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 denotes the application of the herbal enema.  As a direct pathway into the colon, enemas can be a very powerful method for treating many issues and ailments, as well as cleansing toxins (ama) from the intestines.  Since the colon is the home of Vata dosha, Basti is often 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 used to target other doshas and imbalances as well. 

What herbs and substances are best used for Basti?

The traditional Ayurvedic enema often uses an herbal decoction of Dashamula* tea.  Dashamula is the “10 roots” formula that is specific for reducing Vata and all its related disorders.  Many other herbs and substances can be used in Basti therapy as well, depending on the issues and imbalances at hand.   

Dashamula can be mixed with other herbs to form a more appropriate formula.  For instance, the Dashamul tea can be blended with Guduchi* if there is a Pitta imbalance present.  Alternatively, you 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 or Ayurvedic body type), and their Vikruti (current imbalance).    

Other substances can be used for Basti therapy as well.  Some common Ayurvedic substances include ghee, medicated ghee, or sesame oil.  Using an oil base for the enema is called Anuvasan Basti, meaning with oil; whereas the herbal decoction version mentioned above 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 to receive the benefits of both therapies.    

Besides the herbal decoction or the oil enema, a few other substances that are used in 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 Dashamula Basti can be used for most body types and health issues, making this a preferred “go-to” option by many.

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When should you use Basti therapy?

Basti can be used to treat just about any Vata disorder.  In fact, it may be 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 (e.g. Parkinson’s), hypersensitivity, constipation, chronic gas and bloating, debility, depletion, emaciation, sciatica, gout, arthritis, osteoporosis, and dryness; just to name a few.  Since Vata is typically involved in other doshic imbalances, Basti can be used to indirectly alleviate both Pitta and Kapha, treating a wide variety of disorders. 

Another main indication to use Basti therapy would be during times of cleansing*.  Basti is one of the main cleansing therapies in the traditional Ayurvedic Pancha Karma (the five cleansing actions) therapy.  It can be used in many home cleanses such as a kitchari cleanse or a modified home “PK” (panchakarma) as well.  Due to the direct application into the colon, enema therapy is quite effective in flushing out toxins from the intestines, making it very effective to aid in detoxification.  When using Basti for cleansing, you can use the traditional Dashamul decoction, or a blend of Dashamul with a cleansing herb such as Guduchi, Musta, or Kutki.  If parasites are an issue, an anti-parasitical herb such as Vidanga should be used 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 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 to 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 (e.g. bone marrow broth)

How often should you perform Basti?

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

During an Ayurvedic cleanse, Basti is typically performed 2 to 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 removed thoroughly. 

If you are treating an acute or less severe disorder, you can perform Basti for 2 to 3 days consistently.  If the imbalance still remains, wait for 5 to 7 days and repeat until the imbalance has healed.   

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

How do you apply Basti?

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The first step in applying Basti is knowing the substance to use (e.g. 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 time to relax after the treatment. 

Materials needed for Basti:

• Enema Bag
• Herbal medicine decoction 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 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 Basti
• Avoid food for at least 2 to 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 avoiding heavy food (e.g. meat, pasta, dairy, junk food) and favoring easy-to-digest meals such as kitchari, porridges, or soup
• Choose a comfortable and warm space to perform this procedure; 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 (Ayurvedic Enema) 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 to 9 feet up.

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

4. Have an empty container or jar at hand.  Open the tube over the empty jar, letting out the herbal infusion to fill the entire tube completely before the insertion.  This is a quick open and close, so be prepared to close it quickly to avoid wasting too much liquid.  *This step is important to let out any air in the tube and avoid air going 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. After insertion, 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 to 10 minutes.

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

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

12. Try to retain the herbal infusion (or oil, etc.) 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.  The herbal enema may be retained indefinitely if the colon is dry.  

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 questions or concerns around this, it is highly recommended to see a skilled Ayurvedic practitioner for guidance.

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