“But Dr. XYZ told me it is! And he/she is the best ozone expert out there! It's even in his/her book!”
If a doctor or any ozone expert tells you that RIs* and DIVs are equally powerful, that means that with a high probability that doctor has not tried those ozone therapies to treat neurological conditions like brain infection or inflammation and compared the two; neither on him/herself nor on his/her patients.  
A central nervous system related condition is one of the best ways to assess how well a given ozone protocol (except EI, which will get ozone directly into the brain) supplies ozone to the blood, since when ozone is directly pumped into a vein, it will reach the head within few minutes.
If there is an ongoing infection or inflammation present in that area, people usually feel an instant relief from an o3 IV. So one can roughly compare the effect of a DIV on a neurological condition with the effect of a RI on that same condition to get a feel of how much ozone is being supplied to the blood via RI (or any other ozone procedure).
I’ve done a few hundred self-administered DIVs (60cc each at an o3 concentration of around 23ug/ml, without any anti-oxidant supplementation) and I’ve done around 100 rectal insufflations so far – and I can say beyond any doubt that those 2 modalities don’t even come close when it comes to how they treat the whole body.
DIVs (direct ozone IVs), are performed by injecting a pure o2/o3 gas mix directly into the vein. The blood cells transport the o2/o3 mix throughout the body.
Given that blood circulates the entire body in around 1 to 2 minutes, the effect of DIVs can be often felt immediately. It’s not uncommon that patients with neurological conditions feel an instant relief several minutes into receiving a DIV even before the procedure is concluded.
RI, on the other hand, stands for the rectal insufflation of ca. 500ml of o2/o3 gas into the lower colon. Once the gas is infused, the gas reacts with whatever fecal residue is still present (which is minimized but not completely eliminated with an enema), whatever bacterial or fungal pathogens (e.g. candida) are still there, whatever inflammatory conditions might be going on and then the remainder will be absorbed by the colon walls.
Whatever is left of the ozone after it cleaned house in the colon, is being transported via the intestinal walls into the portal vein, which then transports the o2/o3 into the liver at what point the ozone – or whatever is left of it after it had reacted with the various toxins stored in the liver – can enter the larger blood stream after leaving the liver.
So, given that there are all those things that the ozone has to pass through and react with on its way to the liver: the colon, the toxins in the colon, the portal vein and the toxins therein and the liver and the toxins in the liver, the probability that the concentration of the ozone after leaving the liver is as strong as when ozone enters the blood stream directly through DIVs – is very low to none.
Of course, as with all theoretical explanations as why a given protocol will or will not work: they’re only as good as they can predict real life experience.
So, really the best way to test the theory is to have both a RI and a DIV performed (preferably at the same or similar level of infection and without anti-oxidants) and compare the sensation achieved during the two modalities and their efficacy when treating various symptoms.
Ss to my personal experience: having suffered from a systemic lyme infection for close to 20 years which I have a good reason to believe was accompanied by systemic inflammation (as well in the brain, as in joints, digestive tract and skin and nails) RIs would never give me this unique sensation of peace, dissolution of anxiety and the piercing of the veil which seemed to perpetually stand between me and reality, the way DIVs would.
For me, RIs were mostly a powerful modality to treat local, digestive issues. (also: if any specific brain related either cognitive or emotional symptoms are present, which might be related to an infection or inflammation or both in the brain and there is no access to a DIV, what one can do, is compare 10 to 20 min long ear insufflations (EI) to RIs. Ear insufflations address directly the brain just like DIVs. So by doing RIs and comparing them to longer EIs one can get an approximate idea of the effect of RIs on the brain.)
The reason why some doctors might be comparing RI to DIVs is that many ozone doctors are conventionally trained MDs who later specialized in holistic medicine. Hence, oftentimes they will apply an allopathic approach onto ozone therapy and treat ozone like a drug, which it isn’t. Which results in them comparing the total amount of ozone supplied to the body with the various modalities without taking into consideration the importance of locality, the method of application and time when treating patients with ozone therapy.
*there are 2 different ways to administer rectal insufflations:
1) the infusion of maximum 500 ml of an o2/o3 gas mix into the colon, usually by using an external bag. This procedure takes around 10 to 15 min; 
2) the infusion of o2/o3 gas at a continuous low flow of 1/32 LPM or 1/64 LPM by attaching the catheter directly to the o3 generator. Those low flows allow for insufflations of 40 min or longer, since at that rate it’s assumed that the gas is absorbed by the colon at the same rate as it’s being infused.
Both modalities are to be performed after a colon cleansing water enema.
When talking about RI the above article assumes that method 1) is used.

Disclaimer: I am not a medical doctor or any sort of therapist and am not suggesting any medical or therapeutical protocols. This is for information purposes only and to share my experience and knowledge I have gained while treating lyme disease. 

About the author:

PaolaI’m Paola the Crazy Old Ozone Lady behind The Power of Ozone. I’m a licensed naturopathic practitioner, natural health consultant, ozone therapy enthusiast, researcher, and ozone therapy analyst. I hold certificates in ozone therapy, hyperbaric ozone applications, Oxyvenierung, and the Andrew Cutler chelation. I own several ozone generators including a German hyperbaric 10 Pass machine. I have been using ozone for over 13 years, I’ve chelated with the ACC program for close to 5 years and I’ve been carnivore for nearly 1.5 years. This website serves as a resource for those who are interested in ozone therapy and other approaches to successfully manage chronic conditions. 

Legal Disclaimer

Information provided is for informational purposes only and is not a substitute for professional medical advice. No health claims for these products or treatments have been evaluated by the United States Food and Drug Administration (FDA), nor has the FDA nor any other medical authority approved these treatments or products to diagnose, cure, or prevent disease. Neither The Power of Ozone nor the manufacturers of these items are responsible for the misuse of this equipment or the information on this page. It is highly advised to receive professional council from a licensed doctor before using ozone therapy or any of the mentioned products or tests on yourself.

Affiliate Disclosure

This website contains links to vendors of products I endorse, including amazon.com. If you decide to make a purchase through one of my links, they will pay me a commission. This does not influence my opinion about the products, as you can see from my reviews.