The Science behind Basti, or “How can a colon wash cure my joint pains?”

 Basti karma (often shorthanded as ‘Basti’) is a major part of the Ayurvedic Panchakarma therapy. So much so, that some treatises even colloquially call it “half of all medical therapy”. So what really is this Basti? And how effective it really can be?

Whenever a patient asks us Ayurvedic physicians what Basti is, the standard answer comes out, “It is a medicated colon wash made of various herbal oils and/or decoctions, customized for each patient, that can cure a wide range of Vaata dominant disorders.” Now, ‘colon wash’ being a despised procedure for many, the first question that gets blurted is “How can a colon wash relieve my headache/arthritis/diabetes?”. This doubt is but obvious, since allopathic medicine mostly uses enemas only in constipation or some rare conditions.

So today we elaborate this very interesting question using raw 21st century science.

To understand it better, let us first take a primer on the human digestive system. The food we eat, passes through roughly 3 phases of digestion –

Human digestive system (Simplified diagram).

  1. Stomach, where mainly, most of the proteins get digested by the gastric juice (HCl).
  2. Small intestine, where mostly the carbs and fat get digested by the pancreatic juice and through emulsification by bile salts, and get absorbed in bloodstream,along with the proteins.
  3. Colon (large intestine), where mainly the minerals, water and electrolytes get absorbed and reabsorbed.From there, the leftover residue (faeces) get excreted through the anus via the rectum.

Now, in order to function efficiently, the inner cell lining of the colon is naturally far more conducive to material exchange with bloodstream, than the other surfaces in the body. This becomes one reason why a Basti (that delivers medications directly into the colon) can prove a faster and more efficacious delivery route for specific drugs, rather than the oral or topical route. The bioavailability (percentage of administered medicine that actually gets absorbed into the patient’s bloodstream) of Basti’s active ingredients is touted around 90 to 95% by various sources, as compared to 60 to 70% of corresponding oral medicines and 40 to 50% of topical medicines. So Basti is somewhat the Ayurvedic non-invasive answer to modern IV injections, which obviously have 100% bioavailability.

Also, just as it can deliver medicine through the conducive colon epithelium, it is also claimed to cause a reverse exchange in some cases, eliminating metabolic toxins from the bloodstream. Though we won’t back this claim for lack of scientific study data, the efficacy of Basti formulations is time tested.

Then comes the second, yet important reason. Though the first two phases of digestion digest mainly proteins, carbs and fats, they also cause a lot of chemical changes that render several medicinal compounds in the food useless. This is the very same reason why some modern medicines have to be injected only, instead of giving orally, to avoid these chemical changes. So how to get such volatile medications directly into your bloodstream? Bypass the first two phases and deliver them directly to the 3rd phase (colon) for absorption, using a Basti.

Also, yet another obstacle in drug delivery is the Liver, which metabolises and destroys several drugs before they can even act on the target organ. Ironically, all drugs digested and absorbed by oral route go directly to the liver first. However, 50% of the rectally administered drugs (Basti) get absorbed through the external haemorrhoidal veins which have the very useful drainage route that bypasses the liver, and goes straight back to the heart, and gets distributed throughout the body from there. Thought they too are eventually metabolised by the liver, this route gives better half-life to the drug.

A question would naturally come to mind now – Why go for a messy Basti if a two-minute injection shot too, can do a similar job?

The answer is simple and straight – just the way some meds have to be delivered by injections only, some meds have to be delivered by Basti only. How come?

Any average Ayurvedic decoction/oil made of just 3 to 5 herbs even, contains a cocktail of hundreds of active bio-compounds. (That, in fact, is the reason why Ayurvedic drugs have such negligible side effects – the biomolecules that prevent any possible side effects also get added in the same formulation). No research till date has been able to synthetically mimic these biochemical cocktails in their purest form. It means that a sterile injectable dose of a herbal decoction is not going to be available in the near future at least. Naturally, it follows that a Basti is the most viable option when you wish to take benefit of an effective herbal treatment.

Add to this, the fact that injection medications enter only the bloodstream directly, while Basti medications percolate directly into the lymphatic system as well, without being taken up largely by cell receptors.

Cross-section of human gut, showing various layers. Note the lymphatic tissue (green lobes [5]) so near to the inner lumen.

So, with the primary doubts now addressed, we turn to what can a Basti be good for.

Well, this is such a big specialization in itself, that whole textbooks have *actually* been written on it. Still, to be short, Basti can be used in –
– all types of arthritis (OA, RA, gout, AnS, etc.)
– Pelvic inflammatory disease
– menopausal disturbances
– several neuro-myopathies
– aging related disorders
– chronic bronchitis
– diabetes mellitus
– epilepsy
– various psychiatric disorders etc.

to name a few diseases.

So now you know why and how an colon wash… no, a BASTI can relieve a headache or painful knees within minutes. Still, know well that it is largely the doctor’s skill and judgement of your Prakriti/disease, and his choice of ingredients accordingly, that plays the key roll in how much relief you get from the therapy. So, always choose a good qualified doctor not just for Basti, but for any Ayurvedic treatment.

About the Author – 

Dr. Harshad Rajandekar, BAMS, CMA Inter., is a practising consultant in Ayurvedic and Integrative medicine based out of Nashik (India), licensed to practice Ayurveda and modern medicine in the state of Maharashtra, India. He believes in combining the best of old and new to provide optimum holistic cures and wellness to his patients.
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7 thoughts on “The Science behind Basti, or “How can a colon wash cure my joint pains?”

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    1. You’re welcome… as of now, we do not have in-campus residential facilities, but Nashik being a very famous tourist city, a lot of accommodation options are already available, so that most tourist patients prefer selecting their hotels/lodgings by themselves. However, we do provide assistance and info if asked for.

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