Changes

A. Basti is intended to reach complete large intestine up to caecum. Thus two factors are very much needed:

A. Basti is intended to reach complete large intestine up to caecum. Thus two factors are very much needed:

1. Administering sufficient  fluid volume more than minimum 240 ml as it is maximum tolerated rectal volume in adult person.   If it is administered in low volume then basti may not even cross the rectum.

1. Administering sufficient  fluid volume more than minimum 240 ml as it is maximum tolerated rectal volume in adult person.<ref>van Meegdenburg, Maxime & Heineman, Erik & Broens, Paul. (2015). Dyssynergic defecation may aggravate constipation: Results of mostly pediatric cases with congenital anorectal malformation. The American Journal of Surgery. 210. 10.1016/j.amjsurg.2014.09.038.</ref> If it is administered in low volume then basti may not even cross the rectum.

2. Basti need to be administered with generous force to generate mild reverse peristalsis/ retroperistalsis which actually takes basti content higher up to the ceacum and  may be upto terminal ileum. That is why basti is contraindicated in empty stomach and also not to be given with a great force as this may amplify the retroperistalsis due to hyper-irritation of bowel and direct contact of basti content to mucosa may further irritate it. Terminal ileum and duodenum are known for their retroperistaltic potential,  thus basti content may come out of mouth due to stimulation of vomiting centre in this mechanism if classical method is followed but in improper way. However retroperistalsis set in colon and normal peristaltic wave coming from stomach and small intestine is actually responsible for churning of Basti, Mala and Dosha in colon which is actual intended effect of Niruha Basti. This is reason behind asking patient to take food immediately after Niruha evacuation to prevent excess retroperistaltic wave to avoid Pratiloma Gati of Vata.

2. Basti need to be administered with generous force to generate mild reverse peristalsis/ retroperistalsis which actually takes basti content higher up to the ceacum and  may be upto terminal ileum. That is why basti is contraindicated in empty stomach and also not to be given with a great force as this may amplify the retroperistalsis due to hyper-irritation of bowel and direct contact of basti content to mucosa may further irritate it. Terminal ileum and duodenum are known for their retroperistaltic potential,  thus basti content may come out of mouth due to stimulation of vomiting centre in this mechanism if classical method is followed but in improper way. However retroperistalsis set in colon and normal peristaltic wave coming from stomach and small intestine is actually responsible for churning of Basti, Mala and Dosha in colon which is actual intended effect of Niruha Basti. This is reason behind asking patient to take food immediately after Niruha evacuation to prevent excess retroperistaltic wave to avoid Pratiloma Gati of Vata.

'''Dr.Aneesh:''' Article about rectal volume is not available. But the maximum tolerated rectal volume is 240ml.(data available)

'''Dr.Aneesh:''' Article about rectal volume is not available. But the maximum tolerated rectal volume is 240ml.(data available)

The statement regarding need of giving food immediately after niruha seems to be logical but not backed with scientific proof.

The statement regarding need of giving food immediately after niruha seems to be logical but not backed with scientific proof.

== Administration of Basti ==

== Administration of Basti ==

'''Dr.Swapnil Auti:''' A lot work can be done to improvise the basti preparation procedure for which research is needed. For e.g. basti prepared by classical method remains stable in emulsion form hardly for 30 min. But using latest techniques of emulsification we can make basti preparations stable for long duration by which it is possible to make readily available basti kits for easy practical utility and for better results.

'''Dr.Swapnil Auti:''' A lot work can be done to improvise the basti preparation procedure for which research is needed. For e.g. basti prepared by classical method remains stable in emulsion form hardly for 30 min. But using latest techniques of emulsification we can make basti preparations stable for long duration by which it is possible to make readily available basti kits for easy practical utility and for better results.