Select Page

I had never heard of a probiotic enema until I read The Brain Maker by Dr. David Perlmutter. The book talks about Christopher, a teenage boy who had Tourette’s syndrome since he was six. Typically, Tourette’s patients have spontaneous, uncontrolled movements like head or leg jerks and repeat sounds or words. There are over 100,000 children in the US with the disease, and more than 5 times as many boys as girls. Although Christopher was able to attend school, by the time he was 13, he was suffering from social stigma associated with his involuntary movements (fortunately, he had no verbal symptoms).

When Dr. Perlmutter interviewed Christopher’s mother, several facts pointed to his gut as being the source of the disease: 1) the boy’s Tourette’s symptoms worsened after eating specific foods, 2) Christopher had received multiple antibiotics when he was young, and 3) his blood showed elevated antibodies for the streptococcus bacteria, and researchers feel that these antibodies might also be attacking structures in the brain and that Tourette’s might be an autoimmune disease.

Studies show that there is a higher incidence of Tourette’s in those who have experienced psychosocial stress, which increases the production of the stress hormone cortisol. It is known that increased cortisol results in increased gut permeability and a leaky gut. A leaky gut, in turn, allows undigested food and toxins into the bloodstream, stimulating an immune response. Part of the immune response is the production of cytokines, which are chemicals that result in an increase in cortisol. And so the vicious cycle continues.

Dr. Perlmutter reasoned that Christopher’s medical history indicated a massive disruption of his gut bacteria and recommended that the boy take probiotic enemas rather than oral probiotics. The morning after Christopher’s first probiotic enema, his mother called to report that her son’s body had become noticeably calmer. Under Dr. Perlmutter’s supervision, treatment was continued daily and the probiotic dosage was increased to 1200 billion units. Christopher’s Tourette’s symptoms virtually disappeared with this treatment program.

Research studies document the beneficial effects of probiotics enema treatment and you can find Dr. Perlmutter’s probiotic enema procedure on Please note, Dr. Perlmutter says that it is essential to have your doctor’s approval before beginning his enema program. If you Google probiotic enemas, you will find numerous sites that also offer specific recommendations.

Many traditional systems of medicine, including Ayurveda, use enemas. Ayurveda refers to an enema as a basti or vasti. It is a valuable part of a purification treatment program called panchakarma and has proved especially effective for Vata related disorders. The classical texts of Ayurveda credit this treatment with increased immunity, strengthening mind and body, cleansing of impurities, and promoting longevity.

In Sanskrit, the word vasti means bladder (an animal bladder was originally used as an enema bag). There are different types of bastis, some for purification and elimination, and others to strengthen the tissues and provide valuable nutrients. Bastis are prepared in various ways, using ingredients like sesame oil, medicated ghee, buttermilk, lassi, and a large number of different herbs (and even the use of specific animal parts).

Very little is known in the West about the use of bastis, but they can be thought of as early probiotic enemas, especially when lassi is a component. The use of sesame oil is particularly interesting because modern science has shown this oil to have anti-inflammatory and anti-cancer effects on colon cells. The latest research shows how certain Ayurvedic herbs affect beneficially affect the microbiome.  What is clear is that the ancient Ayurveda doctors fully understood the importance of the digestive system and how to repair and rebalance the gut using bastis or enemas.


We have described Dr. Perlmutter’s enema procedure both on our website and in our book Gut Crisis.



  1. Oliva, S et al., Randomised clinical trial: the effectiveness of Lactobacillus reuteri ATCC 55730 rectal enema in children with active distal ulcerative colitis. Aliment Pharmacol Ther 2012; 35: 327–334
  2. Periasamy, S et al., Sesame oil accelerates healing of 2,4,6-trinitrobenzenesulfonic acid-induced acute colitis by attenuating inflammation and fibrosis. JPEN J Parenter Enteral Nutr. 2013 Sep;37(5):674-82
  3. Hou, RC et al., Increase of viability of entrapped cells of Lactobacillus delbrueckii ssp. bulgaricus in artificial sesame oil emulsions. J Dairy Sci. 2003 Feb;86(2):424-8.
  4. Matthes, H et al., Clinical Trial: probiotic treatment of acute distal ulcerative colitis with rectally administered Escherichia coli Nissle 1917 (EcN). BMC Complementary and Alternative Medicine 2010; 10:13
  5. Peterson, CT et al., Prebiotic Potential of Herbal Medicines Used in Digestive Health and Disease THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE, Published Online: