Assalamualaikum Secara tidak sengaja seperti biasanya disaat iklan saya memindahlan saluran televisi yang lebih menarik. Semalam di sebuah saluran televisi, tepatnya Metro TV pada saat program Welcome to BCA yang disiarkan pukul 21:30wib, ada seorang narasumber dr. Karli sebagi penerapi pengobatan alternatif yaitu colon cleansing. Sebelumnya saya sudah pernah membaca terapi colon cleansing di Okezone.com dan juga menerima perihal terapi colon cleansing ini dari milis sehat, dan saya menduga kedepan akan menjadi pembicaraan yang cukup hangat di media massa dan di milis-milis. Buat saya sangat disayangkan, program ini yang sejatinya lebih mengedepankan aspek sosio ekonomi kok malah lebih banyak aspek jualan terapinya, belum lagi kejelasan secara ilmiah dengan terapi ini, yang ada seperti halnya terapi alternatif lainnya hanya mengedepankan testimoni tidak berdasarkan Evidence Based Medicine (EBM), sementara untuk diketahui biaya terapi ini tergolong tidak murah sekitar Rp 3juta sekali terapi, padahal menurut dr. Karli perlu dilakukan beberapa kali terapi/ 7 kali berturut-turut untuk pertama kali (tergantung kondisi) dan rutin untuk setiap tahunnya. Saya tidak sedang apriori dengan colon cleansing, namun demikian saya punya sedikit catatan/ artikel yang mungkin bisa merubah opini anda paska menonton acara tersebut. Saya mengajak kepada para pembaca blog ini untuk selalu common sense dengan berbagai macam terapi komplemen yang begitu banyaknya di negeri ini, tidak ada regulasinya apalagi dengan klaim yang sangat luar biasa. FDA sebagai pembuatan kebijakan yang mengatur obat dan makanan di Amerika hanya mengatur produksi peralatan yang digunakan dalam hidroterapi usus besar tetapi tidak mengatur penggunaan layanan, atau suplemen yang digunakan dalam colon cleansing dan isi produk juga tidak diverifikasi atau diuji. FDA juga telah mengeluarkan beberapa surat peringatan dari produsen dan pemasok peralatan colon hidroterapi tentang klaim-klaimnya yang sangat bombastis dan melanggar keselamatan. Jangan lupa kerangka berfikir Kita adalah riks and benefit, informasi sudah begitu mudahnya untuk kita akses. Terlebih statment yang disampaikan dr. Karli semalam sungguh mencengangkan buat saya yang awam. Apakah tepat menyamakan kondisi usus besar kita dengan pipa saluran air yang sudah berpuluh-puluh tahun dialiri air sehingga terjadi pengendapan atau menurut dr. Karli adalah toksin? Sedikit yang saya fahami, bahwa secara fisiologis, tubuh memiliki organ ginjal untuk melakukan filtrasi darah dan juga organ hati yang melakukan detoksifikasi terhadap toksin yang masuk tubuh. Konsep colon cleansing menjelaskan bahwa bagaimanapun kotoran dalam usus besar/ colon tidak bisa disaring sepenuhnya oleh organ-organ tersebut. Akibatnya terjadi penumpukan kotoran yang, masih menurut konsep tersebut yang berada di sepanjang usus besar /colon. Karena itu, diperlukan tindakan pembersihan/detoksifikasi dengan cara memasukan sebuah selang/ Canula (ujung selang plastik) yang berdiameter 0.5 cm dimasukkan melalui dubur (anus) kurang lebih 5 cm dengan posisi tidur terlentang pada alat colon cleansing, kemudain mengalirkan air kedalam usus besar mengunakan dorongan gaya grafitasi air yang turun dari tangki air. Pasien mengendalikan sendiri air yang masuk dan keluar seperti menahan dan melepas buang air besar. Pengalaman saya dengan Ibu mertua saya yang kebetulan belum lama melakukan colonoscopy untuk terapi APC di RS Pondok Indah dan RS Husada, sama sekali tidak tampak adanya kerak seperti yang disebutkan dr. Karli dari hasil pencitraan/ colonoscopy tersebut ataukah memang saya yang awam atau memang tidak dapat di citrakan. Sebagai sebuah disiplin ilmu, kedokteran tentu menuntut prinsip logiko-hipotetiko-verifikatif. Konsepnya harus bisa dijelaskan secara logis. Dalam beberapa hal, colon cleansing bagi saya sangat tidak logis sehingga menyisakan ruang yang masih “abu-abu”. Ruang inilah yang kemudain menimbulkan pertanyaan-pertanyaan yang belum terjelaskan. Karena itulah, sulit untuk menerima konsep tersebut.Sementara menurut statment beliau juga sedang melakukan kerjasama di rumah sakit-rumah sakit. Jadi saya menjadi aneh ketika beliau menjelaskan hal ini, sehingga memaksa saya untuk menulis sekedar berbagi agar mendapatkan informasi yang seimbang. Tempo, 13 April 2009 sudah mempublikasikannya: Pembersihan Kolon, Perlu atau Tidak? Masih ingat