by | Nov 11, 2018 | 62 comments

PLEASE READ FIRSTHow to protect yourself from breathing ozone
What are rectal insufflations?
What equipment do you need?
How to perform rectal insufflations
How to perform direct rectal insufflations
Risks and how to avoid them



During rectal insufflations a mix of ozone/oxygen is introduced through a catheter into the colon. It’s a type of gas enema. The ozone helps remove inflammation and kills pathogens like bacteria, viruses, parasites and yeast. It can help restore healthy gut flora. Some of the ozone is absorbed by the colon walls and the resulting oxidative by-products travel through the portal vein to the liver and potentially enter the blood stream. Some sources claim that RI are a valid substitute for ozone blood treatments, others (like Prof. Velio Bocci) call this into question. Recommended is to not introduce more than 200 ml of ozone at one time.



Here, I present the in my opinion best way to perform rectal insufflations. This method uses a 200 ml syringe, an adapter and a syringe filling station. You can watch the whole process in this video (with a minor modification. I use a different catheter and hence also a different adapter in the video) which is also posted at the end of this page. This procedure requires an adapter, which you will have to make yourself. Below, I will explain what you need for that and how to put it together.

You need:

1. Oxygen source (tank or concentrator) including low flow regulator

2. Ozone generator

3. Syringe filling station with a filter

4. DIY adapter (luer lock connectors, an on/off valve, 2 silicone pieces) 

5. Syringe

6. Catheters

7. Extras: a towel, a lubricant (olive oil), vinyl gloves, a garbage bin.

I use the EliteO3 Dual Cell ozone generator, an oxygen tank, and a syringe filling station from Promolife. But one can also use an oxygen concentrator with a low flow regulator and a whole variety of different other ozone generators instead.

1. Oxygen source:

Either an oxygen tank or an oxygen concentrator can be used which produces oxygen of at least 90% purity. Whatever oxygen source you choose, make sure your ozone generator is able to produce concentrations between 20 and 50 mcg/ml at the given oxygen flow. Consult the chart of your ozone generator to find out whether you will be able to produce those concentrations.

2. Ozone generator: 

It should be an oxygen fed generator which can produce ozone concentrations of at least up to 50 mcg/ml. Any of the recommended generators on this page will do the job. The one in the pictures above is the EliteO3 Dual Cell from Promolife.

3. Syringe Filling Station: 

to fill and refill the syringe. It comes with a filter. I strongly recommend using the filter to prevent oil from the lubricated syringe from entering your generator. You can also do without the filling station and simply use a piece of silicone tubing and a luer lock connector. Or simply attach the filter directly to the ozone out port on the Promolife and then fill the syringe through the port. I highly recommend the filling station though, because due to its attached destructor it minimizes the exposure to ozone in the air.

In my opinion the best way to perform RI is with the 200 ml polycarbonate syringe, an adapter and a catheter.

4. Adapter:

The adapter will allow you to refill the syringe multiple times. The on / off valve makes sure that no contamination from liquified feces will reach the syringe while you unhook it. The adapter can be reused indefinitely. The adapter I explain here is slightly different from the one in the video, since here I use luer lock catheters, whereas in the video I use standard Coloplast catheters which require a different connector.

You need the following parts in order to build the adapter:

An ON/OFF Valve and a pair of luer lock connectors.

And two pieces of silicone tubing, one can be a little shorter than the other. You can choose 3 and 5 inches, respectively. You can cut silicone tubing with a pair of scissors. The ideal size for the tubing is 3/16″ ID x 5/16″ OD.

1. Line everything up, as shown above. 

2. Connect all the luer lock connectors with the silicone tubing. 

3. The ready DIY RI adapter. 

5. Syringe: 

I recommend the 200 ml polycarbonate syringe with a silicone stopper from Promolife. It is ideal for rectal insufflations. Make sure to lubricate the stopper with some olive oil, since when the syringe is new the stopper sits very tightly. With a little bit of oil it works perfectly.

