recommended to use organic due to the increased chance of exposure to pesticides with conventional coffee. Personally I would not worry about following with a water enema; and if I did, I’d make a mild saline solution. You can find more about that online. The frequency of enemas varies depending on the patient’s needs. Some cancer patients do them daily. Others do them daily, weekly, or less frequently.
From a professional barista, putting coffee in the fridge or freezer CAUSES IT TO GO RANCID. Do NOT do this.
Also, the author clearly has little care for their patients if they suggest using STARBUCKS instant coffee, as pesticides are prolific and this does more harm than healing, also they over-roast (ie BURN) their beans, which makes them highly carcinogenic (see the CA PROP-95 warning Starbucks legally must alert the public to).
While the information for mental health is helpful, I had to discredit this article and fact check it. The author clearly didn’t and is sadly lazy, to the detriment of their readers.
Great advice! Thank you!
Why do you say avoid light roast? I thought light roast is what you want to use since it has higher caffeine content.
I’m also interested in getting the answer to this question. Thank you,
It is. But make sure you use the light coffee only after adjusting your body to the dark coffee for some time. Light coffee can be really hard on the gallbladder. I HIGHLY recommend seeing a functional medicine doctor prior to doing a coffee enema, as FD’s treat to heal the entire body, and western med docs (like this one) don’t have time to do a lot of fact checking. There are bad stigmas in their community for naturopathy). Sad but true.
This doc is not trained in functional medicine. I hate that he’s giving false i formation. Also, make sure you don’t put the coffee in the freezer, it causes the beans to go rancid as well.
Is a plain water enema also effective in stimulating the vagus nerve in the same way as gagging and gargling? I’m not sure I feel comfortable about using coffee for enema but would be happy to use water if it still improves vagal tone.
A plain water enema may not be quite as effective for vagal stimulation, but the distension caused in the intestines will still activate the vagus nerve pathway.
Also, the act of attempting to hold the water for as long as possible activates the vagus. If you are new to enemas, keep in mind you will get better at the holding over time.
The coffee aids in stimulating the vagus but also stimulates receptors that cause the gall bladder to contract and encourages purging of toxins and metabolism end-products for elimination.
Some people find a plain water enema to be harsh for the system – what might be better is a slightly saline water solution (very mild saline solution is ideal: use a ratio of 1 tsp salt to 2 cups water, and use sea salt, not iodized salt).
I loved reading this. I have been looking for a more I depth explanation as to what really happens when doing a coffee enema. All the more reason to do them! Thank you<
I’ve done coffee enemas for years. I’ve found that if the solution is significantly below body temperature my colon does not relax to allow the solution to travel and it causes unpleasant pressure in the descending colon. “room temperature” in my experience is too cool. It should feel warm on your wrist. Regarding frequency, I’ve found that daily is too frequent. It seems to wash out too much of my microbiota and I develop constipation.
I am glad you mentioned this Mark. I had the same experience. You would think author would cover this too. I was regular with healthy bowel movements before and coffee enemas I have messed my guts for years 🙁 I had tried this “remedy to heal autoimmune illness”. It made it all worse I am afraid and 6 years later I still struggle with this.
Me too. I developed constipation after doing coffee enema for a year 2-3 times a week. We’re you able to resolve your issues? Tnx , Vera
Thank you, helped explain everything I need to get started.
Glad to hear it!
How often should this (enema coffee) be done? Could it be daily? Thank you for valuable information.
GREAT information! This is much more comprehensive than other things I’ve read & it’s boosted my confidence going forward. I just did my first coffee enema yesterday & I certainly learned I need to make some adjustments!! Haaha My ingredients seem just fine but several steps to be tweaked now, should get me on a far more effective track! Btw, my purpose is for liver damage “fixing”; any tips appreciated!!
Two things: 1) I am surprised I need to boil the coffee for so long…6–8 minutes of actual boiling time??
2) I previously read to strain my coffee through cheese cloth & not a coffee filter to allow certain oils to come through & be more effective. Do you concur? (And I’ve folded my cheese cloth over once to filter – good?)
— J Sam
I believe the coffee is boiled longer than you might steep/boil for drinking to extract more of the elements that impact clearance of toxins from the body.
As far as oils, that seems to be up for debate, but I’ve never actually heard Dr. Kharrazian address it. If you go online and peruse various purported expert websites on coffee enemas, you will find vastly different opinions on dark vs light roast, as well as a number of other topics (google up L. Wilson and Gerson, for example).
Some say to avoid very oily coffee because excess oils can lend to excess amounts of rancid oil in the coffee, which can contain toxic free radicals. I do not know if more oils would come through more easily via cheesecloth than a filter, or how they apply to the topic of free radicals. Others strictly recommend light or green beans.
Personally, I always use organic beans that are as fresh as possible, grind the beans just before use (pre-grinding can expose more oils to the air which will potentially increase rancidity and levels of free radicals) and I don’t strain it – I just carefully pour the liquid off the grounds and stop before the slurry drains with it.
For patients with severe brain degeneration, sometimes it is done daily. For average issues, Dr. Kharrazian recently mentioned it would be less often.
This is very interesting. I knew this kind of enema and did it many times. Here in France, a Naturopath doctor (Michel Dogna) recommended we use green coffee.
In your article, you do not precise if it is green coffee I just guess it is roasted coffee as
Yes, there are vastly differing opinions on whether to use green/light beans or a darker roast, each with their reasons. If you look up Gerson vs L. Wilson you can find those arguments. I have not heard Dr. Kharrazian mention green or light roast in particular. He is more concerned with it being organic to avoid pesticides, and that the roast is not overly oily, since excess oils can increase the levels of toxic free radicals in the coffee, which of course would be introduced to the body.