Farrah Fawcett? Salah satu bintang pemeran serial televisi Charlie’s Angels itu pekan lalu diberitakan terkena kanker anal yang sudah menyebar ke hati. Nah, dari kabar yang ditulis berbagai media asing, penyebabnya adalah pembersihan usus besar (colon cleansing) yang sering dia lakukan. Tentu saja, kabar tentang penyebab ini masih belum bisa dinyatakan akurat. Namun hal itu bisa membuka pertanyaan tentang perlu-tidaknya pembersihan kolon. Maklum, penggelontoran usus besar makin disukai orang kota, sejak paham detoksifikasi menjamur. Selalu saja muncul produk herbal baru yang bisa digunakan untuk proses pembersihan ini. Dalam pandangan manusia urban, colon cleansing merupakan solusi instan dari gaya hidup mereka yang ”sangat kota”—sibuk, stres, makan tak teratur, terjebak konsumsi junk food, dan tidak cukup olahraga serta istirahat—dan keinginan untuk tetap sehat. Dalam paham pembersihan kolon ini, semua kotoran dan racun yang parkir di usus besar bisa digelontor tuntas—limbahnya banyak, hitam, dan menjijikkan. Sehingga, dengan usus besar bersih, berat badan pun bisa berkurang. Menurut kelompok yang mengakui kebenaran terapi ini, racun yang bersarang di sepanjang usus merupakan penyebab berbagai gangguan kesehatan seperti artritis (tulang bengkok), alergi, dan asma. Mereka juga percaya bahwa cara ini bisa mengusir penyakit, karena racun yang biasanya bersemayam nyaman dalam lipatan-lipatan usus besar akan digelontor keluar. Alhasil, bila usus besar bersih, selain penyakit tak datang, organ kolonnya pun sehat. Memang belum ada bukti ilmiah tentang keuntungan terapi kolon ini. Bahkan, bagi para pengkritiknya, pembersihan kolon pada umumnya dianggap tidak penting dan malah bisa membahayakan kesehatan. Meskipun dokter mengharuskan pembersihan kolon sebelum tindakan medis tertentu, seperti kolonoskopi—pemeriksaan kondisi di dalam kolon dengan alat seperti kateter yang dilengkapi kamera—kebanyakan dokter tidak merekomendasikan colon cleansing untuk detoksifikasi. Yang juga dikhawatirkan, pembersihan kolon malah mengakibatkan risiko dehidrasi. Risiko ini makin besar bila zat pencahar seperti sodium fosfat ikut digunakan. Zat seperti itu juga bisa membahayakan fungsi ginjal. Menurut Ari Fahrial Syam, ahli gastroenterologi dari Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Indonesia, ”Terapi kolon hanya bersifat sesaat. Jadi, manfaatnya kurang.” Padahal, dalam hal kesehatan pencernaan—termasuk usus besar—yang dibutuhkan adalah keteraturan. ”Terapi kolon juga bisa mengganggu keseimbangan flora di dalam usus,” tutur Ari Fahrial. Sehingga, menurut dokter di Rumah Sakit Cipto Mangunkusumo itu, yang jauh lebih penting adalah memastikan proses metabolisme di dalam tubuh berjalan dengan baik. Selengkapnya : http://majalah.tempointeraktif.com/ Menurut sumber yang saya : Namun, pakar gastroenterologi dari Fakultas Kedokteran Universitas Indonesia (FK-UI) Prof. DR. Dr. Daldiyono Hardjodisastro, SpPD, KGEH dalam Majalah Tempo berpendapat lain. Semua jenis cuci usus pasti memiliki efek samping karena colon hydrotherapy adalah campur tangan terhadap otonomi usus yang berisiko merusak rumah tangga internal usus. Koloni bakteri pembusuk makanan, misalnya, bisa ikut dikeluarkan sehingga irama pencernaan terganggu. Selain itu campur tangan yang terlalu banyak akan membuat pencernaan bergantung pada obat atau mesin cuci usus. Sebetulnya alam sudah menyediakan sistem pencernaan yang memadai. Berbagai masalah di usus akan muncul lantaran yang bersangkutan tidak mengkonsumsi menu makanan seimbang, misalnya didominasi daging plus lemak atau kurang makanan berserat. Untuk mengatasi berbagai hambatan itu sebaiknya tidak mengambil jalan pintas dengan menggunakan pencahar atau cuci usus. Jadi, “Tidak bisa semua orang, apalagi untuk tujuan membersihkan jerawat lalu berbondong-bondong mencuci usus,” katanya. Saran serupa juga disampaikan oleh Dr. Albert. Agar usus besar kita tak mudah ‘kotor’, perlu diperhatikan pola pola makan seimbang yang terdiri dari 80 persen sayuran dan buah, dan 20 persen sisanya protein. Dengan pola makanan seperti itu kebutuhan akan serat yang 30 gram per hari itu terpenuhi. “Serat itu untuk pencernaan kita fungsinya seperti sikat yang membersihkan pencernaan,” katanya. Selengkapnya : http://wap.korantempo.com/ Menurut sebuah situs yang mengelola masalah Fraud/Penipuan seputar kesehatan Quackwatch: “Colon Cleansing” Colon