6. Catheter:

is inserted into the rectum and then connected with the adapter and then the syringe. There are different types of catheters with different connecting ends. The catheter on this page has a luer lock attachment, so it perfectly fits with all the adapter I show above. But one can also use standard adapter with a silicone cone finish. In which case a slightly different connector is needed at the end of the adapter. You can find further information and links to that underneath the description of the video.

The 200 ml polycarbonate syringe is an ideal solution for rectal insufflations. The materials are polycarbonate and silicone, making it uniquely ozone resistant. 

This catheter connects perfectly with a luer lock connector. 

7. Extras:

Latex free gloves, a lubricant, a garbage bin, and a towel

Gloves: Rectal insufflations are a messy affair. It’s recommended to use gloves when applying the lubricant, introducing the catheter, and pulling it out. Make sure the gloves are latex-free since ozone destroys latex immediately.

Lubricant: Use it to facilitate the introduction of the catheter. You can use any ozonated or vegetable oil, or any cream of your choice.

Garbage bin: Keep it close. Once the catheter is out, you need to act quickly!

Towel: use an old towel to protect your furniture.



1. Prepare everything: put a towel on your couch, connect the oxygen source with the ozone generator, plug both into the power supply, connect the syringe filling station with the ozone generator. Have everything else close by: adapter, catheter, oil or cream, lubricated syringe, garbage bin, gloves.

2. Get undressed.

3. Open the oxygen source. If it’s a tank: open the valve of the tank and the regulator at a low flow of 1/8 LPM. If it’s an oxygen concentrator: let the concentrator warm up for around 10 min, then adjust the regulator  to 1/8 LPM. Let the oxygen flow before you turn on the ozone generator to flush all the lines. Make sure the valve on the filling station is turned so that it does not block the oxygen flow.

4. Connect the syringe to the syringe filling station. Turn the valve so that the oxygen flows into the destructor, not the syringe.

5. Turn the ozone generator on. Choose the desired ozone concentration. Allow the ozone generator to warm up for 10 to 15 seconds. Make sure the ozone goes into the destructor of the filling station.

6. Turn the valve on the filling station to let the gas flow into the syringe. If the plunger doesn’t move, help it out by pulling on it gently. Fill the whole 200 ml.

7. When done, turn the valve of the filling station again to divert the flow of ozone into destructor. Do not unscrew the syringe from the filing station yet. (If you decide to unscrew it, so park it close by upside UP. Do not lay it down on its side)

8. Turn the ozone generator off. Turn oxygen source off.

9. Put on gloves, lie down, apply the oil, insert catheter.

10. Connect the adapter with the catheter.

11. Unscrew the full syringe from the filling station, connect it with the adapter.

12. Make sure the ON / OFF valve on the adapter is open. Start pushing the content of the syringe into your colon. Suggested are 10 ml every 10 to 15 seconds.

13. If you want to use another syringe full, then close the valve of the adapter before you unscrew the syringe. This will prevent liquified stool to come up through the catheter. Unscrew the syringe, open the oxygen source again, turn the ozone generator on and repeat everything as above. Then screw the syringe onto the adapter again, open the ON / OFF valve and start pushing the piston.

14. When done, remove the catheter, dispose of it. Remain horizontal for a few minutes.

15. Repeat as often as prescribed by your ozone practitioner.



Another method of performing RI is the *direct method*. It means that instead of using a syringe or a bag, one connects the catheter directly with the ozone generator. There is a direct flow of the gas from the ozone generator into the colon.

There are several important considerations to make with direct RI:

1. The oxygen flow should be very low, not higher than 1/8 LPM. So either 1/8, 1/16, or 1/32 LPM.

2. The total amount of oxygen should not exceed 500 ml. Although, as stated above, even lower amounts of max 200 ml would be preferable (if you want to know why I think that, please watch the video below about risks and complications).

