Wednesday, March 01, 2006

Nasal irrigation

Staving off the common cold for years at a time may be a pipe dream, but I'm willing to keep trying. So last night, inspired in part by this NPR report, I finally tried nasal irrigation. The concept seems simple enough: squirt salt water up your nose in order to rinse out your nasal cavity and sinuses. As discussed in a recent, surprisingly readable review article called Nasal Irrigations: Good or Bad? (click here for the complete article), nasal irrigation is apparently safe and effective for treating many conditions affecting the nasal cavity and sinuses (especially sinusitis and rhinitis). Some people claim that regular irrigation actually prevents colds. But exactly how it works remains a mystery. Does nasal irrigation just rinse away excess mucus, which traps viruses and other infectious agents? Or does it somehow enhance the function of cilia, the hair-like microscopic whips found on cells throughout the respiratory tract that normally brush mucus away?

There is also no consensus about the best way to perform a nasal irrigation, or about the ingredients one should use. I decided to go with one of the recipes in the review article:
After mixing it up, I leaned over the kitchen sink and administered the saline using an awkward combination of "positive pressure" (squirting with a bottle), "negative pressure" (inhaling), and gravity (pouring it in with my head tipped back). I haven't decided yet which method I like best, but they all did the trick. It wasn't as unpleasant as I imagined; in fact, I kind of liked it, in much the same way that I enjoy cleaning my ears with Q-tips after a shower. It's nice to give a little attention to neglected body parts like the nasal cavity and the ear canal.

One thing I'd recommend is letting your nose drain as much as possible on its own before blowing your nose in the standard way (i.e., blowing it forcefully while letting air escape through only one nostril at a time). By blowing my nose too soon I ended up forcing saline into my left middle ear (the space immediately behind the eardrum) via the eustachian tube (a structure I describe in more detail in a previous post). Oddly enough, it felt exactly like getting water in my ear canal during swimming. Fortunately, the fix was quick and easy - I just tipped my head to the right and the wayward saline came pouring out! Good thing I paid attention in anatomy class. 8-)

88 Comments:

At 3/09/2006 8:11 PM, Blogger little yoda said...

I tried the nasal irrigation once as part of a yoga retreat. I used a ceramic pot that looked like it could be used for gravy to funnel the water in the nose. I bet nasal irrigation gets addicting, much like people who are addicted to laxatives.

 
At 3/10/2006 12:37 PM, Blogger Brad said...

I've been doing nasal irrigation faithfully for about a week now. Don't know if I'm developing an addiction or dependency, but it's not unpleasant. I'd put nasal irrigation in the same category as brushing my teeth.

 
At 3/16/2006 10:16 AM, Blogger Kkay said...

I wonder if it is in the same category as brushing teeth and washing the body- which was once believed to be unnecessary or even dangerous- or if it's more like removing earwax or ...(trying to put this delicately)... the cleansing of inner feminine orfices, both of which doctors recommend be done sparingly as too much 'internal cleansing' is upsetting to the natural balance and defenses of the body.

 
At 3/16/2006 12:59 PM, Blogger Brad said...

Yeah, it might be possible to overdo it (which is true for just about anything), but I'm not concerned about doing it twice a day. Here's an excerpt from the review article I cited:

"Nasal irrigations have been shown to be safe. Side effects encountered are minimal. Local irritation, itching, burning, otalgia, and pooling in sinuses with subsequent drainage have been reported. This pooling,with delayed discharge in some head positions, is most commonly seen in patients who have undergone previous sinus surgery."

 
At 4/24/2006 8:47 PM, Anonymous Dave H. said...

Brad, I purchased a "Grossan tip" about a decade ago (easy to find online). The tip was developed by an ENT specialist...he's sold a bazillion of 'em. It's used on a personal Waterpik for nasal irrigation. Cost me $17 for the tip and maybe $39 for a Waterpik. I'm a perennial allergy sufferer, and live with sinus congestion, but the Grossan tip allows me to "clear things out" after mowing the lawn, hiking, playing softball, or coming down with a cold. It does not "cure" a cold or allergies, but it does help - I stopped all the pills with the exception of over-the-counter pseudephedrine. An even bigger benefit is that I NEVER get sinus infections, much less one requiring antibiotics. That nonsense stopped 10 years ago. It's simple, painless, takes 3 minutes, and you just use warm water and some table salt, kept under the sink. Seems goofy until you do it the first time, which is when you'll say Hey! Why didn't I know about this?

 
At 4/24/2006 10:10 PM, Blogger Brad said...

Thanks for the tip (no pun intended)! I wonder if your regular nasal irrigation has cut down the frequency of colds....

 
At 4/25/2006 8:09 PM, Anonymous Dave H. said...

Well, I doubt that nasal irrigation cuts down the frequency of colds. It does lessen the severity a bit. It improves my overall sinus function, and as I mentioned it prevents the dreaded sinus infections (from bacteria) that can occur after a cold or from allergies. I should add that the warm low-pressure continuous wash from the Grossan method is much more effective than simply trying to squirt or inhale saline solution.

 
At 4/27/2006 4:57 PM, Anonymous Carrie said...

Hi Brad, I recently stumbled across your blog, and I can't get enough! I find the human body so incredibly facinating.
I don't know if you're the only anatomy prof at UVM-SOM, but I have an ex-boyfriend who is currently a 4th year there. When he was taking anatomy during his first year, he would tell the most amazing stories about things he'd done in lab or interesting facts that he'd learned. So, if you were indeed his prof. at any point, it sounds like you inspire your students in the same way you inspire your readers. Your passion for this subject is quite catching! Best of luck on your journey through medschool.

 
At 4/27/2006 5:00 PM, Anonymous Carrie said...

Oops! I forgot my inital reason for posting:
Does it burn at all to do the nasal irrigation? I'm thinking of times when I've experienced water inadvertently going up my nose, and it burned!

