Basti therapy is one of the major pancharma treatments. Ayurvedic basti refers to the introduction of certain oils, herbal concoctions, and sometimes milk or other liquids through the perineum- anus, urethra in men or vagina in women. Basti is the most effective treatment for vata dosha or vata disorders. The term 'Basti' literally means bag or bladder. In ancient times, sterilized urinary bladders of animals were used to inject the fluids into the rectum. Therefore, this ayurvedic therapy came to be known as Basti Karma.

Basti v/s Enema

Ayurvedic Basti involves instilling liquids like medicated oils, herbal concoctions and milk through the perineum. The purpose of this therapy is to clean or heal the lower part ( below umbilical region) of the body. The ama or toxins accumulated in the lower part of the body or the toxins pushed to the colon, urinary tract or reproductive tract due to previous ayurvedic therapies like Panchakarma- Purva Karma including snehan (Oil-therapy) or swedan (Sweat-therapy) is cleared through basti therapies. Enema, on the other hand, refers to injecting of a fluid into the rectum to cause a bowel movement. It is a more localized, symptomatic treatment. Basti has significant multiple effects for treating various diseases and other medical conditions. In administration, effects and intent the Ayurvedic Basti differs significantly from Enema and Colonic treatments which only address the eliminative capacity of the colon.

How Basti Therapy Works?

Basti therapy is mostly prescribed for people with Vata Dosha Ayurvedic Body Type. Vata's predominant site is the colon and as stated earlier too, Basti is the most effective treatment for vata disorders. Vata is the motive force behind the elimination and retention of feces, urine, bile and other excreta. It is primarily located in the large intestine. However, the bone tissue or asthi dhatu is also a site for vata. Medication administered through rectum effects asthi dhatu. The mucus membrane of the colon is related to the outer covering of the bones (periosteum), which nourishes the bones. Any medication given through rectum goes into the deeper tissues, like bones, and corrects vata disorders.

Types of Ayurvedic Basti Therapies

There are different types of Bastis categorized on the basis of bodily area from where fluids are injected; fluids (oil and decoctions) used; administration process; and number of sessions required. Anuvasana Basti(oil enema)– In this type of basti, medicated oils are used to cure accute vata disorders. It is mainly recommended when a person experiences excessive hunger or dryness related to vata imbalances.

Niruha or Asthapana Basti (decoction enema)- It is mainly enema of water based medical extracts or medicated water. This basti is used for evacuation of vata, nervous diseases, gastro-intestinal vata conditions, gout, certain fever conditions, unconsciousness, certain urinary disorders, appetite, pain, hyperacidity and heart diseases.

Uttara Basti (Vaginal Basti)- Enema is given through vagina in women. Uttara Basti is for certain gynecological disorders like uterine prolapsed, leucorrhoea, mennorhagia, urinary obstruction, habitual abortions, infertility, and ovulation disorders etc.

Mutrashaya Basti (Urethra Basti)- Enema is given through urethra in men. This basti treatment is for selected semen disorders and for certain problems regarding painful urination or bladder infections.

Matra Basti (daily oil enema)- is used for very lean or thin person emaciated by overwork, too much exercise or heavy lifting, too much sexual activity or someone with chronic vata disorders. This Basti therapy basically aims at giving strength and promotes weight apart from helping in elimination of waste products.

Karma Basti – It is a scheduled Basti treatment which needs 30 sessions of basti therapy. It begins with Anuvasana Basti and is followed by Niruha basti – both of which continue on alternate days. The last six Bastis are the Anuvasana Basti.

Kala Basti- It is also a scheduled Basti treatment with 10 oil and 6 decoction basti sessions. The series remain same as in Karma Basti with last four sessions of Anuvasana Basti.

Yoga Basti- A scheduled Basti treatment with 5 oil and 3 decoction basti sessions. It begins with Anuvasana Basti and followed by Nirooha basti on alternate days. Last two sessions include Anuvasana Basti.

Bruhan Basti (nutritional enema)- This enema is meant for providing deep nutrition in select conditions. Conventionally, highly nutritive substances such as warm milk, meat broth, bone marrow soup and herbs like Asparagus Racemosus (shatavari)and ashwagandha are used for Bruhana Basti.