3. In order to make sure the total amount is not exceeded, one needs to perform the following calculation:

Example: if you want to introduce max. 500 ml into your colon, you do as follows:

a) Read the chosen oxygen flow you selected on the oxygen regulator, so for example 1/8 LPM.

b) Write the fraction of 1/8 LPM as ml per minute by typing 1 ÷ 8 = 0.125 x 1000 into your calculator. You will obtain 125. That’s 125 milliliters per minute now (MLPM).

c) Divide 500 ml / 125 MLPM = 4 minutes. You should allow the oxygen to flow for around 4 minutes in order to not exceed the maximum amount of 500 ml. For 200 ml it would be 200 ml / 125 MLPM = 1.6 minutes.





  • weak colon, prone to rupture
  • transplanted organ

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 diagnostic tools have been evaluated by the United States Food and Drug Administration (FDA), nor has the FDA nor any other medical authority approved these 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. 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.




  2. Tony Tan

    Where to purchase equipments for rectal insufflation at Perth WA.

    • paola d

      Hi Tony,
      best is to join the Facebook group “Ozone Therapy at home Australia”.
      They will give you tips where to get the best deals for your equipment.

    • Joanne


      I am in Perth, WA and I bought the equipment from prolife. No issue with importing.

      Getting the oxygen source is a bit more difficult because you need UHP oxygen and if you don’t have a prescription you need to give another reason for its delivery. The cylinders are also extremely large.

  3. Cassie

    Where can I purchase equipment for rectal insufflation in the United States?

  4. Joyce Stephenson

    How do I purchase an ozone therapy machine in Queensland Australia?

    • paola d

      Hi Joyce,
      all the ozone generators listed here are available internationally: .
      Make sure to pick the 230 V type if you gonna pick one which does not run on universal voltage.
      I can also recommend joining the Facebook group “Ozone at home Australia/international”.

  5. Ruth

    How often should RI be used (times per week?) and for how long (weeks/months/years)?

    • paola d

      Hi Ruth,
      there are different opinions on that and best is to consult an ozone doctor or ozone practitioner.
      First, it depends what you are treating.
      Some doctors say one can do up to 2 RI per day daily for a number of weeks or until resolution of symptoms.
      There are home users who have been doing RI three times per week for months. As long as one gets benefit from them, one can keep going, seems to be the consensus.

      Hope this helps.

  6. Rodney Thomas

    Do the benefits of insufflation come from increasing oxygenation in the host through a systemic increase in o2? Or does the o3 (or its metabolites) have systemic oxidative capacity? I assume it’s the latter, otherwise a plain old o2 insufflation would suffice?

    On another note, do you have any second hand experience of penile insufflations? Ive been using them and seem to get much better results compared with rectal, however I’m not sure on what’s considered a safe volume and at what gamma. I would be keen to learn more.

    Many thanks

    • paola d

      Hi Rodney,
      the benefits from insufflation come from directly killing pathogens and inflammation and from the by-products like lipid peroxides.
      I have no first, second nor third hand 😉 experience with penile insufflation, sorry.
      But I would not go over 150 ml in volume at a concentration of max ca. 50 mcg/ml.
      Hope this helps!

  7. Andrew

    Is it necessary to replace the silicon tubing used in insuflations in a regular time period? I can’t seem to find any information on this.

    • paola d

      Hi Andrew,
      you don’t really need to replace silicone tubing. But if you see dirt inside which you can’t get out or if you see that it starts getting hard, then it is better to replace it.
      I also prefer to have a dedicated RI or VI tubing, in order to not use the same tubing for let’s say ozonating water that I used for RI, know what I mean?

  8. Bill

    Good instructional article. I have been doing RI for about a year using the bags and catheters. The bags are good for 5-8 uses. They begin to leak and no longer fill completely. I see that Promolife has replaced the 5-pack with a 3-pack for $59.95. Yet I can buy a single bag for $9.95. The single bag is half price!

    I am curious about the syringe. Does it breakdown after 5-8 uses like the bags? Are there larger ones – like 500 or 750 ml?

    • paola d

      Hi Bill,
      yes, I saw that with the 3-pack. That is weird … I will ask them about it.

      The syringe definitely lasts longer.
      I am not aware of larger syringes. Larger ones would be really difficult to handle, I can imagine, since one needs to be able to grab the plunger with one’s fingers. A 500ml syringe would make that basically impossible.