 
At 4/27/2006 5:50 PM, Anonymous Anonymous said...

Brad, if I may answer Carrie... when I use the Grossan tip on my Waterpik it doesn't burn at all. I know exactly what you mean Carrie, but the saline solution (a teaspoon of salt in the basin of warm water) somewhat matches the natural salinity inside my noggin, and doesn't really feel like much of anything. Certainly doesn't sting or burn. You could also buy Grossan Breathe-Ease™ solution online, which might be more gentle than simply using saltwater... but I've never felt the need to do so.

 
At 4/27/2006 6:05 PM, Blogger Brad said...

Hi Carrie, I agree with Dave H - I never get a burning sensation when I irrigate. The key, I believe, is to use a warm saline solution, not pure water (although to be honest, I just use a room temperature saline solution). Incidentally, irrigation isn't awkward at all for me now; with my head tilted backwards about 45 degrees, I squeeze the bottle gently but let gravity do most of the work. Also, thanks for your kind words! I enjoy blogging and hope to keep it up indefinitely.

 
At 11/17/2006 9:58 AM, Anonymous Anonymous said...

I started nasa irrigation about three weeks ago. I bought one of the devices advertised online. At first, I was afraid of the feeling I get when water gets up my nose when I dive into the pool or take a swim in the ocean. After I bought the device I kept it under my bathroom sink for about two weeks. Eventually I summoned up courage to use. It worked as stated however, I did not see a clump of mucus that I was expecting. I have been using it ever since. I cannot attest to its effectiveness yet, maybe that will come later.

Michael (Mission Hills, CA)

 
At 3/02/2007 10:48 PM, Blogger jimmy74 said...

i suffer from nasal polyps, and when i found out, i started using nasal irrigation. one person on the blog said that he turned his or her head backwards. i have been doing it for quite some time, but i find it better to put my head tilted downward. the solution drains out, but sometimes i pinch my nose and hold it there for a while. i the logic is that when you tilt your head back the solution goes into the upper sinuses which may not need that much rinsing because they are most always dry. what i am usually surfing the net looking for is different recipes to try, that do not use chemicals. i want something that will dissolve the polyps naturally without surgery. maybe it is wishful thinking. but if you have some recipes that are natural that might work please post.

jimmy j

 
At 3/05/2007 3:51 PM, Anonymous Anonymous said...

jimmyj - i suffered with polyps for years and finally had surgery a few moths ago. it was life changing - literally. now i do the sinus irrigation just to keep things clean. my point is, dont be afraid of the surgery, it was a couple weeks of discomfort followed by an amazing ability to breathe and smell again.

 
At 3/27/2007 12:42 AM, Anonymous George said...

I started irrigation ~15 years ago when I had a painful sinus infection and couldn't get a doctor's appointment. On chatting to the woman who cleans the office, she told me about the salt-water trick, recommended to her by a doctor who had refused to give her anti-histamine since she was pregnant at the time.

Well, it worked... and amazingly quickly I had this green glue[ugh] washed out of my nasal cavities and feeling fine - took 2 or 3 repeats in one day to get the worst of it out but the very first relieved most of the pain. I haven't even considered an anti-histamine since - probably what caused the stubborn congestion in the first place.

I use about 1/2 teaspoon of table salt in a largish mug of warm water, sniff it up and roll my head around so it gets into the passages under the eyes, then blast it out:-), one nostril at a time. I do this as I feel the need - I'd always had a tendency to get congested easily but much less so since I started "washing". I usually finish off with a quick gargle which helps clear out any PND.

I haven't had a cold in 10 years now and I wonder if this procedure could have saved me that nasty sub-mucous resection I had done years ago, in my teens.

 
At 4/13/2007 12:24 PM, Blogger DDeden said...

Hi folks, if you want to know:

Why do people (but not other primates) sneeze at the sun?

Why do people (but not other primates) have white eyes?

Why do people (but not other primates)
have external bony noses?

Why do people (but not other primates) have so much skin fat, especially babies?

Why do apes have laryngeal air sacs yet people don't?

The answer my friends is diving at the seashores for a million years.

Believe it or not!

David Deden
Director, Naturalist, Author
The Humboldt Eureka -
Aquamarine Research Clinic
THE-ARC.

 
At 4/13/2007 3:43 PM, Blogger DDeden said...

To explain, nasal irrigation is effective because it simulates the condition of ancient ancestral human divers who allowed clean pure seawater into the nasal cavities and sinuses and middle ears, sealed by the closed upper palate, when diving for seafood, thus not requiring equalization at depth. The same method is used by some free-divers today (Sebastien Murat). Our mucus is approx. the same pH as seawater, and is hypertonic saline. Freshwater should not regularly be used in nasal irrigation, and hard water should be avoided.

Much more info. at my THE-ARC.wikispaces site and THE-ARC.blogspot blog and at AAT yahoogroups.

 
At 4/16/2007 6:16 PM, Anonymous Anonymous said...

I have been thru sinus sx almost 2 yrs ago with excellent results. I still have recurrent infections( I have 2 young children) and I religiously use my sinus rinse. Let me make your life easier...just go to CVS or Walgreens and purchase a sinus rinse bottle www.sinusrinse.com for about $10-15. You get premade packets and its very portable. I use it with the onset of any symptoms or during peak allergy season. My ENT recommended it.
My ENT highly recommends to his pts to use the sinus rinse or any type of sinus irrigation. Enough said. Hope it helps!!

 
At 4/27/2007 1:39 PM, Anonymous Anonymous said...

This blog is very informative. I and 53 and have had recurrent sinus infection for years. This includes periodic sinus closing due to polyps that requires low dose of prednisone (5 mg qid) and an antibiotic. ENT has suggested surgery, but he noted that in many it comes back later. I have tried to use the rinses (Neil Med's) but it seems that sometimes an infection will come on faster. First, any thoughts about about the above. Finally, has anyone heard of the "Balloon Sinuplasty" and has it been helpful in those with polyps. Thanks.

