Niruha Basti (Decoction Enema)
Niruha basti is the cleansing decoction enema of pañcakarma: a compounded mixture of kvātha, saindhava, madhu, sneha and kalka, given rectally and expelled within about forty-five minutes. It is usually alternated with anuvāsana basti. The source record marks it vaidya-only, and it is not a home enema.
Requires a qualified vaidya. This is clinical work requiring a qualified vaidya, and often a supervised setting. It is described here so you understand what it is and why it needs supervision. It is not something to attempt, and this page is deliberately not a set of instructions.
What it is
Niruha basti, also called āsthāpana, is the cleansing form of basti: a medicated decoction enema, as opposed to anuvāsana basti, the oil-retention enema. The source record glosses it as “medicated decoction enema (cleansing)”, files it under pañcakarma with subcategory niruha, and marks it vaidya-only.
Basti is the procedure Ayurveda treats as the most consequential of the five, and this page is a description of it, not a method.
Where it comes from in the classical literature
Both of the record’s citations check out.
- Caraka Siddhisthāna 1, Kalpanā Siddhi, is the opening chapter of the Siddhisthāna and gives the overall shape of the pañcakarma procedures, setting out the basic concepts of vamana, virecana, basti and nasya, with niruha described as the evacuative decoction enema used for purification.
- Suśruta Cikitsāsthāna 35 to 38 is the basti block: 35 on the measures and divisions of enema therapy, 36 on the complications of enema administration, 37 on anuvāsana and uttara basti, and 38, Nirūha Krama Cikitsitam, on the procedure of the decoction enema itself.
That chapter 36 exists at all is worth noting. The classical tradition devotes an entire chapter to what goes wrong with basti, which is the clearest signal in the sources about why this sits with a vaidya.
What it involves
The record’s protocol runs across more than one day.
Before. Anuvāsana basti, the oil enema, is given the day before.
During. A mixture of medicated kvātha with saindhava, madhu, sneha and kalka, around six hundred millilitres, is administered rectally and expelled within about forty-five minutes.
After. A light warm meal of rice and dāl. Anuvāsana basti often follows the next day, the two alternating.
The record gives no total course length, no season and no frequency beyond that alternation, and lists no adverse events.
What is used
The record names no specific dravyas and no specific oils, only the classes of ingredient that make up the mixture: kvātha (decoction), saindhava (rock salt), madhu (honey), sneha (an oleaginous medium) and kalka (herbal paste). Which decoction and which sneha are chosen is the clinical content of the procedure, and the record does not record it.
What to ask before booking
Because the record puts this with a vaidya, the reader’s part is assessment rather than execution. Worth asking: whether the preparatory anuvāsana basti is included, since the record treats it as part of the protocol; what decoction is being used; how many bastis are planned and over how many days; what the clinic does if the enema is not expelled in the expected time; and what the diet is meant to be on procedure days.
Anyone with rectal bleeding, inflammatory bowel disease, recent abdominal or anorectal surgery, severe haemorrhoids, a bowel obstruction, uncontrolled diarrhoea, or who is pregnant, should be raising it before any enema is discussed.
Cautions
- Vaidya-only. The record marks it so, and Suśruta gives a whole chapter, Cikitsāsthāna 36, to the complications of enema administration.
- This is not the same thing as a retail enema kit. The record's mixture is compounded from a medicated decoction with rock salt, honey, an oleaginous medium and herbal paste, and the composition is a clinical decision.
- The record's volume, around six hundred millilitres, and its expected expulsion within about forty-five minutes, are that protocol's figures in a supervised setting, not a home measure.
- Rectal bleeding, inflammatory bowel disease, recent abdominal or anorectal surgery, severe haemorrhoids, suspected obstruction, uncontrolled diarrhoea and pregnancy all need to be disclosed before any enema is considered.
- The record carries no adverse-event data and no red flags. Those fields were never filled; the absence is not reassurance.
Substances named
Saindhava (rock salt)
Classical source
Caraka Siddhisthāna 1 (Kalpanā Siddhi); Suśruta Cikitsāsthāna 35–38, of which 38 is Nirūha Krama Cikitsitam — checked against a published translation
Both citations verified as given, no correction needed. Caraka Siddhisthāna 1 = Kalpanā Siddhi, confirmed via carakasamhitaonline.com and easyayurveda.com as the chapter giving the overall content of the pañcakarma procedures, with niruha described as the evacuative decoction enema used for purification. The Suśruta range was checked chapter by chapter against easyayurveda.com and pocketayurveda.com chapter pages: 35 Netra Basti Pramāṇa Vibhāga Cikitsitam (description of enema therapy), 36 Netrabasti Vyāpat Cikitsitam (complications of enema administration), 37 Anuvāsanottarabasti Cikitsitam, 38 Nirūha Krama Cikitsitam (procedure of decoction enema).
Common questions
- What is the difference between niruha and anuvāsana basti?
- Niruha is the cleansing decoction enema, made from a medicated kvātha compounded with saindhava, madhu, sneha and kalka, and expelled. Anuvāsana is the oil enema. The record's protocol has them working together: anuvāsana the day before, niruha on the day, and anuvāsana often again the next day, alternating.
- How long is it held?
- The record says the niruha mixture is expelled within about forty-five minutes of administration. Its stated volume is around six hundred millilitres. The record gives no total course length, so how many bastis a course involves is not something this page can tell you.
- Can basti be done at home?
- The source record classifies it vaidya-only, so this reference does not present it as a home procedure. The classical literature reinforces the point: Suśruta Cikitsāsthāna 36 is an entire chapter on the complications of enema administration, and the composition of the mixture is itself a clinical judgement.
Reviewed by Dr. Awadesh Pratap Singh, BAMS, on 18 September 2026. What that review covered.
Consult a qualified vaidya before acting on anything here. Ayurvedic practice is prescribed to a person, not to a condition: the same procedure is given, modified or withheld depending on your constitution, your agni, the season and what else you are already doing. A page cannot know any of that.