    • Faith

      Hi Bill 🙂 We bought the syringe after using half a dozen bags. The syringe is MUCH better. We have used it 40+ times and still going strong!

      • paola d

        Hi Faith,

        thanks for the feedback!
        Yes, the syringe is great.

  9. Nick L

    What impact does rectal ozone have on your microbiom – do you need to take probiotics if you are doing rectal ozone? Is there a number of consecutive sessions you should not go beyond at one time?

    • paola d

      Hi Nick,
      many ozone practitioners recommend probiotics after RI. I think it is not absolutely necessary, but not detrimental either, in most cases.
      “Is there a number of consecutive sessions you should not go beyond at one time?” – Not that I know, no.

  10. Carla maloney

    I have been on a liquid diet for 2 years(juicing and bone broth).solid food food gets stuck in my esophagus.2 years ago the doctor urged me to go to emergency room as he thought I had all the symptoms of esophageal cancer, I never went.did not like the survival rate of modern all started with constant extreme stress.acid reflux destroyed digestive tract and gut lining.barely digesting not have bowel movement unless I have an enema.started doing rectal ozone insufflations, at home it’s giving me painful heartburn.i want to continue doing it because I believe it will can I heal and protect the digestive tract from the ozone so I can continue doing it.i need something powerful asap.Please help, don’t know what else to do.Thank You Paola

    • paola d

      Hi Carla,
      please, find a doctor in your area who does ozone therapy and consult with him.
      If ozone is the solution for you, he should be able to offer guidance.
      But you might also want to switch to vaginal insufflations and start drinking ozonated water and see how that goes.
      If you have amalgam fillings – have them removed. If you had them removed already, then starting chelation would be a good idea:

  11. Lia

    Hello Paola:

    I am trying to be time efficient with all my treament regimens. They consist of vitamins twice a day, infra red sauna (biomat) and ozone.

    How long before ozone is it advisable to take vitamins? How long after. I do VI and RI alternating days. I will be starting 10 pass for 2 sessions this week and then plan on 2-3 weeks of daily MAH per Silvia Menendez.

    Also is it ok to do EI and VI/RI the same day? And if I do EI is there any time constraint on taking vitamins?

    Well time for the sauna!!

    Thank you in advance. I have tried to look this up on line, but hard to get the info

    • paola d

      Hi Lia,
      in order to maximize the benefit from ozone it is recommended to take antioxidatn Vitamins at least an hour after ozone or several hours before ozone.
      The bio-mat can be used at any time with ozone, if you are doing well with it.


  12. Ricardo Reis

    Hi. Pretty nice article!

    I have done rectal ozone insulfflations before without major issues.
    Today I’ve made the treatment on a new clinic, and I started to feel some muscle pain
    and a bit of brain fog. (Seems I’m full of gut candida and some bad bacteria)

    Could this be a symptom of herxheimer?

    Best regards,
    Ricardo Reis.

    • paola d

      Hi Ricardo,
      yes, it could be die-off from candida.

  13. Vicky

    Can catheters be reused if cleaned properly? If yes, what’s the recommended sterilization method?

    • paola d

      Hi Vicky,
      yes, some people reuse their catheters.
      They soak them in 3% H2O2 (hydrogen peroxide) and then rinse them out thoroughly.

  14. Frank

    Is there a number of session to be take and feel results?

    • paola d

      Hi Frank,
      this is very individual.
      It depends on what one is treating, how frequently, with what volume at which concentration …
      Some ozone practitioners recommend up to 2 RI daily at various volumes and concentrations.


  15. Frank

    Thanks Paola
    I am thinking on days/months as health and anti aging regular treatment for senior:)

    • paola d

      Hi Frank,
      there is no set guideline for anti-aging ozone treatments.
      But many suggest a series of 10 to 12 treatments twice a year.
      Or how many you feel give you benefit.


  16. Chris Pfeiffer

    Why would someone not infuse the ozone into water and then use the water for an enema.

  17. Chris C

    Hi Paola,

    Great site!