 
At 4/28/2007 8:21 AM, Anonymous Anonymous said...

Hi, I just tried the nasal irrigation and it felt horrid! It felt like I had jumped in the pool and water had gone up my nose and into my brain!! It really really hurt all around the back and side of my head. I leaned over the sink with my head turned to the side and slightly up and poured the water slowly in one nostril. What am I doing wrong? Help Please!!!

 
At 4/29/2007 7:30 AM, Blogger Brad said...

Anonymous on 4/27, I can't comment on whether or not you should have the polyps surgically removed, but I'd certainly get a second (medical) opinion before going ahead with it. There are always trade-offs. For more information on balloon sinuplasty, check out my post and talk to your ENT.

Anonymous on 4/28, I'm sorry to hear that your first experience was so miserable! First I'd make sure that your recipe is correct (all the right ingredients in the right amounts). I'd also try irrigating with warm (not hot) saline - much more pleasant than cold. Finally, you might try a different method.

Here's how I do it now (and I've been doing it consistently, morning and evening, ever since I wrote the original post). Standing in front of a sink, I tilt my head backwards and gently squeeze the saline into one nostril until it feels about right (not too much or too little fluid). With my head still tilted backwards, I rock my head from side to side to "swish" the saline around my nasal cavity. Then I lean forward and gently expel the contents (out both nostrils) into the sink. Finally I blow my nose (again, being gentle is key) and wipe away any residual fluid.

BTW, I also add a small amount of mouthwash to my recipe because I like its scent, but I wouldn't recommend that to people with sensitive noses- it stings if you add too much.

 
At 5/02/2007 1:50 PM, Anonymous Anonymous said...

I'm glad I found this blog. I just tried a neti pot after watching the method on Oprah. I'd heard of it before, but was sure it would feel like I was drowning. Once I saw it, it looked easy.

My first time was good. But since then, seems like it takes awhile for the saline to start running out the other nostril. I feel like it's getting into my upper sinus and in my eye sockets, where the salt seems to burn a bit.

The outcome is still very good. Normally, I would wake up in the middle of the night and cough for an hour. Now I just go back to sleep. I breathe much better.

Any pointers on my technique?

 
At 5/19/2007 3:31 AM, Anonymous Shannon said...

From time to time I wake in the night feeling as if I'm drowing and gashing for air. I assume this is from mucus draining down my throat. I usual try to cough to get some relief and go back to sleep. Anyone have any thoughts on whether this technique could possibly relieve this symptom? This tends to happen during the peak seasonal allergy times, so I'm pretty sure it is allergy related.

Thanks

 
At 5/19/2007 9:04 PM, Blogger Brad said...

Hi Shannon,

Sounds like your condition merits a visit to the doctor, in this case probably an ENT. I do know that nasal irrigation is very safe and helps a lot of people with chronic sinusitis. I wouldn't be surprised if it helps people with allergies too.

 
At 6/07/2007 11:18 AM, Anonymous Shannon said...

I just wanted to share my experience over the last three weeks using a NeilMed Sinus Rinse Kit. Simply put I feel like a different person. My wife says that I no longer snore, I don't wake up multiple times in the middle of the night and I have completed quit using nasal sprays like Afrin to allow comfortable breathing.

The first couple of times I did the rinse I found it tolerable, but that was about out. I found that a little bit warmer water seemed to make it much easier to tolerate and after a few days of doing it in the morning and at night that I have no problems doing it. I've added this to my morning and night rituals and still just can't believe how much it has helped. My wife even jumped on the bandwagon to see if it would help were with her seemingly constant runny noes, and it has.

I'm so glad that I came across your blog entry (at 4 am one morning after getting up from not sleeping with sinus problems). I would encourage anyone with similar issues to at least give it a try for a few days. It won't kill ya, and you might just find that it helps.

Thanks again

 
At 10/25/2007 12:41 AM, Anonymous Anonymous said...

there's an interesting wiki entry on "nasal irrigation", which outlines 3 stages of flushing. Is there a method of cleaning out the upper sinuses ie in your forehead? These always get infected during the colds I get. Any tips or views as to whether it is a good idea or not are welcome.

 
At 10/26/2007 4:38 PM, Blogger Brad said...

I'm not aware of any method for irrigating the frontal sinus. Maybe turning your head upside down during ordinary nasal irrigation could do it, but I'm guessing that would be uncomfortable and ineffective....

 
At 11/05/2007 2:22 PM, Anonymous Anonymous said...

I have had sinus problems for so long now I cant remember,i had a septoplasy 5 years ago but that did not help at all and was very unpleasant. Nasal irrigation does help some,certainly cant hurt,I plan on having the sinuplasty procedure ,I will let everyone know how it goes. Cuda

 
At 2/28/2008 8:51 AM, Blogger redburnbj said...

I just heard about nasal irrigation after an unnescesary trip to the dentist. I had such a "toothache" I thought I had a cavity, but by the time my appointment came, ithe "toothache" was gone. Turns out, no cavity, just sinus pressure on the root! The dental assistant recomended the NeilMed Sinus kit, but I must admit, I tucked the coupon away and thought she was a little crazy. I mean, I am not going to squirt stuff up my nose for a toothache. Hmmm, maybe it's worth a try. Glad to see some "recipies" here, I thought there must be a formula to it without buying a kit.

 
At 4/03/2008 11:00 AM, Anonymous Anonymous said...

My waterpik and grossan irrigator have really been instrumental in saving my life. I have had two sinus surgeries (which I had to have because there was so much damage--the last one was for the ethmoids) and irrigation helped me to heal much faster. Part of what works is the very warm salty water and the pulsing action. Use the lowest setting and let it run through the whole small container. Move it around too to reach the various sinuses. One problem however is if you have a major infection etc. there can be serious blockages and i would be cautious to begin. I do this with the support of my ENT. If you can't find an ENT who supports this therapy then get another--he might be a dinosaur. Mine gets irrigation and gives me anti-fungal or antibiotic medications to put in the water. I love this device. I love my ENT.

