Things to remember before Vasti Karma

Vasti is mainly indicated in vata predominant diseases. The two types of abnormalities of vata namely, avarana and dhatuksaya can be treated by vasti karma.  Direct application of this kind of treatment ot pakvasaya (Colon) helps not only in regulating and co-ordinating vata dosa in its site. So it is designated as “ardha chikitsa”.  It is most important treatment among all the 5 major panchakarmas.

Tips  for Vasti Karma

• While administering Vasti, the physician should not be anxious. It is not an open heart surgery, but at the same time, it has to be done carefully.
• It is better to do per rectal examination  (proctoscopy)  before vasti.
• The basic cardiology examination are essential before major vastis like lekhana vasti.
• Hepatitis vaccination should be given to the attender.
• Importance has to be given for sterilization of vasti netra.
• Matra vasti can be done at home.
• We have seen anuvasana getting retained to the maximum of one day.
• Anuvasana should be done on the same day for vastis like erandamuladi niruham, kshara vasti, vaitarana vasti, mutra vasti and lekhana vasti. Vatapitta samana tailas like dhanwantaram and madhuyastadi yogas should be considered for anuvasanam in these cases. It prevent colonic ulceration.
• The doses of classical niruha vasti is 1.2 litre.
• The dosage of madhutailikam can be given up to 900ml.
• During vasti ask the patient to relax the anal sphincters by breathing through mouth or counting numbers loudly. So that the insertion of the noozle will be easier.
• The patient should be told not to lock the toilet door.
• Most of niruha vasti will come within a maximum duration of 10 minutes.
• We have never seen any retention of niruha vasti in our practice.
• Practically we have seen dehydration anal pain, diarrhea, abdominal discomfort and hypokalemia in our practice. One cardiac arrest and death was also reported.
• If the patient is affected with vata alone, but has not been properly oleated, we can give niruha vasti by increasing the oil in the preparation.
• Ksira vasti is used as substitute for virechana in acute cases of paksaghata and in elderly where virechana is contraindicated.
• Kalka is the pradhana dravya of vasti. Kalka gives life to vasti.
• Bacterial contamination can be avoided by using clean pestle and mortar.
• Some people do not filter the final product of niruha dravya. It is better to remove the kalka dravya to avoid diverculitis, by filtering.
• Gomutra can be avoided as because of risk of leptospirosis infection.
• Dhanyamla can be safely used for lekhana vasti.
• Vasti karma can alter the bacterial flora of intestine.
• 20% of urinary infection is seen after uttarvasti inspite of being cautious.
• If we are using simple rubber catheter for uttarvasti in male it is better to dispose it after single use.
• Niruha vasti during 7^th month of pregnancy can act like a pelvic irritant, stimulate uterine contractions and produce pre mature labour. It has to be done in 9^th month only.
• Blood grouping, Rh matching etc, are probably not needed as it is not parenteral.