cleansers are marketed as powders to which water is added before use. The ingredients vary from one product to another, but the basic ingredients include fiber (e.g. psyllium, flaxseed, bentonite) and laxatives such as cascara and magnesium oxide. Other ingredients include vitamins, minerals, amino acids, herbs, and probiotics, all of which are variously claimed to promote detoxification, boost the immune system, promote weight loss and restore helpful bacteria. Magnesium oxide is claimed to release nascent oxygen. The laxative ingredients may be included in the powder or as a separate herbal tea. Users are generally instructed to drink 6-10 glasses of water daily. The recommended duration of use varies from a few days to several months. Some people have reported expelling large amounts of what they claim to be feces that have accumulated on he intestinal wall. However, experts believe these are simply “casts” formed by the fiber contained in the “cleansing” products. In the absence of constipation, concern about regularity should be met with reassurance. If hard stools are a problem and no underlying pathology is suspected, increasing dietary fiber or using a stool softener should help. “Cleansing” products offer no additional benefit, and some can cause unnecessary bloating, cramps and diarrhea. Selengkapnya : http://www.quackwatch.org/01QuackeryRelatedTopics/detox_overview.html Masih dari sumber yang sama : Gastrointestinal Quackery: Colonics, Laxatives, and More Stephen Barrett, M.D. The importance of “regularity” to overall health has been greatly overestimated for thousands of years. Ancient Egyptians associated feces with decay and used enemas and laxatives liberally. In more recent times, this concern has been embodied in the concept of “autointoxication” and has been promoted by warnings against “irregularity.” [1] The theory of “autointoxication” states that stagnation of the large intestine (colon) causes toxins to form that are absorbed and poison the body. Some proponents depict the large intestine as a “sewage system” that becomes a “cesspool” if neglected. Other proponents state that constipation causes hardened feces to accumulate for months (or even years) on the walls of the large intestine and block it from absorbing or eliminating properly. This, they say, causes food to remain undigested and wastes from the blood to be reabsorbed by the body [2]. Around the turn of the twentieth century many physicians accepted the concept of autointoxication, but it was abandoned after scientific observations proved it wrong. In 1919 and 1922, it was clearly demonstrated that symptoms of headache, fatigue, and loss of appetite that accompanied fecal impaction were caused by mechanical distension of the colon rather than by production or absorption of toxins [3,4]. Moreover, direct observation of the colon during surgical procedures or autopsies found no evidence that hardened feces accumulate on the intestinal walls. Today we know that most of the digestive process takes place in the small intestine, from which nutrients are absorbed into the body. The remaining mixture of food and undigested particles then enters the large intestine, which can be compared to a 40-inch-long hollow tube. Its principal functions are to transport food wastes from the small intestine to the rectum for elimination and to absorb minerals and water. Careful observations have shown that the bowel habits of healthy individuals can vary greatly. Although most people have a movement daily, some have several movements each day, while others can go several days or even longer with no adverse effects. The popular diet book Fit for Life (1986) is based on the notion that when certain foods are eaten together, they “rot,” poison the system, and make the person fat. To avoid this, the authors recommend that fats, carbohydrates and protein foods be eaten at separate meals, emphasizing fruits and vegetables because foods high in water content can “wash the toxic waste from the inside of the body” instead of “clogging” the body. These ideas are utter nonsense [5]. Some chiropractors, naturopaths, and assorted food faddists claim that “death begins in the colon” and that “90 percent of all diseases are caused by improperly working bowels.” The practices they recommend include fasting, periodic “cleansing” of the intestines, and colonic