 
At 4/16/2008 2:09 AM, Blogger subhash said...

i am suffering from Allergy Rhinitis causing stuffy nose, sneezing and running nose. the worst part is it is causing breathing problem and i can not sleep in the night. i use some corticosteroid but they give temporary relief. Can any blogger suggest any remedy and particularly the role of nasal irrigation in relieving the symptoms or its treatment. Thanks

 
At 11/06/2008 10:04 PM, Anonymous Rachel said...

Where to begin? I'm 45 and my nose has been making me miserable since I was 4. I'm an asthma / bronchitis case, but we have always known that if we could ever stop the nose, we'd stop the chest. I have tried Grossan Irrigator, Neil Med bottle and Neil Med Neti Pot. I suffered a very severe viral attack this summer with resulting severe bacterial infection of sinuses and then chest. The infection was made worse by a "rebound" I had from a cortisone nasal spray I had used effectively in the past. Being very allergic to most antibiotics, after 1 course of Ceftin and 1 course of Z-Pak we decided to "wait and see". The Neil Med bottle was not working. That is when I tried the Grossan Irrigator (first with Neil Med solution and then with Grossan's solution). I would not use the Irrigator with Neil Med's solution again. When I used the Grossan Irrigator with the Grossan Solution as directed, I can confirm that, as much as I am aware, it broke up my sinus infection. Still don't know how. But ... It left my sinuses with trauma - after that, I could not use that or the Neil med bottle. So, I switched to Neil Med Neti Pot, which did work. I think the virus plus infection created terrible trauma in my sinuses and chest, which is still in healing mode. I've just started back "on the bottle" and am getting some inflamation relief from Singulair, instead of using the topical stearoids. Overall, I think it is better to irrigate than not, but we have to listen to how our bodies respond and make adjustments as necessary - there is no "one size fits all" approach. If you're not sure how to begin, start gently and with whichever side of the nose is least prone to giving you trouble (the healthier side - if you have one).

 
At 12/26/2008 9:20 PM, Anonymous Anonymous said...

I've been using a rubber bulb baby syringe for irrigation - one of those bulb powered devices designed to remove the snot from a baby, for about a year. Cheap and effective. Use non-iodized sea salt in a warm solution. Taste it - if it's slightly salty it won't burn.

Nothing is perfect in the sinusitus world but this is a good as it gets.

 
At 1/03/2009 12:27 AM, Anonymous Anonymous said...

I have had sinus problems for1 years now and mainly stuck with over-the-counter allergy meds which helped for a while.Lately though,I have had a terrible time with pressure and dizziness. I tried a sinus rinse but,I was so blocked the solution would only dribble out and nothing really actually came draining out. Should I keep trying or should the first time have produced some kind of result? I also have started feeling fullness in my right ear--maybe time to see a doctor?

 
At 1/03/2009 8:35 PM, Blogger Brad said...

Anonymous, obviously I can't give medical advice, but I'd say that, for severe cases of sinusitis, the best treatment is a combination of antibiotics, nasal irrigation, and possibly other meds/procedures. I'd make an appointment with your doctor if things aren't getting better.

 
At 1/09/2009 1:31 PM, Anonymous Anonymous said...

Hello, I have an urgent question. i really hope you can ease my mind. I caught a nasty cold at the start of this week. Yesterday I was feeling so miserable and congested that I decided to do some research. So I came across nasal irrigation. However the site I followed claimed that you should 'use as much salt as you can handle' so I made a solution of roughly 3 teaspoons of seasalt to half a cup of water. When I sniffed it up, it burned so much. And now I am freaking out because although i was able to breathe through my nose afterwards, I am unable to SMELL!!! Aahhh, please, please tell me this is normal? And now that I've done added research, it seems that the salt ratio to water should actually be very weak :( Any insight??

 
At 1/10/2009 10:26 AM, Blogger Brad said...

Hi anonymous, I'd recommend the recipe shown above. It's a fairly mild saline solution that I've used regularly for almost 3 years now. Your loss of smell is probably temporary - one great thing about olfactory cells is their ability to regenerate (http://en.wikipedia.org/wiki/Olfactory_receptor_neuron).

 
At 1/27/2009 12:54 PM, Anonymous Anonymous said...

For those of you having problems getting all of that congestion out, simply tilting your head around won't always work. I have been irrigating my sinuses daily since 2003. Before that I had about 7 sinus surgeries. Not one since.

I use a blue baby bulb syringe (Kroger or BabiesRUS sells them). I dare you to try it...it's so much better than any other method!

The kind with a removable top does not work!

I fill up a tupperware container with about 6 cups of warm water.

1 1/2 tablespoons of non-iodized sea salt(recommended by ENT)

1 teaspoon of backing soda.

I just stand over the sink with my nose down over the sink and flush it through rotating each side. Just let it fall into the sink. So much comes out each time it is unbelievable. Now I realize why I kept having surgery, because it had nowhere to go before. The bulb syringe is so much better than any neti pot or squeeze bottle. It has much more force, but you can also control that force better than if you used a nose/water pick. I highly recommend this method. It has changed my life. I have only had one cold since 2003 and no sinus infections or headaches. I think that keeping my sinuses clear with the salt water has kept those colds away.

 
At 4/06/2009 12:14 PM, Anonymous Anonymous said...

