Nasal rinsing

Nasal rinsing, or nasal irrigation is a personal hygiene practice in which the nasal cavity is washed.

Effects

• flushing out mucus and debris from the nose and sinuses
• removes nasal swelling
• relives facial pain, headache, halitosis, anterior rhinorrhea and nasal congestion caused by chronic sinusitis
• helping to breathe better during acute upper respiratory infection
• providing relief of the symptoms associated with allergic rhinitis
• preventing puffy eyes effect in case of allergies

NB! Do not do this if your nose is clogged completely. Please consult your physician in case you have any doubts about the safety of this method for you.

Origin, history

Nasal irrigation, which is called Jala Neti in Sanksrit, was developed as an ayurvedic Yoga tradition in ancient India, and is one of the six cleansing practices, or “kriyas”, of Yoga. It is believed that clear breathing leads to clear thinking; therefore, by purifying the nose, a higher state of meditation can be achieved. In addition, yogis believe that cleaning the nose helped overcome addictions, mood swings, and complaints.

It is also a step in the ablution practices (Wudu) of Muslims.
In the US, the Neti pot first gained popularity after Dr. Oz featured it on the Oprah Winfrey show in 2007.
In the countries of former Soviet Union, cleansing nose with saline water is considered as safe and effective folk method of treatment, that can be done even for infants.

Preparation

For this hygiene practice you will need:

Saline water solution

You can either buy a saline solutions designed for nasal irrigation at the pharmacy, or make it on your own.
It's very simple:

1. Measure one teaspoon of natural sea salt or non-iodized table salt (kosher, canning, or pickling salt) without any anti-caking agents or preservatives, as they can irritate the nasal and sinus cavities.
2. Add 1/4-1/3 teaspoon of baking soda (optional).
3. Add one glass (250 ml or 8 ounces) of lukewarm water that is either distilled, sterile, boiled and cooled, or properly filtered. Do not use tap water.
4. Stir until the salt and baking soda are dissolved in the water. Make sure you are using a sterile instrument to stir the mixture.

Container to administer the solution

You have some choices here:

• Neti pot
  

• Bulb syringe
  

File:Syringe bulb.jpg

• Squeeze bottle
  

File:Squeeze bottle.jpg

• Nasal irrigation device
  

File:Nose irrigator.jpg

• Just your cupped hands
  

File:Cupped hands.png

Whatever you choose, make sure it is thoroughly cleaned and sterilized before and after usage, and your hands are washed.

Process

The procedure depends on the container you choose, but mainly it consists of such steps:

1. Fill the container with saline solution.
2. Bend over the the sink or a large bowl and turn your head to the side so that your ear is facing the sink. Keep your forehead at the same height as the chin, or slightly higher.
3. Breathe through your mouth.
4. Insert the spout of the container in the upper nostril. Hold it in such a way as to form a seal, preventing water from coming back out the entrance. Slowly raise the handle of your irrigation device. If you are using a syringe bulb, you may now begin to gently squeeze the saline solution out. If you are using a neti pot, simply let the water flow slowly into the upper nostril and out of the lower nostril. Empty ½ of the container per nostril. You may find it helpful to produce "Iii" sound while doing that.
5. Repeat the process on the other side.
6. Rest your head over the sink and blow your nose gently (without using your fingers to pinch it) to remove the excess water. Do this until most of the dripping has subsided and you can breathe through the nose easily again.
7. Remove the rest of the water and completely clear out your nose by blowing into a tissue, without closing off either nostril.

• If the solution drains out of your mouth, lower your forehead in relation to your chin.
  

If you are using your hands only, do the following:

1. Scoop up the saline solution with your cupped hands.
2. Bend over the the sink or a large bowl and lean your head to your palms.
3. Snort the water with your nose.
4. Let the water pour out of your mouth. Make sure you let it out in time so you don't have choking feeling. It might take some practice to make it feel comfortable.
5. Rest your head over the sink and blow your nose gently (without using your fingers to pinch it) to remove the excess water. Do this until most of the dripping has subsided and you can breathe through the nose easily again.
6. Remove the rest of the water and completely clear out your nose by blowing into a tissue, without closing off either nostril.

Questions

How often can I do it?

You can do it as often as it is comfortable for you. As it is symptomatic treatment, do it until the unpleasant symptoms disappear, for instance, twice a day till the end of blooming season of flowers you are allergic to, or a few times a day until your running nose gets better.

What are the contraindications?

It is not recommended to do nasal rinsing without the doctor's permission in following cases:

• Clogged nasal cavity that you cannot breathe through the nose at all.
• Predisposition to otitis and other ear diseases.
• Severe dizziness and fatigue, as in this cases it is not absolutely safe to perform this procedure.

Are there any scientific proofs of this method?

Yes, there are plenty. You can look through those articles and studies:

• Tomooka LT, Murphy C, Davidson TM (2000). "Clinical Study and Literature Review of Nasal Irrigation". The Laryngoscope. 110 (7): 1189–1193. doi:10.1097/00005537-200007000-00023. PMID 10892694.
• Brown CL, Graham SM (February 2004). "Nasal irrigations: good or bad?". Curr Opin Otolaryngol Head Neck Surg. 12 (1): 9–13. doi:10.1097/00020840-200402000-00004. PMID 14712112.
• Rabago D, Pasic T, Zgierska A, Mundt M, Barrett B, Maberry R (2005). "The Efficacy of Hypertonic Saline Nasal Irrigation for Chronic Sinonasal Symptoms". Otolaryngology - Head and Neck Surgery. 133 (1): 3–8. doi:10.1016/j.otohns.2005.03.002. PMID 16025044.
• Harvey R, Hannan SA, Badia L, Scadding G (2007). Harvey, Richard, ed. "Nasal saline irrigations for the symptoms of chronic rhinosinusitis". Cochrane database of systematic reviews (Online) (3): CD006394. doi:10.1002/14651858.CD006394.pub2. PMID 17636843.
• Pynnonen MA, Mukerji SS, Kim HM, Adams ME, Terrell JE (2007). "Nasal Saline for Chronic Sinonasal Symptoms: A Randomized Controlled Trial". Archives of Otolaryngology - Head and Neck Surgery. 133 (11): 1115–1120. doi:10.1001/archotol.133.11.1115. PMID 18025315.
• Rabago, David (1 June 2008). "The Use of Saline Nasal Irrigation in Common Upper Respiratory Conditions". U.S. Pharmacist.
• Sarah-Anne Schumann; John Hickner (July 2008). "Patients insist on antibiotics for sinusitis? Here is a good reason to say "no"" (PDF). The Journal of Family Practice. 57 (7).
• Kassel JC, King D, Spurling GK (2010). King, David, ed. "Saline nasal irrigation for acute upper respiratory tract infections". Cochrane Database Syst Rev (3): CD006821. doi:10.1002/14651858.CD006821.pub2. PMID 20238351.
• Hermelingmeier, Kristina E.; Weber, Rainer K.; Hellmich, Martin; Heubach, Christine P.; Mösges, Ralph (2012-09-01). "Nasal irrigation as an adjunctive treatment in allergic rhinitis: a systematic review and meta-analysis". American Journal of Rhinology & Allergy. 26 (5): e119–125. doi:10.2500/ajra.2012.26.3787. ISSN 1945-8932. PMC 3904042Freely accessible. PMID 23168142.
• King, D; Mitchell, B; Williams, CP; Spurling, GK (20 April 2015). "Saline nasal irrigation for acute upper respiratory tract infections.". The Cochrane database of systematic reviews. 4: CD006821. doi:10.1002/14651858.CD006821.pub3. PMID 25892369.