irrigation. a.. Fasting is said to “rejuvenate” the digestive organs, increase elimination of “toxins, and “purify” the body.” b.. Cleansing” can be accomplished with a variety of “natural” laxative products. c.. Colonic irrigation is performed by passing a rubber tube through the rectum. Some proponents have advocated that the tube be inserted as much as 30 inches. Warm water-often 20 gallons or more-is pumped in and out through the tube, a few pints at a time, to wash out the contents of the large intestine. (An ordinary enema uses about a quart of fluid.) Some practitioners add herbs, coffee, enzymes, wheat or grass extract, or other substances to the enema solution. The Total Health Connection and Canadian Natural Health and Healing Center Web sites provide more details of proponents’ claims. The latter states that “there is only one cause of disease-toxemia” and offers “the most comprehensive in-depth colon therapy on the continent.” The course costs $985 for 5 days of in-clinic training or $295 by correspondence. Some “alternative” practitioners make bogus diagnoses of “parasites,” for which they recommend “intestinal cleansers,” plant enzymes, homeopathic remedies. Health-food stores sell products of this type with claims that they can “rejuvenate” the body and kill the alleged invaders. The danger of these practices depends upon how much they are used and whether they are substituted for necessary medical care. Whereas a 1-day fast is likely to be harmless (though useless), prolonged fasting can be fatal. “Cleansing” with products composed of herbs and dietary fiber is unlikely to be physically harmful, but the products involved can be expensive. Some people have reported expelling large amounts of what they claim to be feces that have accumulated on he intestinal wall. However, experts believe these are simply “casts” formed by the fiber contained in the “cleansing” products. Although laxative ads warn against “irregularity,” constipation should be defined not by the frequency of movements but by the hardness of the stool. Ordinary constipation usually can be remedied by increasing the fiber content of the diet, drinking adequate amounts of water, and engaging in regular exercise. If the bowel is basically normal, dietary fiber increases the bulk of the stool, softens it, and speeds transit time. Defecating soon after the urge is felt also can be helpful because if urges are ignored, the rectum may eventually stop signaling when defecation is needed. Stimulant laxatives (such as cascara or castor oil) can damage the nerve cells in the colon wall, decreasing the force of contractions and increasing the tendency toward constipation. Thus, people who take strong laxatives whenever they “miss a movement” may wind up unable to move their bowels without them. Frequent enemas can also lead to dependence [6]. A doctor should be consulted if constipation persists or represents a significant change in bowel pattern. Colonic irrigation, which also can be expensive, has considerable potential for harm. The process can be very uncomfortable, since the presence of the tube can induce severe cramps and pain. If the equipment is not adequately sterilized between treatments, disease germs from one person’s large intestine can be transmitted to others. Several outbreaks of serious infections have been reported, including one in which contaminated equipment caused amebiasis in 36 people, 6 of whom died following bowel perforation [7-9]. Cases of heart failure (from excessive fluid absorption into the bloodstream) and electrolyte imbalance have also been reported [10]. Direct rectal perforation has also been reported [11]. Yet no license or training is required to operate a colonic-irrigation device. In 1985, a California judge ruled that colonic irrigation is an invasive medical procedure that may not be performed by chiropractors and the California Health Department’s Infectious Disease Branch stated: “The practice of colonic irrigation by chiropractors, physical therapists, or physicians should cease. Colonic irrigation can do no good, only harm.” The National Council Against Health Fraud agrees [12]. Legal Action The FDA classifies colonic irrigation systems as Class III devices that cannot be legally marketed except for medically indicated colon cleansing (such as before a radiologic endoscopic examination). No