WAACH: Facts

Brief summary of history of colon hydrotherapy in WA State


Before 2007 – Colon Hydrotherapy has been traditionally taught in Naturopathic Medicine Schools and trade schools and performed by trained technicians or ND’s with NO complaints of harm in WA State.

2007- 2009 – DOH identifies colon hydrotherapist who is practicing medicine, signing his name Dr. Yow, and attempting to cure disease and diagnose medical conditions. The DOH successfully charges the provider,  “Dirk Yow’s practice of colon hydrotherapy is the practice of medicine.”  

2009 – Following the Court case and a sunrise review ordered to determine if the colon hydrotherapy industry was fiscally viable for licensure, the DOH pursued multiple complaints of “practicing medicine without a license” on independent technicians in WA State.  These were NOT complaints of safety concerns or harm. These complaints were dismissed, and resolutions were put in place to establish informal regulation of the service providers. 

After allegations of practicing medicine without a license were dropped, the DOH legal team leadership (Kristi Weeks – Director of Policy and Legal Affairs, Karen Jensen – Assistant Secretary of State), Representative Tami Green, and WAACH (Washington Association of Colon Hydrotherapy) also worked on House Bill 2004 to ensure the service would be provided safely by unlicensed providers, and access to Colon Hydrotherapy would not be drastically minimized. 

Ultimately, with agreement from the Washington Association of Naturopathic Physicians, the bill was finalized and passed 13:1 out of the committee but did not make it to the floor due to other prioritized bills. 

2009-2018 – Colon Hydrotherapy providers and ND’s have been operating according  to the resolutions set forth in 2009 with total compliance and safety and in “GOOD FAITH” with the DOH.  There are currently 70+ small businesses providing this therapy throughout WA State, including several ND clinics offering these therapies from trained and unlicensed service providers. 

2018 – 2019-  DOH issues complaints (internally generated) against several Colon Hydrotherapy providers across the state of WA for practicing medicine without a license for providing this therapy. The DOH also issues complaints against 2 Naturopathic Doctor’s for aiding and abetting those providers.  Other Naturopathic Doctors come under fire for having colon hydrotherapy in their clinics and for providing indirect oversight through prescriptive support for purchasing supplies.  Resolutions and good faith agreement from 2009 are not acknowledged by the DOH. 

It is determined that legislation must be finalized to ensure the future of these therapies and the livelihoods of those people providing the therapy.

We are deeply grateful to the DOH team of 2009 [Noteably Karen Jensen, Asst. Secretary of Health, and Kristi Weeks, Dir. of Policy and Legal Affairs] for their willingness to work through difficulties and to be educated by WAACH resulting in the thriving industry of today. We are also deeply grateful to Rep. Tami Green for living up to the votes that got her into office and truly looking out for the welfare of WA State residents and businesses. None of these people are still working in either the DOH or legislature, so the education and activism process must begin again.


The Colon Hydrotherapy industry is on the verge of a shut down, again (2009 being the last time). What does this mean? It means that the DOH is attempting to stop non-medically licensed practitioners from providing colon hydrotherapy services. This includes Naturopathic doctors being unable to delegate out this service to non-medically licensed practitioners. The DOH is attempting to limit the service to only be available through licensed physicians (Naturopathic Doctors (ND or NT), Osteopathic Doctors (OP) and Medical Doctors (MD). In WA state it is estimated that there are 3 clinics with NDs practicing colon hydrotherapy and colon hydrotherapy is considered a small portion of the work they are doing. At this point we are unaware of any OPs or MDs providing colon hydrotherapy.

It is estimated that there are 70+ providers providing colon hydrotherapy in WA State. This has become a serious threat to these professionals who will lose their livelihoods, many of them having practiced for 10-20 years, most (if not all) women. Thousands of community members around WA state will lose access to colon hydrotherapy and the cost of the sessions are estimated to increase 100-200% more to justify a doctor providing the service.

As of Aug 1, 2019 the DOH has advanced investigations on 8 non-medically licensed colon hydrotherapists throughout the state. The first 3 investigations are wrapping up with Intents to Cease and Desist (stop performing) colon hydrotherapy, threats to suspend credentials for massage therapy and fines assessed at $1000, $5000 and $10,000. All people under investigation are women as this is a female dominated industry. All of the complaints that initiated these investigations came from within the DOH and have nothing to do with safety or harm done.

NOTICE: All documents presented below are public record and are available through public disclosure requests that can be made directly to the Department of Health. WAACH retains all records in its archive. Full documents are presented here to attempt to keep the presentation as reasonably concise, as possible.

The DOH is taking the position that colon hydrotherapy is the practice of medicine without taking into full consideration the policy position it took in 2009 allowing unlicensed individuals to perform colonics without a medical license or medical supervision OR the fact that it co-wrote HB 2004 in 2009 supporting ND indirect supervision of unlicensed practitioners to provide colonics and that the bill received a passing 13:1 vote of support in the Legislative House Committee for Healthcare and Wellness overwhelmingly acknowledging the safety. Intensifying the problem is the fact that none of the DOH staff from 2009 are currently employed at the DOH. Current staff members are not acknowledging the previous good faith agreement to not pursue non-licensed providers of colon hydrotherapy unless there is a safety issue.

The DOH is substantiating its position that colon hydrotherapy is the practice of medicine based on the following:

  • (2008) State vs. Yow appeals court case, and
  • (Jan 2009) Sunrise Review opinion

Though the DOH continues to state that there is law, rule and/or policy that includes colon hydrotherapy in any scope of practice or states colon hydrotherapy as the practice of medicine it has yet to be identified in writing anywhere.

Miscellaneous NOTES:

  • The last government stance on colon hydrotherapy was from the DOH and it removed its position that colon hydrotherapy is the practice of medicine as confirmed by notices of correction, amended notices of correction and a stipulation.  The Amended Notices of Correction, removing colon hydrotherapy as the practice of medicine, was supported by Kristi Weeks (Dir. Of Policy and Legal Affairs) and Karen Jensen (Assistant Secretary of Health) with collaborative support from Representative Tami Green.
  • 2009 Emails related to the above activity to/from Kristi Weeks, Karen Jensen, Rep. Tami Green and the WAACH lobbyist at the time are in WAACH’s archive.   In one email it was stated that Rep. Tami Green “also questioned the authority of the DOH to take these actions, especially since the Sunrise Review has not been formally adopted, and that the agency does not appear to have a rule finding it to be the practice of medicine.“
  • In 2009 the “Aiding and Abetting” threat was also presented and then removed by the DOH.
  • There is no law stating colon hydrotherapy is the practice of medicine.Colon Hydrotherapy is not identified in scope of practice in any RCW, rule or policy in any form. The only document that directly refers to an actual policy regarding colon hydrotherapy is the one referred to in the email from Kristi Weeks on July 31, 2019.

Concerns about the Sunrise Review for colon hydrotherapy

The Sunrise Review in 2009 was conducted to determine if Colon Hydrotherapy should be regulated. Due to the small size of the industry it was determined that it should not be independently regulated and could be easily fiscally managed by classifying it under the “practice of medicine” which is already heavily regulated. This Review came before the resolution process was put into place and unintended consequences of an industry shutdown were underway. The Sunrise Review is not legally binding and DOH legal leadership was able to navigate this and support colon hydrotherapy providers in going back to work in 2009.

The following image is from page 2 of the Sunrise Review. Note that it is not legally binding or precedent setting. It is only a recommendation. The DOH refers to the Sunrise Review as policy, and it is not.