Why Your Physician Recommends Nasal Irrigation
Nasal irrigation with salt water (saline) is also called nasal wash, rinse, douche, or lavage. This is often recommended by physicians to reduce the frequency and severity of the symptoms associated with inflammation of the nose owing to allergies or other causes. Nasal irrigation can also reduce the number and severity of infections of the sinuses. Nasal irrigation works by thinning and removing mucous, clearing proteins that cause inflammation, and flushing out nasal allergens, irritants, and bacteria from the nose and sinus cavities.
Irrigation is also typically recommended for patients after sinus surgery. The mechanical action of the rinses softens and removes crusts and facilitates healing. If your surgeon uses dissolvable packing during the surgery, the irrigation will help it dissolve.
How to Perform Irrigation
High-volume (>3 oz or 100 mL) rinses are most effective. Any device that applies this volume of saline is good to use. There are squeeze bottles, devices that pour, and motorized devices that can be chosen by preference. Most of these devices allow for irrigation of 4 oz per side. To make saline, use 8 oz of distilled water and mix it with a premixed saline packet. Distilled water is the easiest to use, but if unavailable, you can boil tap water for 3 minutes and let it cool to room temperature before rinsing with it. Using unsterilized water can result in serious infections. The Centers for Disease Control website provides more information on the proper preparation of sinus rinses. Nasal irrigation should be warmed in a microwave in increments of 5 to 10 seconds to avoid overheating or by running the nasal irrigation bottle under warm water. If you forget to add the salt or salt packet, the rinse may cause discomfort. Many people find it easiest to perform the rinse by leaning over a sink or in the shower. You should tilt your head down and turn so that 1 nostril is pointing down while the other is pointing up. Squeeze the bottle and deliver the irrigation into the up nostril. The rinse will come out of the other nostril.
What to Expect
You should experience a sense of freshness and cleanliness in the nose after rinse. The most common adverse effects are mild nasal irritation, ear pressure, minor nose bleeding, and saline dripping out of the nose several minutes to hours later. These are uncommon and can be avoided by trying a different delivery device, altering the force of irrigation, or taking a few days off from irrigating.
Medications
Saline irrigation and topical nasal steroids are the main treatments for inflammatory and infectious nose and sinus problems. These topical steroids come as sprays but can also be prescribed as a powder or liquid and added to your nasal irrigation. If you are using a topical steroid spray, do your saline nasal irrigation first so you do not wash the medicine out of your nose.
For More Information
- Is Rinsing Your Sinuses With Neti Pots Safe?
https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm316375.htm - Sinus Rinsing For Health or Religious Practice
https://www.cdc.gov/parasites/naegleria/sinus-rinsing.html
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Article Information
Published Online: July 18, 2019. doi:10.1001/jamaoto.2019.1713
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