I've had sinus problems, polyps that led to asthma and loss of smell/taste since 91, a few surgeries, anitbiotics, steroids, sprays, antihistamines.....u name it. A new ENT prescibed a Budesonide compound for nasal irrigation. I tried it for about 6 weeks, but wasn't disciplined in using it twice daily as prescribed, and didn't notice any difference, so I talked my primary doc into a dose pak of steroids (the wonder drug) and enjoyed about 6 weeks of symptom-free sinuses. Probably everything else was painless, too. When the steroid started to wear off, I went back to the Budesonide irrigations, 20cc each nostril, twice daily, religously and noticed a remarkable improvement after about 10 days. I kept it up, as I was able to breathe, smell, taste, etc. I don't dare quit. I use a nedi pot, but am considering the water pik like device, as I think I would waste less compound. The theory my ENT described is that the crap in the air contains fungus that irritates the sinuses and keeping it flushed out keeps any fungus from settling and irritating, multiplying, causing infections. Also this compound is a steroid similar to the sprays, but a higher dosage, and the method of administering is much more adequate ( a flood vs. a spray ! ) the local steroid does not have the same ill side effects as the oral or injected ones, but it still has the anti-inflammmatory benefit required for polyp reduction. I had to post as I know how miserable I was and how many thing I've tried with little success. This seems to be working. I also take singulair, and another doc said ZANTAC has antihistamine benefits, so I take one a day - can't hurt...!?!?!
Good Luck - hope you can breathe easy and smell the roses.

 
At 4/13/2009 9:27 PM, Anonymous Anonymous said...

In reading about irrigation, I haven't seen anyone suggest that it works, in part, because the saline just plain kills germs. Given that salt is now a substitute for chlorine in many swimming pools, it stands to reason that this is part of the explanation for why irrigation works. Could this be? Any thoughts?

 
At 5/09/2009 1:55 AM, Anonymous Anonymous said...

I use a SinuPulse pulsating irrigator and it really keps me clear and fre of any sinus infections. It is so much easier to use than the neti pots whihc are a bit rediculous and only make sense for their cheap price. If you can afford a $100 investment in your health I suggest the Sinupulse it gets places the neti pots can only dream of.

 
At 5/13/2009 9:39 AM, Anonymous Anonymous said...

Hello,
I've tried nasal irrigation for three days now, once a day. and i have to be doing something wrong because it burns really badly in my nose and under my eyes during and after. I just did it about half an hour ago and it still burns if I breath in deep. I'm a little worried about it but everywhere I read says it can't damage you.
I'm using warm water with 1/3 tsp of sea salt.
Anyone have any idea what I'm doing wrong?

 
At 5/31/2009 3:24 PM, Anonymous Anonymous said...

I had an MD pathophys instructor who swore by nasal irrigation. He worked for years in southern California and said the surfers had the best sinuses of any population he'd worked with.

 
At 7/05/2009 10:29 PM, Anonymous Anonymous said...

Mold count is high here in Northeast so I ran back to my nasal pulse irrigator. Regarding teeth and sinuses, old root canals have been theorized to be problematic,. (Google "The Truth About Root Canals") I had an old one retreated recently. The endodontist said it was infected. After treatment for the tooth my two inhaler a day asthma has cleared but I broke out in the worst sinus case in years. Can't be infection because I was on ten day course of antibiotics for infection. I will keep rinsing and follow up with an oral surgeon. The ENTs can't make up their minds if I am a surgery candidate or not. Based on what I have read the only treatment I might consider is the balloon surgery, but apparently the jury is still out on the efficacy of that. As for the rinses it is weird sometimes lots of stuff comes out and sometimes nothing. My symptoms are so inconsistent and erratic it is difficult to report let alone diagnose.

 
At 10/03/2009 5:29 PM, Anonymous G said...

Hi
I have been using sinus rinse but every time I start to use it my nose has dried up blood in my nose and it's very dry it hurts, after an hour. I have tried saline spray same results. Anyone else have this?
G

 
At 10/26/2009 2:59 PM, Anonymous Anonymous said...

I am finally reluctantly
irrigating my nose at the recommendation of a friend who is an RT. He noticed that I am always blowing my nose and clearing my throat and seems more concerned than I am that I am "suffering" so much. I know that irrigations help alot of people but I have an aversion to the idea of ANYTHING going up my nose due to negative experiences in childhood. I've had sinus and throat problems since I was a child and my parents would take me to the to an ENT on a regular basis for a procedure called "Proetz". I had to lie down on a table with my head tilted back hanging off the edge of the table while the doctor flooded my nasal passages with saline followed by suctioning and then stinging, bitter tasting nose drops that slid down the back of my throat and made me gag and cough. THis was repeated several times in each nostril. Throughout the procedure I had to say "kitty kitty". Though the procedure only lasted about 5 minutes, I remember feeling extremely uncomfortable. It took 2 or 3 nurses to hold me down. Afterwards, I don't remember feeling much better than before the treatment. I cried so hard, that my eyes and nose dripped mucous and tears afterward. The treatments didn't seem to do much good. I still got alot of sinus infections and colds. The mucous would just come back again and I'd have to go back for more nose clean-outs. I HATED THEM. I am an adult now and in charge of my own nose so, I have given it a try, using the pre-filled saline Ocean irrigation bottle and leaning over the sink. I have to say I don't like it but it's not as bad as those "Proetz" torture treatments with the rubber hose and the suction catheter. So far, after 4 days of twice daily irrigations, I'm not noticing any difference in the runny nose and post nasal drip. It's still the same. Maybe I'm not torturing myself enough?

 
At 10/28/2009 11:52 AM, Anonymous Anonymous said...

I have been unable to smell anything for the past 4 months, I was checked out about 3 weeks ago and the doc said I had a sinus infectiona and gave me some antibiotics (amoxicilan) anyways he also recommended NeilMed Sinus Relief which is a pre mixed salt and backing soda mixture that comes with a nice bottle that squirts up one side of your nose and comes down the other. I find it was very pleasing and almost conforting at first but now sometimes after I use it I get a bad stinging and headaches afterwards in my sinus area. Thinking I might not have done it right I used the bottle to just put water without the mixture and it stung even more, took the headache away for about 15 minutes and then it came back. It also stated not to use it if you have an ear infection. I don't think I have one but I do feel a little tension in the ears, probably because of the way I blow my nose after. Is anyone else having the same problem?

