I've heard that it is necessary to do the epsolm salt. The first time, my hubby didn't, and he had ab cramps for like 24 hrs. I personally had a hard time swallowing the water, so I measured and made capsules. Lot's easier. Also, I think the first two or three flushes are hard on the body, making everything ache, especially places where you already do. My third one wasn't as bad, and I look forward to the fourth. Sure makes you feel icky the first two times, but the pain I felt is no more than what I've felt for all these years anyway. Good luck