system has been approved for “routine” colon cleansing to promote the general well being of a patient. Since 1997, the agency has issued at least seven warning letters related to colon therapy: a.. In 1997, Colon Therapeutics, of Groves, Texas, and its owner Jimmy John Girouard were warned about safety and quality control violations of the Jimmy John colon hydrotherapy unit and related devices [13]. b.. In 1997, Tiller Mind & Body, of San Antonio, Texas and its owner Jeri C. Tiller, were ordered to stop claiming that their Libbe colonic irrigation device was effective against acne, allergies, asthma and low-grade chronic infections and improved liver function and capillary and lymphatic circulation [14]. c.. In 1997, Colon Hygiene Services, of Austin, Texas and its owner Rocky Bruno was notified that their colonic irrigation system could not be legally marketed without FDA approval [15]. d.. In 1999, Dotolo Research Corporation, of Pinellas Park, Florida, and its chief executive officer Raymond Dotolo were warned about quality control violations and lack of FDA approval for marketing its Toxygen BSC-UV colonic irrigation system [16]. e.. In 2001, Clearwater Colon Hydrotherapy, of Ocala, Florida, and its vice president Stuart K. Baker were warned about quality control violations and lack of FDA approval for marketing their colonic irrigators [17]. f.. In 2003. the International Colon Hydrotherapy Association, of San Antonio, Texas and its executive director Augustine R. Hoenninger, III, PhD, ND, were notified that it lacked FDA approval to sponsor “research” that had been proposed or actually begun on the devices of five companies [18]. g.. In 2003, Girourd and Colon Therapeutics were notified that his devices require professional supervision and cannot be legally marketed directly to consumers. The letter noted that he had obtained marketing clearance only for use in medically indicated colon cleansing, such as before radiologic or sigmoidoscopic examinations [19]. h.. In 2003, the Wood Hygienic Institute of Kissimmee, Florida, and its owner Helen Wood were warned about quality control violations and the use of unapproved therapeutic claims in marketing their devices [20]. Girouard, Colon Therapeutics, Tiller Mind & Body, operators of the Years to Your Life Health Centers, companies that manufactured several components of Girouard’s colonic irrigation systems, and organizations that trained operators of the devices are being sued in connection with the death of a 72-year-old woman who perforated her large intestine while administering colonic irrigation. The suit alleges that the woman was unsupervised when she administered the “colonic,” perforated her colon early in the procedure, required surgery the same day, and remained seriously ill for several months before she died from liver failure. The complaint also alleges that Years to Your Life Health Center falsely advertised colonic irrigations as “painless” procedures which provided health benefits including an improved immune system and increased energy, as well as relief from indigestion, diarrhea, constipation, weight loss, body odor, candida, acne, mucus colitis, gas, food cravings, fatigue, obesity, diverticulosis, bad breath, parasitic infections, and premenstrual syndrome [21]. In response to the woman’s death and reports of serious injuries to four other patients, the Texas Attorney General filed lawsuits against: a.. Girouard and Colon Therapeutics b.. Abundant Health and Wellness Institute, and its owner, Cordelia Beall c.. Gentle Colonics Inc. and its owner, Denson Ingram d.. Eternal Health Inc., doing business as Years to Your Life and Cynthia Pitre e.. Jennifer Jackson, doing business as Body Cleanse Spa f.. Tiller Mind Body Inc., doing business as Mind Body Naturopathic Institute and Jerri Tiller g.. International Association for Colon Hydrotherapy, Class 3 Study Group and Augustine R. Hoenninger III h.. Linda Gonzalez, doing business as El Paso Health Center. i.. Soledad Herrera, doing business as Body Matters of El Paso j.. Lisa Ramoin, doing business as Alternative Health (Houston) k.. Janice Jackson, doing as InsideOut and Within (Houston) The suits charged all of the defendants with engaging in the promotion, sale or unauthorized use of prescription devices for colonic hydrotherapy treatments without physician involvement. In 2004 and 2005, the cases involving Girouard, Ingram, Beall, the Jacksons, Herrera, Ramoin, and their companies were settled with consent agreements under which they would pay a total of $178,000 in civil penalties, fees, and costs to the state [22-24]. For Additional Information a.. How Clean Should Your Colon Be? References. 