 
At 10/29/2009 10:21 AM, Blogger Blogmaster said...

Neti Pot are just great for nasal irrigation.

 
At 12/14/2009 9:48 AM, Blogger Linda said...

Infection.org is a purely informational site dedicated to the general Public. It provides a focal point on the Internet for Infection information. I am contacting you in order to inquire if you could add a link to Infection.org. We also have a section where we could post qualified resource links on Infection.org. If you have any questions feel free to email me. And hopefully you can add a link on your site to Infection.org.If you want more information on that please email me back with the subject line as your URL

Thanks for your Time and Have a Wonderful Holiday Season.

 
At 1/19/2010 9:56 PM, Anonymous Anonymous said...

Just tried a neti pot that I picked up at Walgreen's. I've had a sinus infection for a few days and it's probably the most painful one I've ever had. The neti pot has provided more immediate relief than anything else I've tried. A little tricky to figure out at first... I recommend that you concentrate on breathing through your mouth while using it. The other problem I need to figure out is how to prevent the exiting fluid from following my mustache and flowing down my chest!

Jim

 
At 1/24/2010 8:45 AM, Blogger Melissa said...

Thanks for the great info! I just tried a bulb syringe with salt water today, first day of a sinus infection. So far, so good...

I wonder whether nasal irrigation helps in part because bacteria thrive in an acidic environment? Hmmm...

 
At 2/15/2010 10:30 AM, Anonymous Anonymous said...

Kept telling my twenty-something kids that they could short cut their colds by using these saline rinses. I find I can get in and out of a cold in about three days. Took my son two years to try, but he just found out it was true. Both caught a cold the same week, my daughter is still snuffling at the end of two weeks, my son was out the other end of it in three days.

 
At 3/26/2010 12:25 PM, Anonymous Anonymous said...

I was wondering if anyone had come up with some recipe to actually bring down the swelling of the turbinates and make it so I can breathe again. I'm an English teacher living in South Korea and this Yellow Dust is about to kill me.

For anyone who doesn't know, Yellow dust is a combination of sand, pollutants, viruses, and bacteria (among other crap) that blows east from the Mangolian Desert areas.

 
At 5/03/2010 9:08 AM, Blogger ktbmom said...

I have suffered from polyps and sinus infections for years. My ENT doctor suggests doing nasal irrigations, and always when you have a sinus infection. He claims that antibiotics work in the tissues of the sinuses and when there is a pool of infection the drugs only treats the edges of the pool of infection. Makes sense. He is nationally renowned for his cutting edge technology and findings. He suggests the homemade saline solution and a water pik with a nasal cannula (can be found on internet). He claims to do it once or twice a day. He also suggests doing this and not jumping to surgery. I also read an article somewhere about Johnson's Baby Shampoo, like 1cc to 500cc of saline water (research this amount) because the Johnson's helps in the sinuses.
Link to that information
http://drdavidson.ucsd.edu/portals/0/nasal.htm
I like the water pik irrigation and find it very helpful. Before water pik, was using a nasal suction bulb that we use on babies.
Good luck everyone and try things and use what works best for you. We are all different so different things work for different people.

 
At 5/31/2010 1:23 AM, Anonymous Anonymous said...

help tired it with warm water and was one of the most painfull things.. several times similar experience...with gentle pressure warm water ..like an ice pick up my nose .. makes a brain freeze from an over cold drink feel pleasant in comparison .. followed the directions ... nose is somewhat clogged .. what am i doing wrong

 
At 6/01/2010 12:03 PM, Blogger Brad said...

If you followed the recipe, I'm not sure what went wrong. Do you have this reaction to *any* liquid entering your nasal cavity? Make sure the ingredients have dissolved completely before irrigating. You could try using a different brand of salt, or try changing the amount of salt. Or you might try a commercially available solution. Hope that helps!

 
At 6/08/2010 5:07 PM, Anonymous Anonymous said...

I have tried the nasal irrigation using the baby bubles others have mentioned. I can't tell that they help any. I hot shower seems to help just as much. It only takes 15 - 30 minutes after nasal irrigation for me to "lock up" again. The irrigation never gets into my upper cavities where most of the severe pain occurs. Like many things it is not a cure all for everyone. Oh where in the world is everyone finding the Water Picks? An antique store? I have not seen them since the 70's.

 
At 6/09/2010 6:40 PM, Anonymous Kumar said...

Visit http://www.neilmed.com/neilmedblog
You will find all the informations there. It's very very helpful.

 
At 7/13/2010 12:27 PM, Anonymous buy viagra said...

I read a blog that said that some nasal spray products can be used if you are sleeplessness, if you feel that coffee is hurting your stomach, maybe you should try it.

 
At 9/04/2010 7:38 AM, Anonymous Anonymous said...

I have had a head cold for about a day and a half and this morning my head was so congested. I have a neil-med sinus bottle and solution packets I bought a while back and have used it maybe twice ( I didn't have a cold then). I thought it would probably help me with my congestion this morning. When I flushed the right side there were green/yellow clumps of mucus and very little discomfort. When I did the left side however there was so much pain and presssure in my right ear. I managed to finish the rinse but OW did that hurt! IS it because that side was more congested than the other?

Thanks

 
At 9/09/2010 11:45 AM, Blogger Brad said...

Anonymous on 9/4, I think you're correct - more congestion due to more mucus or drier, stickier mucus, or perhaps due to more swollen mucous membranes. I'd keep at it, but be gentle!

 
At 11/30/2010 7:45 AM, Anonymous Anonymous said...

I tried using a neti pot several times with varying strengths of saline and everytime it burned so bad I had to stop. My eyes became very blood shot. I have been tilting my head down and to the side. Any suggestions?

 
At 12/04/2010 6:53 PM, Blogger Brad said...

