Basti: The Ayurvedic Enema and its Multitude of Health Benefits and Uses

If you are familiar with Ayurveda you may have heard of the term Basti.  Basti’s literal translation is “bladder”, however, the Basti therapy referred to in Ayurveda is often talking about the application of the herbal enema.  As a direct pathway into the colon, the Ayurvedic enema is very powerful for treating a number of issues and ailments, as well as cleansing toxins (ama) from the intestines.  Since the colon is the home of Vata dosha, more often than not, Basti is used to treat Vata disorders including constipation, dryness, depletion, insomnia, nervous system disorders, arthritis, osteoporosis, and the like.  Although it is considered the main treatment for Vata, different herbs and substances can be utilized to target other doshas and imbalances as well. 

What herbs and substances are best used for Basti?

The traditional Ayurvedic enema often utilizes an herbal decoction of Dashamul tea.  This is a “10 root” formula that is a powerful pacifier for Vata dosha and all its related disorders.  Although this tends to be the most commonly used formula, many herbs can be used, depending on the issues and imbalances at hand.  In fact, the Dashamul can even be mixed with other herbs to form a more appropriate formula.  For instance, if one is experiencing a Pitta imbalance, often the Dashamul tea can be blended with Guduchi, one of the main herbs for combating Pitta.  Alternatively, one can mix Punarnava with the Dashamul during a Kapha imbalance.  In general, most herbs can be administered through Basti, depending on the needs of the individual, their Prakruti (constitution) and their Vikruti (current imbalance).    

The Ayurvedic enema is very a effective way of administering the herbs due to the direct absorption that takes place into the colon.  At times however, other substances can be used as well.  Other common medical substances include ghee, medicated ghee, or sesame oil.  Using an oil base for the enema is called Anuvasan Basti, meaning with oil.  Alternatively, the herbal decoction version is called Niruha Basti, meaning without oil.  The oil method is most useful in disturbances that do not involve toxins (ama).  If toxins are present, it is crucial to avoid the use of oil or ghee, as these substances can drive the toxins deeper into the tissues.  If there are no signs of toxins, using oils or ghee can be a very powerful way to reduce Vata, anxiety, dryness, constipation and general depletion of the tissues.  At times, these methods may be alternated in order to receive the benefits of both therapies.    

Besides the herbal decoction or the oil enema, a few other medicinal substances that are used with the various Basti therapies include milk, medicated milk, bone broth, meat broth, herbal juices, honey (blended in the oil), egg whites, salt water, and even cow’s urine.  Each substance possesses specific health benefits and therefore, depending on the individual’s needs, you can choose the medicine that would be most needed at any given time.  In general, the traditional Dashamul Basti can be used for a wide range of body types and issues, making this a preferred “go-to” option by many.

When should one use the Basti?

Basti can be used to treat just about any Vata disorder.  In fact, it is just about the most powerful and effective way to treat Vata due to the direct application into the colon (aka the “home” of Vata).  Common Vata disorders include anxiety, fear, restless mind, sleep disorders, nervous system disorders (i.e. Parkinson’s), hypersensitivity, constipation, chronic gas and bloating, debility, depletion, emaciation, sciatica, gout, arthritis, osteoporosis, and dryness, to name a few.  Further, since Vata is typically involved in other doshic imbalances as the primary movement force, the Basti can be used to indirectly alleviate both Pitta and Kapha, treating a wide variety of disorders and imbalances. 

Another main indication to utilize the Basti therapy would be during times of cleansing.  In fact, it is one of the main cleansing therapies of the traditional Pancha Karma ( lit. the five cleansing actions) therapy.  It is often used in many home cleanses such as the kitchari cleanse or a modified home “PK” (pancha karma) as well.  Due to the direct application into the colon, the enema is quite effective in flushing out toxins from the intestines, making it a useful therapy for detoxification.  When using the Basti for cleansing, one can use the traditional Dashamul decoction, or a blend of Dashamul with a cleansing herb such as Guduchi, Musta or Kutki.  If there are thought to be parasites, it is highly recommended to use an anti-parasitical herb such as Vidanga for beneficial results.       

**Please note that when performing Basti during a cleanse, it is necessary to have gone through the typical “pre-cleanse” practices such as sweating (svedana)  and oiliation (snehana). 

Are there any contraindications with Basti?