1.. Chen TS, Chen PS. Intestinal autointoxication: A gastrointestinal leitmotive. Journal Clinical Gastroenterology 11:343-441, 1989. 2.. Ernst E. Colonic irrigation and the theory of autointoxication: A triumph of ignorance over science. Journal of Clinical Gastroenterology 24:196-198, 1997. 3.. Alvarez WC. Origin of the so-called auto-intoxication symptoms. JAMA 72:8-13, 1919. 4.. Donaldson AN. Relation of constipation to intestinal intoxication. JAMA 78:884-888, 1922. 5.. Kenney JJ. Fit For Life: Some notes on the book and Its roots. Nutrition Forum, March 1986. 6.. Use of enemas is limited. FDA Consumer 18(6):33, 1984. 7.. Amebiasis associated with colonic irrigation - Colorado. Morbidity and Mortality Weekly Report 30:101-102, 1981. 8.. Istre GR and others. An outbreak of amebiasis spread by colonic irrigation at a chiropractic clinic. New England Journal of Medicine 307:339-342, 1982. 9.. Benjamin R and others. The case against colonic irrigation. California Morbidity, Sept 27, 1985. 10.. Eisele JW, Reay DT. Deaths related to coffee enemas. JAMA 244:1608-1609, 1980. 11.. Handley DV and others. Rectal perforation from colonic irrigation administered by alternative practitioners. Medical Journal of Australia 181:575-576, 2004. 12.. Jarvis WT. Colonic Irrigation. National Council Against Health Fraud, 1995. 13.. Baca JR. Warning letter to Colon Therapeutics, April 27, 1997. 14.. Baca, JR. Warning letter to Tiller Mind & Body, June 2, 1997. 15.. Baca JR. Warning letter to Colon Hygiene Services, June 20, 1997. 16.. Tolen DD. Warning letter to Dotolo Research Corporation, July 21, 1999. 17.. Singleton E. Warning letter to Clearwater Colon Hydrotherapy, Sept 13, 2001. 18.. Marcarelli MM. Warning letter to International Colon Hydrotherapy Association, March 21, 2003. 19.. Chappel MA. Warning letter to Colon Therapeutics, Oct 23, 2003. 20.. Ormond E. Warning letter to Wood Hygienic Institute, Oct 23, 2003. 21.. Barrett S. Colonic promoters facing legal actions. Quackwatch, Nov 11, 2003. 22.. Attorney General Abbott sues ‘ colonic hydrotherapy ‘ providers for abuse of medical devices; one death reported: Suits allege unsafe use of devices without physician oversight is a public health issue. Texas Attorney General news release, Dec 1, 2003. 23.. Barrett S. Texas Attorney General reaches settlement with three colonic hydrotherapy providers. Casewatch, July 16, 2004. 24.. Attorney General Abbott wins court judgment with six colon hydrotherapy providers. News release, March 1, 2005. Sumber : http://www.quackwatch.org/01QuackeryRelatedTopics/gastro.html Apa itu Colon Cleansing Adalah suatu metode pembersihan sumber toxin yang berupa kerak dari pembusukan sisa makanan yang mengeras dan melekat pada dinding usus besar, sehingga tercapai kondisi zerotoxin. Dengan cara membasahi kerak tersebut dengan air steril secara berulang-ulang supaya lembek, sehingga perlahan-lahan terkelupas dan keluar bersama air. Proses Colon Cleansing Canula (ujung selang plastik) yang berdiameter 0.5 cm dimasukkan melalui dubur (anus) kurang lebih 5 cm dengan posisi tidur terlentang pada alat colon cleansing, mengalirkan air kedalam usus besar mengunakan dorongan gaya grafitasi air yang turun dari tangki air. Pasien mengendalikan sendiri air yang masuk dan keluar seperti menahan dan melepas buang air besar. Lama waktu colon cleansing 30 menit dilakukan setiap hari selama 7 hari berturut-turut. Manfaat Colon Cleansing Dengan bersihnya toxin, maka beban liver ringan dan fungsinya normal kembali. Nutrisi essensial yang selama ini digunakan untuk detoksifikasi dialihkan untuk memperbaiki seluruh sel-sel organ tubuh yang diikuti perbaikan secara klinis seperti: * Kulit halus dan cerah * Energi meningkat * Vitalitas meningkat * Pembakaran lemak meningkat * Keluhan berbagai penyakit degeneratif secara berangsur-angsur menghilang. Sumber : http://dokter-karli.com/ So, informasi sudah saya sampaikan cukup detail. Andalah yang menentukannya. Sehat itu murah adalah benar. Sehat itu mahal juga benar. Be Smarter…Be Healthier… Wassalamualaikum