    I have a question about the following statement which appears in your the article above:

    “The oxygen concentrator or tank does not have to be low flow since the gas is not introduced directly from the machine but with the use of an intermediary, the bag”.

    I’ve read on other sites that the oxygen flow should be 1/8 or 1/4 LPM to collect ozone in a bag or syringe for rectal insufflations. I’ve also read in another section on your site that I would need to purchase a low flow regulator if I plan to use an oxygen concentrator. So I’m confused. Do I need a low flow regulator for filling an insufflation bag or syringe, or not?


    • paola d

      Hi Chris,

      this all largely depends on which ozone generator you have.

      This statement “the oxygen flow should be 1/8 or 1/4 LPM to collect ozone in a bag or syringe for rectal insufflations” is only true if your ozone generator produces the desired ozone concentration at the flows of 1/8 or 1/4 LPM.

      When you use a bag or insufflation the flow is irrelevant. What is relevant is what you fill the bag with. And what you want to fill the bag with are ozone concentrations of 40 to 50 mcg/ml, tops 70 mcg/ml. If your ozone generator gives you an ozone concentration of let’s say 45 mcg/ml at a flow of 1 LPM, then that is fine for indirect RI. You just hook up the bag to the output of generator, set the oxygen source at 1 LPM, turn the ozone generator on, fill the bag and disconnect everything when the bag is full.

      No need for low flow regulator or anything.

      But if you want to do direct RI *without* the use of a bag, then you need a low flow regulator. Either for your oxygen concentrator or oxygen tank.

      So you need to look at what applications you want to do at which ozone concentrations and if those applications require low flows, like for example ear insufflations. If your machine puts out 45 mcg/ml at 1 LPM, then to get to 20 mcg/ml, one would have to dial the oxygen flow up to something like 2 LPM, this is just a hypothetical example. You can not do ear insufflations with such a high flow or it would blow your ear drums out.


  18. Amy

    Hi Paola,

    Thank you so much for the info… You know so much!
    I have a question, wich protocol would you use for a patient with adrenal fatigue?
    Would you use a combination of therapies? Like maybe, MAAHT and Rectal Ozone? or what would you think would be best?

    Thank you!

    • paola d

      Hi Amy,

      with adrenal fatigue I would look into mercury toxicity and oxalate build-up.

      If it is due to oxalates, ozone can help greatly. I would do any type of ozone IV or ozone saunas.

      Adrenal cortex supplements can help as well.


  19. Robert

    I began to do rectal ozone therapy more than 10 years ago. In those days we simply hooked up the catheter direct to the machine. Can you explain why a bag or syringe is “better”?

    • Robert

      More…maybe it is to ensure a specific volume, but that can be calculated with flow rate/time also, which is what I do. I do not have a weal colon, but also only use low flow rates such as 1/32 or 1/16 l/m.

      • paola d

        Hi Robert,

        yes, as long as you are careful and watch the time during the insufflation, you should be fine.


    • paola d

      Hi Robert,
      it is not necessarily better, but less risky.
      With a syringe or bag you don’t have to set a timer to make sure you don’t go above a certain amount of ozone.

  20. Cynthia kendrick

    I have been doing RI insuflation treatments 4 x per day for 5 weeks- then 3x per day for 5 days, etc. is that too many?i have Addison’s. My stomach is so bloated.

    • paola d

      Hi Cynthia,

      Addison’s disease concerns the adrenals. I would not do RI for that condition.
      I don’t know if ozone would help at all. It is supposed to help stimulate hormone production, so it might …
      But I would rather do ozone saunas with directing the ozone stream towards the adrenals.


  21. John W

    Hi Paola,

    I had colorectal cancer and a colectomy. I’m starting RI at 50mcg/ml. I’m supposed to get to 360ml, 3 times per week, but have only got up to 180ml so far. I’ve had gas/bloating and belching after one or two 60ml syringes. Is this normal? And how long does the O3 need to stay in your system to be effective. Should I try to keep it in for a certain time before passing it? Thanks!

    • paola d

      Hi John,
      has your whole colon been removed or only a part?

