Nasal Irrigation: What is it?

By Melanie DesChatelets, BSc(h), ND • December 8th, 2010 • 5734 Views

A recent review article compiled and showcased the scientific evidence supporting the use of nasal irrigation, an Ayurvedic medical tradition that dates back in medical literature to the early 20th century.

What is it?

A mild saline solution in warm water is inserted into one nostril and drains out of the other nostril. This can be administered using a low-pressure device such as a spray or squirt bottle or using a gravity-based pressure
such as a netti pot.

How does it work?

The exact mechanism of action has yet to be completely understood. The proposed physiological possibilities are that nasal irrigation improves nasal mucosa function by direct clearing, elimination of inflammatory
mediators and improve mucociliary function.

What conditions is nasal irrigation good for?

In preventive studies, nasal saline irrigation was found to be protective with patients having fewer infections, shorter symptom duration, and fewer days of symptoms vs patients who did not perform nasal irrigation.

There is strong evidence that nasal irrigation is effective adjunctive treatment in chronic rhinosinusistis (Runny nose or nasal congestion lasting more than 12 weeks). In a Cochrane review of nasal irrigation demonstrated
that daily use was associated with a 64% reduction in overall symptom severity, significant decrease in use of saline sprays, decrease in antibiotics as well as significant improvement in quality of life.

The evidence is limited and less conclusive in the following conditions. Despite these findings it is strongly recommended in consensus guidelines that a trial of nasal irrigation should be performed as the benefit far outweighs the risk as long as you do not have any contra-indications.

- Rhinitis of pregnancy
- Acute rhinosinusitis
- Irritant or allergic rhinitis (reduces histamine and leukotrienes)
- Upper respiratory tract infection
- Post operative care after endoscopic sinus surgery
- Mild to moderate allergies
- Wegener's granuloatosis

Minor adverse effect

Fewer than 10% report mild self-limiting adverse effects which include sensation of ear fullness, stinging of the nasal mucosa, and rarely epistaxis (nosebleeds). No serious adverse events have been reported.

If stinging of the nasal mucosa is significant ensure you have prepared the saline solution correctly. A higher concentration than desired can produce these symptoms. All other symptoms can be normal when first initiating the practice of nasal irrigation and should cease after several treatments once the mucous has been thinned and easier movement and flow of the irrigation will result. If these symptoms persist after several treatments you should consider ceasing the practice.

Contraindications

Saline...

Tags : Wellness, neti pot, Healthy Living

Author - Melanie DesChatelets, BSc(h), ND

Location: Vancouver, CA

Mélanie DesChâtelets, BSc(h), ND, is a licensed Naturopathic Physician committed to recognizing and attending to the fundamental antecedents of illness. Using the synergistic power of groundbreaking scientificevidence and long standing historical evidence in natural medicine, Mélanie strives to empower individuals to...

Comments and Questions for the Author (2)

drmelaniedeschateletsnd
Hi Dilly,
Thank you for your comment and great questions.

Part A:

The Naegleria fowler amoeba is found in warm freshwater lakes and rivers, in the southern U.S. To give perspective from 2001 to 2010 32 infections were reported in the US a small number considering the millions of people who have been swimming in lakes and rivers. In even rarer cases individuals get infected by using neti pot and infected water. The infection is rare albeit very lethal when it does occur. Precautions are wise to take especially in geographical areas where this is your water source.

In Louisiana the state Epidemiologist Dr. Raoult Ratard made two recommendations for those using the neti pot.
1. Use distilled, sterile ore previously boiled water to make up the irrigation solution.
2. Clean the neti pot

For more information on Naegleria fowler infection the Centers for Disease Control and Prevention does a good job.
http://www.cdc.gov/parasites/naegleria/faqs.html

Part B:

Recently a small preliminary study was presented suggesting it may increase acute sinusitis in daily users. Other evidence suggests it is preventive. Where there is the most evidence is in the use for people with chronic sinusitis. The nasal mucous produces protective immune substances that might be disrupted with daily use of the neti pot. This is why some experts would recommend daily use cautiously including myself. The neti pot can be a very powerful tool but must be used appropriately. At the end of the day it depends on various factors. If someone has been suffering with chronic sinusitis and this provides immense relief when used daily for a period of time then the benefit likely outweighs the risk. I would caution someone who uses it daily with no indication for daily use. I know it's not a clear cut answer but often science isn't and making that decision requires assessing the entire picture. At then end of the day the best question to ask yourself is … are you experiencing acute sinusitis more often than previously? If so consider that it might be due to the neti pot.

Have a great day.
about a year ago in Vancouver, CA
dlilly
Hi Melanie. I have a couple of questions. I've used a neti pot every morning for several years. Recently an article ran about two people in Louisiana who died due to contracting a brain-eating amoeba via their neti pots. Is it recommended to use distilled water rather than tap water in order to avoid this scenario?

Also, I was warned by a few people about overusing the neti pot. I was told that everyday use will actually weaken my immunity as it will not allow the natural flora to grow. Is there any validity to this claim?
about a year ago in Warren, US