Anonymous on 11/30, sounds like you haven't found the right concentration of salt. I've had success with the recipe on this post, but your mileage may vary. Make sure the ingredients have dissolved completely before irrigating. You could try using a different brand of salt (e.g. one without iodine, one with smaller crystals). Or you might try a commercially available solution. Hope that helps!

 
At 12/07/2010 7:26 PM, Anonymous Anonymous said...

Whenever I have a crazy runny/clogged nose, I neti it up and feel better. I like it, but I only do it if I'm sick or bored.

 
At 12/07/2010 7:28 PM, Blogger kelly said...

11/30 person, this happened to me too!
The difference between that horrible time and every other time I've netied is that I used table salt.
mistaaaaaaake.
owy.
if you get a netimed one, it comes with deiodized salt, and it's mucho better.

 
At 12/08/2010 2:34 PM, Blogger Pat said...

Just returned from post FESS (functional endoscopic sinus surgery) checkup at Mayo - Rochester. Have been instructed to add Budesonide repsule to Hydro Pulse irrigator. Freaked out when I read about Budesonide but on further research it appears to work differently when used as a sinus rinse.

I really like the Breathease XL powder more than regular saline. It seems to be less irritating to my nasal passages than the NeilMed powder.

Anyway, I seem to be healing well after three weeks post ethmoidectomy.

 
At 2/04/2011 5:32 PM, Anonymous Anonymous said...

I've been trying for the past week to irrigate my nose with first just a spouted measuring cup and then a squirt bottle, but I can't make it work right. The water doesn't come out the other side, it comes back out the same side.

I've been blocking off the back of the roof of my mouth in hopes of preventing the water from running down my throat. Could I really be exerting enough pressure that I'm keeping the water from going through?

I don't think I can make myself inhale water. Is there something else I can do to make this work?

 
At 2/08/2011 9:39 AM, Blogger Brad said...

Sounds like you may not be tipping your head back far enough.

Here's how I do it now (and I've been doing it consistently, morning and evening, ever since I wrote the original post). Standing in front of a sink, I tilt my head backwards and gently squeeze the saline into one nostril until it feels about right (not too much or too little fluid). With my head still tilted backwards, I rotate my head left and right to "swish" the saline around my nasal cavity. Then I lean forward and gently expel the contents (out both nostrils) into the sink. Finally I blow my nose (again, being gentle is key) and wipe away any residual fluid.

Keep experimenting. I guess it is possible this method won't work well with your particular anatomy, but I'm optimistic.

 
At 3/24/2011 2:46 PM, Anonymous moon daisy said...

Hi, I came across your blog by searching on 'nasal irrigation won't come out the other side', and found this comment and response! I've been having the same problem, and I think some water also probably remains in there somewhere, each time I try it - which isn't helping.

I haven't been tilting my head backwards at all though, just kind of leaning forwards over the sink, with my head tilted to one side. I will try it the way you suggested and see if anything comes out.

Thanks for the idea.

 
At 3/24/2011 2:58 PM, Anonymous moon daisy said...

One more question, when you tilt your head back, how do you stop all the salt water simply going down the back of your throat? I'm thinking that maybe I'm built differently to everyone else..

 
At 3/26/2011 8:39 PM, Blogger Brad said...

Hi moon daisy, I think I block the saline by elevating my soft palate, but I'm not really sure. Easier to do than describe. I assume most people can do this with some practice, but I could be wrong.

 
At 3/30/2011 3:23 PM, Anonymous moon daisy said...

Hi, thanks. I've since discovered on another site that you can stop the saline going down your throat by breathing through your mouth while you do the irrigation.

I got it to work in the end, with a little water coming out the other side. So now my nasal sinuses are clear, but my throat hurts and my ears are blocked and painful. Is this related to the nasal irrigation do you think? Did I simply move the infection, or just a coincidence? Thanks.

 
At 3/31/2011 8:43 AM, Blogger Brad said...

Hard to say for sure. Blowing your nose does carry a small risk of forcing infected nasal mucus into the middle ear cavity. It could also be coincidence (i.e., the natural progression of your infection)...

 
At 4/26/2011 8:14 AM, Blogger john said...

This comment has been removed by the author.

 
At 4/29/2011 8:29 AM, Anonymous Anonymous said...

I tried this once, using the special "neti pot." I ended up getting a very sore throat and a bad cold afterward, which made me wonder if I somehow disrupted some delicate balance in my nose and throat. (I read somewhere that we have immune enhancing molecules in our nose and throat.) Because of this, I'm hesitant to try it again.

 
At 6/09/2011 10:40 PM, Blogger Julie said...

I like the Neti pots. They do wonders for me when I am getting a cold, especially a head cold. A good irrigation with the Neti when I feel the cold coming on generally helps reduce the duration of the cold and congestion.
- nasal irrigation

 
At 10/10/2011 1:37 AM, Anonymous Anonymous said...

I notice a great variation in the amount of salt people are using for irrigation. We are supposed to use a normal "Isotonic" concentration of salt which means the same as your body has. That is made with 1 tsp of salt per quart of water, or 1/2 tsp per pint of water. The addition of baking soda helps clean thing out and adjusts the PH of the solution so it is the same as the nose. Using more salt than 1 teaspoon per quart is not good because it upsets the balance in the nose and stings as well. All the pre-packaged mixes use this "isotonic" concentration and baking soda to adjust PH to normal.

 
At 12/03/2011 4:49 PM, Anonymous Zach said...

The second Anonymous above is ignorant. You probably used the special "neti pot." because you felt like you were or going getting sick, correct?

You were inevitably getting sick. Clearing your nasal passages wasn't going to stop, help or cause your illness towards having a sore throat.

 
At 12/12/2011 8:32 AM, Anonymous Anonymous said...