    • John

      Paola, only a part of the colon was removed; 15 inches.


  22. Xavier

    Hi Paola.

    I had a question regarding the ozone concentration.

    I started doing RI at 22 mcg/ml, that used to give me pretty strong die off reactions. After a while they were too weak, didn’t feel any benefits in doing such low concentration. So I gradually started increasing ozone concentration, now I’m at 75 gamma, is that ok or is that too much? I feel good doing it at that concentration but a lot of people are saying that’s too much and that it’s more harmful than beneficial. I wanted to know your opinion. Thanks.

  23. Chris

    Hi Paola,

    I have a question about your instructions for performing rectal insufflations above. Under #11 where it says “Unscrew the full syringe from the filling station, connect it with the adapter”, wouldn’t I be releasing ozone into the environment until the time that I actually get the syringe attached to the DIY adaptor? Wouldn’t that be a problem?

    • paola d

      Hi Chris,

      as long as you keep the syringe upright, no ozone should escape or minimal at best.
      Ozone is heavier than air. So as long as you don’t tilt the syringe, no ozone will pour out.
      If you want to be super cautious, get a mask and wear it for the duration of working with ozone.


  24. Rodrigo

    I wonder if 750ml of Ozone at 43 Gamma would be a recommended dose for immune stimulation. Could you give me some help?

    • paola d

      Hi Rodrigo,

      I personally would be cautious about using amounts above 200 ml for RI.
      Also better than RI would be ozone saunas in my opinion.


  25. laura

    hello Paola I was wondering if an oxygen concentrator is good to get with a low flow regulator and also could I ozonate a glass or two of water and throw it in my bath water? thank you for being you

      • JR

        Hello, if heat destroys the ozone, how are ozone saunas beneficial? Thanks

      • Paola Dziwetzki

        Hi JR,

        the heat does not destroy all the ozone. Which one can see on the fact that when stepping out of the sauna there is so much ozone that one has to be careful not to breathe it in.


  26. Chris C.

    Hi Paola,

    Have a Syringe from PromoLife, Oxygen concentrator, cheap hack flowmeter as on your oxygen concentrator page. Everything seems to be set up and working fine, flowmeter at the right level, but suddenly the syringe is not filling on its own. I have to pull the plunger out. Does the syringe have to be oiled every time? Does this suggest I have a problem elsewhere. Everything seems to be set up correctly as I have done before otherwise. Any suggestions?


    • paola d

      Hi Chris,

      the plunger of the syringe needs to move really easily. If it’s not, then re-apply the oil. You may need to before every application.
      Or you may have a leakage somewhere …


    • Lyel

      What do you think about doing RI on daily basis. I have talassemia trace and would like to use o3 daily to enhance blood oxigenation. My former o3 pratitioner advices me not to do RI daily because it can cause damage do good gut bacteria and eventually have disbiose. What do you think?

      • Paola Dziwetzki

        Hi Lyel,

        I agree that RI longterm could have a detrimental effect on the gut biome. If this is in fact so, we don’t know since no one ever tested this. But since ozone can kill any bacteria known to man, it would stand to reason that it would also kill good gut bacteria.

        I would rather suggest to do ozone saunas, or drink ozonated water, or get ozone IVs done regularly. Or do hyperbaric oxygen, or H2O2 soaking baths.


  27. Ken

    CommeHi Paloa-

    Nice video on RI! I’ve learned a lot from your research. I have question regarding the use of an Oxygen Concentrator for RI uses. According to Dr. Rowen, OC produces Five (5)% of Nitrogen, and shouldn’t be used for RI. See link attached- start at 37: 00 tape counter. By the way, in this video Dr. Rowen didn’t elaborate on why Nitrogen isn’t good for RI uses. If you have any literature on this please let me know. Thanks.


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Paola Dziwetzki, NP

I’m Paola, aka the Crazy Old Ozone Lady. I help people use ozone therapy in the most effective way. I have used ozone and diet to successfully treat psoriasis, joint pain, chronic fatigue, a low immune system, herpes infections, and a few other conditions.
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