Decoction Enema

🌿 Understanding Decoction Enema (Kashaya Basti) in Ayurveda

What is Decoction Enema? 💫

Decoction Enema is an Ayurvedic therapy where medicated decoctions are administered rectally. It primarily aims to clean the lower part of the alimentary tract.

Pre-Treatment Preparation 🔄

Before undergoing a decoction enema, the following preparatory measures must be taken:

• Complete oleation and fomentation therapy
• Undergo oil enema one day prior to the decoction enema
• Fast on the day of therapy (no food should be taken before the procedure)

Medicinal Ingredients 🧪

Required substances:

• Rock Salt: 15 gm
• Honey: 150 ml
• Sahacharadi Taila (Vasti Paka): 150 ml
• Paste of Dill seeds: 30 gm
• Castor root: 150 gm

Decoction Preparation Process 🍃

• Create the base decoction:
  • Boil castor root (150 gm) in 5.5 liters of water
  • Reduce to 650 ml and set aside as the final ingredient
• Mix ingredients in sequence:
  • Add rock salt
  • Mix in honey
  • Add Sahacharadi Taila
  • Incorporate dill seeds paste (ground on stone)
  • Finally, mix in the castor root decoction
• Final preparation:
  • Filter the mixture
  • Warm to lukewarm temperature
  • Transfer to an enema can

Administration Procedure 🧴

• Positioning:
  • Lie on left lateral side
  • Extend left leg
  • Flex right leg at knee joint
• Insertion process:
  • Lubricate nozzle and anus with oil
  • Expel air from tube by pouring some medicine out
  • Insert nozzle into anus
  • Raise enema can to allow decoction flow
  • Remove nozzle before all medicine is administered (prevents air entry)
• Post-insertion procedure:
  • Lie on back facing upwards
  • Receive gentle clockwise stomach massage
  • Have palms and feet massaged
  • Allow therapist to assist with gentle leg stretches:
    • Therapist lifts legs gently three times
    • With knees straight, legs are raised up and down three times
  • Important: Do not perform stretches independently (may cause abdominal stress)
  • Use restroom only when unable to hold the liquid longer

Common Reactions ⚠️ 

• Stronger cramps than experienced in Virechana
• Possible burping and dizziness
• Safety note: Do not lock bathroom door in case assistance is needed

Completion Process 🔄 

• Elimination process typically completes within 48 minutes
• If elimination is incomplete:
  • Laxative herbs may be administered
  • Another enema may be given after 30 minutes
  • Additional massage of stomach, palms, and hands
• Critical: All decoction must be fully eliminated from the body

Signs of Successful Therapy 🌟

Successful therapy is indicated by:

• Downward movement of Vata, Pitta, and Kapha
• Full-body lightness
• Downward movement of stool
• Post-procedure exhaustion
• Elimination of hard, dry stool (with pressure)
• Foamy, darkish secretion with flatus

Post-Procedure Care 🌱

1. Immediate care:
   • Take a warm shower after completion
   • Eat light, warm, moist food when hungry (e.g., khichdi without ghee or spices)
   • Rest and sleep on the day of procedure
2. Following day:
   • Continue with light food
   • Undergo oil enema

Complications from Excessive Treatment ⚠️ 

Overuse of decoction enema may cause:

• Excessive diarrhea
• Dehydration
• Rectal or uterine prolapse
• Greenish or reddish anal secretions
• Inflammation and anal bleeding
• Numbness or stiffness in the body
• Tremors
• Extreme exhaustion (some exhaustion is normal even with optimal procedure)

Contraindications ❌ 

Decoction enema should NOT be performed in cases of:

• Children, elderly, or debilitated patients
• Lower alimentary tract inflammation
• Downward bleeding (including menstruation)
• Pregnancy or within 45 days post-delivery
• Recent injury or surgery
• Diarrhea or dehydration
• Same-day purification therapy
• Uterine or rectal prolapse
• Extreme obesity or thinness
• Bleeding hemorrhoids
• Rectal swelling or burns
• Weak digestion
• Perforated intestines
• Recent food consumption

References

Primary Source: School of Ayurveda and Panchkarma - Lectures and Notes