I'm a regular neti pot user. Does wonders for my allergies. I have found it best to do it in the shower, so I set up the salt mix beforehand, set it next to the shower, grab it at some point during the shower and fill it with warm water. I have also found that tilting the head sideways and employing the technique of allowing the water to fill one side, then doing a sucking motion to pull it through and spit it out through the mouth is the most effective / most cleansing. Alot easier to do this in the shower, than over a sink. Just FYI; good luck to all new neti fans!

 
At 12/17/2011 5:00 PM, Anonymous Anonymous said...

I use tree tea oil for the first time to jelp with my allergy flareup. I used 5 drops to 1 cup of water....I think that was too much. I experienced extreme pain in my sinuses all to the back of my head. I even had a bloodvessel break in my eye. That was 2 hours ago and it still hurts..however it is getting a little better. Any dangers here....

 
At 1/03/2012 11:39 AM, Blogger 1234 said...

Danger...Don't use tap water for neti pot...use distilled water
Brain-eating buggies may be lurking...
In humans, N. fowleri can invade the central nervous system via the nose (specifically through the olfactory mucosa and cribriform plate of the nasal tissues). The penetration initially results in significant necrosis of and hemorrhaging in the olfactory bulbs. From there, the amoebae climbs along nerve fibers through the floor of the cranium via the cribriform plate and into the brain. The organism begins to consume cells of the brain piecemeal by means of a unique sucking apparatus extended from its cell surface.[

http://www.npr.org/blogs/health/2011/12/19/143960631/second-neti-pot-death-from-amoeba-prompts-tap-water-warning

 
At 3/18/2012 11:45 AM, Anonymous Anonymous said...

I too have been given budesonide as well as gentamicin to put in an irrigator. The side effects freak me out. I do have the ringing in the ears.

Two surgeries and I still feel awful. Still clogged and my right eustacian tube is still clogged. ENT thinks something else is going on. Possibly allergies. Any thoughts?

 
At 7/05/2012 8:12 AM, Anonymous Anonymous said...

Don't forget to boil the water lol or you could die from parasites that are found in tap water.

 
At 7/30/2013 9:02 AM, Blogger elhnad said...

Brad,

what do you think of friggy's flip turn sinus flush, in which you tilt your head back but then you also in the shower, lean all the way forward until your head is between your legs.

seems to be based on anatomy just like yours although a bit more so

"The Flip-Turn Sinus Flush (by friggy) removes infected mucus from every part of your sinuses, which Mayo Clinic research shows is the cure for sinusitis, rather than treating sinus tissue with antibiotics. Regular saline irrigation does not work in the upper sinuses, because of gravity, but the Sinus Flush defeats gravity. It works incredibly well with bacterial and viral infections, and some but not all fungal infections. "

http://www.medhelp.org/user_journals/show/2322/The-Sinus-Flush

 
At 8/04/2013 12:22 PM, Anonymous Anonymous said...

Hi,
I never had breathing issues and have been in excellent shape/health all my life as an athlete. These prior 8 months after severe infections in my lymph nodes in my neck and behind my ears, the infection moved to my sinuses and settled in. I do not have insurance as the company I was working for closed. I've had to use sprays for about 8 months now because I could not breathe or even swallow as my nose was so congested. My voice became hoarse. I recently tried the irrigation. My congestion gets worse after irrigation and there is no where for the water to go. It won't go through to the other nostril, just drains out of the same nostril no matter which direction I tilt my head. The more I irrigate, the worse the congestion gets. Any ideas? I'll be able to get to an ENT in a few months when my new insurance kicks in but until then, I'd love to be able to just breathe as a the song says. :)

 
At 11/22/2013 6:46 PM, Anonymous Anonymous said...

Rachel, Xylitol is one of the ingredients in Grossan's pre mixed packets that you add to the warm water.  My GP doctor who is an MD, but has some very non traditional knowledge and practices (like supports natural therapies of all sorts) said that Xylitol makes the sinus environment inhospital bacteria and fungus. I imagine it is sort of like cranberry juice in your bladder. it doesn't kill the bacteria it just makes it harder for them to stick around. I ran out of Grossan pre mix packets and I use the "salt"  from NeilMed Sinus Rinse and 1/2 tsp of Xylitol per 8oz of water or less  if it doesn't dissolve for you.  I don't do the "Tilt back" like many in this blog but I do something else that gets out MAJOR chunks of post nasal drainage (Sorry for the graphic image).  As the machine is on and I'm tilted forward (like they show the young girl demo-ing on Grossan's Site) I plug the draining side completely while opening my mouth, forcing the water up first in my sinus cavity,  then down the back of my throat clearing all the post nasal goop that has been accumulating and thickening giving me a sore throat. The water drains it of my mouth instead.   Do this first on the LOWEST setting and be careful if you have blockage or polyps because it could back into your ears . I did it BEFORE my polyp surgery easy enough but had to be careful.  Now that all that has been removed,  it clears it the scabs and debris from the surgery and excess mucus from the allergies. Irrigation has all been encouraged by my ENT as well. The technique was sort of my accidental invention but it really works.  Sometimes I gently "blow" the open nostril or "hock" while doing the irrigation. That seems to loosen things too.   Again,  Sorry so gross! But it helps! 

 
At 2/07/2014 5:48 PM, Anonymous Prem said...

I was suffering from blocked nose, and sinus allergy for two years. Could not sleep at night, had trouble breathing.
Tried Nasonex, Singulair, Reactine etc. But nothing worked. Had polyps as we'll.
Recently, started nasal rinse using Neilmed plastic bottle that comes with repackaged salt with boiled water.
It worked like magic. I am completely cured. I can breathe now and Polyps disappeared.Allergy gone.
I religiously do nasal rinse now every morning and night.
It works..........please do yourself a favour and use it.

 
At 4/05/2014 5:56 PM, Blogger Greg Marsh said...

I have tried this and I now have a very bad headache and my teeth ache as well. Any suggestions?

I was trying this to get rid of a chronic cough.

 

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