Advantages of Ayurvedic Basti Treatment

Ayurvedic Basti restores the balance of the doshas or the body types. The Vata body type, in particular, can get the maximum benefit of basti ayurvedic therapies. Some of the advantages of Basti include

• It increases weight in emaciated people by providing high nutrition and rejuvenation.
• It is also beneficial in weight loss programmes as some basti treatments reduce weight in the obese
• It improves vision
• It prevents aging and brings back lustre, strength, and longevity.
• It provides relief from constipation, distention, chronic fever, cold, kidney stones.
• It is also used to cure sexual disorders.
• Basti is very beneficial in preventing heart pain, backache, sciatica and other pains in the joints.
• As vata disorder is the main cause of many pains including joint pains and knee pain, basti provides relief in such conditions as arthritis, rheumatism, gout, muscle spasms and headaches.
• It is also effective for most of the digestive disorders like dry colon, dry rectum condition and the tendency towards constipation resulting from such conditions.

These were only some conditions where basti proves to be beneficial. Ayurveda practitioners use basti for treating many other medical conditions including certain chronic diseases too.

Contra Indications for Basti

There are certain health conditions where basti has been restricted to be used because in such conditions, basti can prove to be detrimental to patient's health

Basti has generally to be avoided in all types of diarrheas, dysenteries, rectal bleeding, diabetes, severe anaemia, hypoproteinaemia, breathlessness, pulmonary tuberculosis, infantile problems and senile debility.

Niruha Basti can not be given to pregnant women and children under 10 years of age. It is also not recommended after meals, after sex, after vomiting or purging, if the person is too tired, exhausted and in certain conditions including serious skin disease, urinary disorder, intoxicated states, piles, anorexia, psychosis, dryness of throat, anal inflammation, and oedema.

Anuvasan Basti is also prohibited in conditions as given under Niruha basti. It is also contra indicated in anemia, jaundice, piles, fever, diarrhea, poisoning, enlargement of the spleen, chronic catarrhal inflammation of the nasal mucous membrane, and during fasting.

Side Effects of Basti

If administered properly, Basti karma has very few or no side effects on the body. When Basti therapy remains incomplete, one can experience spasmodic pains, burning sensation, anorectal itching and pain, anorexia, blockage of stools and wind. If excessive basti treatment is provided, it may cause anorectal inflammation and ulceration, fissure, weakness, and muscular cramps.

Precautions and Corrective Measures for Basti

Basti should be administered in the mornings on empty stomach. If that is not possible, it should be given 4-6 hours after a meal. Bowels and bladder must be completely evacuated prior to Basti treatment. A warm oil massage on the belly and back followed by fomentation of the abdomen is recommended before starting basti. For fomentation, a bottle with warm water can be kept on the belly for 10 minutes. If emesis (vomiting) and purgation treatments too are to be given, they are best administered prior to Basti. Medicated water enemas should be retained for 48 minutes or at least for 15 minutes.

If one experiences pain in abdomen after Basti, a gentle massage should be given at the abdomen area. If there is headache after Basti, a gentle head and forehead massage followed by Ginger tea is the best cure. This can be followed by Nasya which is a special ayurvedic treatment to cleanse the sinus area. If the administered liquids are not expelled after 48 minutes another Basti treatment is prescribed with hot water (38C) and fomentation to the lower back and abdomen. Warm water can also be taken. If there is some complication, castor oil with warm water or prune juice should be given immediately to expel loosened toxins from the colon.

Person who has been given basti must have a light diet for a day. He/she must also avoid sitting, standing, and talking for a long duration, traveling, sleeping during the day, coitus (sexual intercourse), exposure to cold or too much sunlight, anxiety, anger, untimely meals, an incompatible diet, and suppression of natural urges like sneezing, farting, burping, and elimination of faeces.

Proper administration of Basti karma is very essential for having maximum benefits. If not done properly, it may lead to various complications. It is, therefore, always advisable to visit an Ayurvedic practitioner or Vaidya before attempting to administer an ayurvedic Basti.