Personally I have found that although “water is warm to the wrist” or other methods are certainly better than nothing, a good quality food or beverage thermometer is easier to use and more accurate. I prefer enemas that are in the 100 F – 103 F range; less and the last of the solution in the bucket/bag may end up a bit chilly which is a cause of cramping. Conversely I think that higher temps destroy more gut bacteria but am not sure of that ( solution temps being too high will cause physical harm of course).
Although I have done enemas in the past with only two coffee enemas “under my belt”, additional ones will contain the opportunity to learn more.
Great tip, thank you!
Wondering if an article can be written to address the posed health risks and concerns regarding coffee enemas? Presented concerns online and in the media include sepsis, proctocolitis, and severe electrolyte imbalances (and possible death). I understand they are uncommon, however, additional information and references on the safety of coffee enemas would be great and useful for those who wish to defend the practice. Thanks!
Uncommon being the key word here.
There’s a reason the media and medical industry frown upon this sort of practise – illness generates money. Medication generates money.
As long as you use sterile equipment, organic coffee and filtered water you should be fine.
Replacing electrolytes can be done easily with a homemade drink of lemon juice, honey and sea salt.
can i make the coffee in my coffee maker?
If you make the coffee in your coffee maker, it will likely not be nearly strong enough. The recommendation to boil it is to increase the elements in the coffee that help stimulate the vagus and other pathways.
Hi Susan (Admin)
Thanks so much for such a detailed instruction on coffee enema. I have experienced doing this for 10 days continuously as I have serious problems with Increased bloating and gas for 3 years. I found it rather work well and the symptom is improving except being so thirsty and a having a desire for eating something sweet though I have supplied my body with enough water/juice to the body. Is this a side effect of coffee enema called dehydration? Can you help give some advice for my case? Thanks so much.
I’m sorry, but I don’t know what to tell you in this case. If you have long-term issues with bloating and gas, it’s not likely enemas are going to fix the actual root cause (which can be varied… SIBO, food reactivity, etc.). In your shoes I’d seek care from a qualified functional medicine practitioner who can help determine what’s behind those symptoms (and the sugar cravings).
Thanks so much for your reply. Best regards.
The sugar cravings are the bad bacteria in your gut screaming to be fed. Starve them. Feed the good bacteria with nutrient-dense, polyphenol rich foods that don’t contain sugar. Add a good probiotic to reinforce the good bacteria. Suffer through the withdrawals for 4 days to a week, and your cravings will be eliminated or greatly reduced. Do the mental work to program yourself to not want sugar.
I learned long ago that you should always drink lots of water when undergoing coffee enemas. What you describe in terms of thirst is totally fine. I am someone who rarely feels any sense of thirst even in the middle of summer, but I always know that it is important to drink a good amount of water when doing coffee enemas, not only for the purpose of hydration, but also to help flush toxins out of your system that can be drawn out by the coffee enema. I can’t comment about sweet tooth.
Same. It helped me with breast implant illness symptoms. My problem was after enema, my skin would be soo dry and I would pee a lot. I feel it was dehydrating me. when I stopped enema, I developed constipation. 🙁
I was taking supplements to help body.
Amazing read. I just purchased your book on Amazon and I’m loving it.
I’ve been doing 2 coffee enemas a day for a week and I already feel like a new person.
Organic Coffee + Filtered water.
What’s the issue with tap water if you’re boiling it first? Does that not kill off unwanted bacteria & evaporate the chlorine?
We need more people like you in the world. Thanks again
Glad you are reading the book. Regarding filtered/purified water: Depending on your water source, chlorine may not be the only compound in the water that’s worth removing.
There are many benefits to coffee enemas and I felt amazing. HOWEVER, there was one significant drawback to using them regularly. My cholesterol skyrocketed. For people with heart issues or cholesterol problems it is something you should be aware of and monitor. The culprits are found in the coffee oils known as diterpenes, the main ones being cafestol and kahweol. The only way to reduce or eliminate these two cholesterol raising ingredients is by using a simple paper coffee filter. Yet, my understanding is that these two ingredients may be essential to obtaining the benefits of the coffee enema. This is something I have been wanting to ask Dr. Kharrazian about for a while, but have never remembered to ask him when I had the chance. Would there still be a net-positive effect if one were to use caffeinated coffee but filter the coffee through a paper filter before administering the coffee enema? Thanks!
That’s an interesting question. I’d like to see if we can ask him at one of his upcoming Facebook Live talks on Thursdays. Do you attend those? His next talk is in early January, and the next few topics are on gut function. If you aren’t on the notification list for the talks, you can join the email list on his website home page.
For those who notice their bowel/gut function improve, how would we know when is the time to wean off coffee enemas? Any typical range you see with patients about when they start noticing improvements and wean off? Weeks/Months? and any guidelines on frequency?
There is no guideline as it really depends on the person. Some may have degeneration advanced to the point that they don’t recover full motility. A good strategy would be to wean off or take a break and see how your body responds.
I have done coffee enemas almost daily for a little over a decade. Although I love coffee enemas and the way they make me feel and are so great for detoxification, I think the coffee enemas may be the reason for an issue I have been having for the last 5 years or so called hemifacial spasm which is involuntary movement of the facial muscles on one side of the face. It’s gotten progressively worse so I’ve started doing research which has led me to this article. I’ve read that the spasms can be caused by pressure to the facial nerve and have also read about issues with the vagus nerve I’ve stopped doing all coffee enemas over 3 weeks ago hoping this would alleviate my symptoms which I’ve seen nothing yet but it’s still early. Is this something you’ve ever heard of or is there somewhere you could direct me to do more research on this? Thank you!
You may want to look into being evaluated by a functional neurologist and/or using Cyrex Labs to be screened for neuroautoimmunity and dietary and chemical immune triggers.