Since the Basti is a relatively “invasive” therapy, one should use knowledge, awareness and precaution before performing.  Here is a non-exhaustive list of some common contraindications for Basti:

Do NOT use Basti during:
  • Pregnancy
  • Menstruation
  • Acute diarrhea
  • Hemorrhoids or rectal polyps
  • Within 2-3 hours after food intake
  • Shortness of breath
  • Rectal or vaginal prolapse
  • Ascites
  • Only a nutritive Basti should be done with severe debility or emaciation (i.e. bone marrow broth)

How often should one perform the Basti?

How often one should perform the Basti will depend on a case by case basis.  If you are treating a severe or chronic disorder, it is likely you will need to perform this multiple times over a prolonged period in order to receive the results you are needing.  This can mean performing multiple days in a row consistently, or several days a week for a specific amount of weeks.  It is important to avoid overdoing it with the Basti, as one can become habituated to the cleansing effect, weakening the colon overtime.  Therefore it is usually best to give breaks in between, even with severe disorders.

During an Ayurvedic cleanse the Basti is typically performed 2-3 days consistently, and then once a week for about 4 weeks during the “post-cleanse” phase.  After the cleanse, the Anuvasana (Oil) Basti can be used (if appropriate), as long as the toxins have been cleared out thoroughly. 

If you are treating an acute or less severe disorder, one can perform the Basti 2-3 days consistently.  If the imbalance still remains, wait 5-7 days and repeat until the disorder is removed.   

Important note: If there are many questions or concerns around this, it is highly recommended to see a skilled Ayurvedic practitioner for guidance.

How do you apply the Basti?

The first step in applying Basti is knowing the substance to use (i.e. Dashamula tea) and the length of time it will be performed.  You will want to make sure you have all of the materials needed and the time to relax after the treatment. 

Materials Needed for Basti:
  • Enema Bag
  • Herbal medicine of choice (lukewarm)
  • Old blanket, towel and/or pillow
  • A jar or container to catch the initial liquid from the tube (see #4 below)

Important notes before administering the Basti therapy:

  • The best times for application are either first thing in the morning or later in the evening 
  • Avoid any exerting activity after the application of the Basti
  • Avoid food 2-3 hours (or more) before and after performing Basti, herbal teas and warm water can be taken as needed
  • Food should be light on the days of application, this means to avoid heavy food (i.e. meat) and favor easy to digest meals such as kitchari, porridges or soup
  • Choose a comfortable and warm space to perform this procedure, feel free to place an old sheet or blanket on the floor to lie on during application

Once you have all of the above in order, it is time for the treatment. 

Basti Instructions:

1. Place the medicine of choice into the enema bag. 

2. Hang the bag using a hanger or similar gadget up at a high elevation, ideally at least 6-9 feet up.

3. Lay a towel or an old sheet on the floor and have a pillow and blanket nearby to keep comfortable after the application. 

4. Have an empty container or jar at hand.  Open the tube over the empty jar, letting the tea move down it, filling the entire tube completely before the insertion.  This is a really quick open and close, so be prepared to close quickly to avoid wasting too much liquid.  ***This step is important to let out any air in the tube, avoiding air coming into the colon!

5. Place a small amount of oil or ghee on the end of the tube to allow easy insertion. 

6. Lay on your left side and insert the end of the enema tube into the rectum about 2 inches, keeping the tube closed. 

7. Open the tube and allow the liquid to flow into the colon.

8. Once the bag is completely empty, close the tube, remove it from the rectum and place it in a safe place.

9. Lay on your left side for 5-10 minutes.

10. Switch to the right side for 5-10 minutes.

11. Place the pillow behind you and lay in a supported supine position.  Stay here for as long as you feel comfortable.

12. The herbal enema may be retained indefinitely if the colon is really dry; this is totally fine.  Otherwise, try to retain it for a minimum of 30 minutes or longer if possible.  If there is too much pressure before then, just retain as long as possible to allow the absorption of the medicine into the colon. 

13. To clean the bag, rinse out immediately after use with hot water in the tub.  Once all of the sediment is removed, get out as much water as possible and then hang to dry.  

Important note: If there are many questions or concerns around this, it is highly recommended to see a skilled Ayurvedic practitioner for guidance.

Purchase our Dashamul Enema Kit here!
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