Rectal ozone therapy (rectal insufflation) is a needle-free systemic ozone method in which an ozone-oxygen mixture is delivered to the bowel through a thin, single-use catheter. The mixture is absorbed through the bowel lining and reaches the liver via the portal vein, and from there the general circulation. Ozone gas is not inhaled; the application is brief and no waiting is needed afterwards.
I am a specialist in anaesthesiology and reanimation. I have practised ozone since 2010, and since 2019 with a Ministry of Health certificate. On this page I explain how the rectal route works, when it comes to the fore and how it differs from the intravenous route. The general framework of ozone and its evidence status are on the ozone therapy page.
How does it work?
The bowel lining is a large, well-perfused surface; the ozone-oxygen mixture turns into oxygen and short-lived compounds on this surface within moments. Some of these compounds act locally on the bowel wall; some are carried via the portal vein to the liver and the general circulation. The mechanism is the same as major autohemotherapy: a controlled oxidative stimulus and the antioxidant response to it 1. The rectal route is the needle-free alternative to the intravenous route for systemic ozone 1.
When do I consider it?
In systemic ozone, the route depends on venous access and the goal: with good access and a full systemic effect in mind, major autohemotherapy comes to the fore; with difficult access, needle avoidance or predominant bowel complaints, the rectal route does. The final choice is made at consultation.
For a person with good venous access, I do not put the rectal route first; I assess it in people with difficult access, those who prefer to avoid needles, and those whose bowel complaints are the main issue. The intravenous route is explained on the major ozone therapy page.
The situations I assess in my practice: people for whom systemic ozone is planned but venous access is difficult; bloating, irregular bowel habit and recurring bowel complaints; and, in diagnosed bowel disease under ongoing follow-up, support alongside that follow-up. What I consistently observe in these areas in clinical practice is a reduction in bowel complaints and general fatigue; I write this as experience, not as a promise. In diagnosed bowel disease, gastroenterology follow-up and medication continue; no medication is stopped for ozone.
Being honest about the level of evidence
Studies exist showing the systemic effect and absorption mechanism of the rectal route 1; in a small randomised trial, rectal ozone was shown to change antioxidant and immune markers in the blood 2. The clinical outcome literature in bowel disease rests on small studies and case series; alongside studies reporting improvement there are studies reporting limited benefit. I do not rely on any study showing the rectal route to be more effective than the intravenous route; I choose the route by the criteria above. I do not give unsourced percentages.
The procedure and pain management
Because I am an anaesthesiologist, I treat pain management as a separate part of the procedure.
The treatment involves no needle; what you feel is a brief, mild sense of fullness or coolness. Privacy is maintained; the application is done under a drape.
Aftercare
Same day
- You can return to daily life; you can drive
- Drink plenty of water; avoid alcohol and heavy exercise
Expected findings No waiting is needed after the procedure; there is no leakage or odour. Mild tiredness or sleepiness may occur on the evening of the procedure and passes by the next day.
Additional advice
- A brief mild feeling of bloating may occur and passes within a few hours
Safety and anatomy
Because allergic reactions can occur rarely, treatments are carried out under medical supervision.
The catheter is thin and single-use; the treatment is carried out under physician supervision.
Legal framework: In Türkiye, ozone therapy is performed by certified physicians within the framework of the Traditional and Complementary Medicine (GETAT) Regulation. My clinic is routinely inspected by the district health directorate of the Ministry of Health and is inspected separately under its health tourism authorisation certificate. The products I use are recorded.
Who is not suitable
Treatment is not performed, or is postponed, in the following situations:
- Active infection or inflammation in the treatment area
- Autoimmune disease in an active phase
- Pregnancy and breastfeeding
- Known hypersensitivity to the product components
- Uncontrolled chronic illness
- Untreated bleeding disorder or unregulated anticoagulant use
I do not perform these treatments during active cancer treatment. For a person with a history of cancer, I make the decision together with the treating specialist.
In systemic ozone, treatment is also not performed in G6PD enzyme deficiency (favism), uncontrolled hyperthyroidism, or during an acute heart attack or stroke.
In rectal treatment, it is also not performed with active haemorrhoidal bleeding, an anal fissure or an active flare of colitis.
Without being a medical contraindication, I also consider expectation and treatment to be mismatched in these situations:
- People with an undiagnosed bowel complaint — a gastroenterology assessment comes first
- People who want to stop their current treatment — follow-up with the relevant specialty continues
- People expecting a lasting result from a single session
Suitability is determined by consultation in every case.
Pricing
Under the applicable regulations, price information cannot be published on our website. The cost of a treatment depends on the product used, the technique chosen and the extent of the treatment. You can call the clinic for detailed information.
Frequently asked questions
How does rectal ozone work?
The ozone-oxygen mixture is absorbed through the bowel lining and turns into oxygen and short-lived compounds; these reach the liver via the portal vein and then the general circulation. The effect is a controlled oxidative stimulus, as in major autohemotherapy.
Will I pass gas or need the toilet after rectal ozone?
No. The mixture is absorbed quickly; there is no leakage and no odour. A brief mild feeling of bloating can occur and passes within a few hours.
Is an enema needed before rectal ozone?
No. No special preparation is required; suitability and details are discussed at consultation.
Planning your visit
My clinic is in Nişantaşı, Şişli, on the European side of Istanbul, approximately 45 minutes from Istanbul Airport.
For rectal ozone therapy I suggest planning a stay of two to three days: arrival, consultation and treatment, and departure. Because this treatment may be planned as more than one session, it may require more than one visit. The first session takes place in Istanbul, and we plan the schedule of any following sessions together according to your travel arrangements, with remote follow-up in between. Flying is generally appropriate 24 hours after an injectable treatment.
Consultations are conducted in English. Follow-up after you return home is arranged remotely, and I remain reachable for any questions during the period in which the result develops.
You can read how I offer this treatment at my clinic, IV Point, on the ozone therapy page.
Dr. Ömer Fatih Şahin — Specialist in Anaesthesiology and Reanimation Diploma Registration No: 113606 Ozone Therapy Certificate — Republic of Türkiye Ministry of Health, 2019
Published: 22 February 2026 · Last updated: 2026-09-21 This content has been medically reviewed by Dr. Ömer Fatih Şahin.
References
- Bocci V, Borrelli E, Travagli V, Zanardi I. The ozone paradox: ozone is a strong oxidant as well as a medical drug. Med Res Rev. 2009;29(4):646–682. https://pubmed.ncbi.nlm.nih.gov/19260079/
- Menéndez Cepero S, et al. Systemic ozone therapy by rectal insufflation for immunoglobulin A deficiency. MEDICC Rev. 2021;23(1):18–23. https://pubmed.ncbi.nlm.nih.gov/34229419/