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The Complete Guide to Nasal Irrigation and Sinus Rinses

The Complete Guide to Nasal Irrigation and Sinus Rinses

Nasal irrigation is a hygienic health practice that has been used for at least five centuries. It is effective against symptoms caused by allergies, the common cold, sinus problems, and other issues that occur in the nasal cavity.

Also known as nasal lavage or nasal wash, this practice has been around since the times of Ayurvedic medicine. Its effects are the result of a thorough rinsing process, which removes any debris and mucus which may be causing blockages and problems in the nose and sinuses.

Due to the presence of salt in the solution, it can be compared to the all-too-common nasal sprays, which have a similar effect. However, nasal irrigation is much more thorough and, thus, more effective.

One particular benefit of nasal irrigation is the ability to perform a sinus rinse. Millions of people are affected by sinus problems, which lead to facial pain and clogged nasal passages. A sinus rinse can help to fight both acute and chronic sinus problems.

You may have already seen videos of people engaging in a nasal wash or nasal flush, and it may look strange or even intimidating (with water going into one nostril and leaving through the other). However, sinus irrigation is, in fact, a simple, gentle, and effective technique that does not require a lot of effort.

In this article, we will look at the origins of nasal irrigation, its benefits, how to do it, and how to avoid the common risks.

The History of Nasal Irrigation

Nasal irrigation is an ancient practice that has been around for at least five centuries, originating in Ayurvedic medical tradition under the term Jala Neti or nasal cleansing. When translated, Jala Neti means ‘guiding water,’ as this is what the practice is all about: guiding water through the nasal passages in order to cleanse them.

According to Ayurvedic medicine, the sense of smell is related to the earth element. It is believed that the five great elements (pancha mahabhutani) interact directly with the human body. Any disorder in the body indicates an imbalance in one or more of these elements.

Additionally, Ayurveda connects the sense organs to organs of action, the nose (believe it or not!) being related to the anus. So, by practicing jala neti, it is believed that not only can one find relief from respiratory issues, but they can also achieve relief from constipation.

Yogic theory also notes the importance of nasal irrigation and sinus washing, as it contributes to balanced breathing. This, in turn, is theorized to bring about a balance in the autonomic nervous system by balancing the sympathetic and parasympathetic nervous systems.

Achieving fuller and freer breathing has also been believed to increase the amount of prana (or life-giving energy) that we absorb. It is also believed to activate the third-eye chakra through the stimulation of the pituitary gland.

So, it may come as no surprise that the first tool for nasal irrigation – the neti pot   was also invented during the onset of Ayurveda and yoga. Originally ceramic, the neti pot has received great attention in the modern world, receiving plastic, metallic, and even electric makeovers.

The Benefits of Nasal Irrigation and Sinus Rinses

Nasal irrigation, and the ability to perform sinus nasal rinses with it, comes with a range of benefits to the respiratory system. Studies have found a positive relationship between nasal irrigation and the relief from symptoms related to rhinosinusitis, viral upper respiratory infections, congestion, allergic rhinitis, and other respiratory health issues.

In particular, it is the saline solution which has these beneficial effects on the nose and sinuses. Here are the most common respiratory issues which can be addressed effectively with the help of nasal irrigation and sinus rinses:

Acute and Chronic Sinusitis

Sinusitis, or rhinosinusitis, can occur as a result of a blockage in the sinus drainage paths. When this happens, the sinus glands continue to produce mucus, which cannot drain, creating pools in which bacteria are free to grow uncontrolled. This results in infections which trigger an inflammatory response. 

The most common symptoms of sinusitis are:

  • Headaches and facial pain, which occur because of swelling in the sinuses;
  • Congestion, resulting from mucus buildup;
  • Thick mucus, sometimes yellow or green-tinted, which happens because of an influx of white blood cells;
  • Loss of smell or taste;
  • Cough;
  • Bad breath;
  • Fever;
  • Toothache; and
  • Fullness in the ears.

Nasal irrigation helps to combat sinusitis through what is known as a sinus rinse. The saline content and the lukewarm water serve to unblock the drainage paths, leading to an effective sinus flush, where the built-up mucus exits the sinuses.

Daily sinus irrigation can also help to prevent sinusitis from happening in the first place. This is because through washing the sinuses daily you can clear any excess mucus and help to moisten the membranes.

Allergic Rhinitis

Allergic rhinitis, also known as hay fever, happens when the nose cavity becomes inflamed in the presence of specific allergens in the air, like pollen. It is the most common type of allergy, affecting between 10-30% of the world population each year.

The symptoms of allergic rhinitis include:

  • Sneezing;
  • Runny nose;
  • Stuffy nose;
  • Itchy nose;
  • Coughing;
  • Sore or scratchy throat;
  • Itchy and watery eyes;
  • Dark circles under the eyes;
  • Frequent headaches;
  • Hives; and
  • Fatigue.

Performing nasal irrigation helps to fight the symptoms of allergic rhinitis. The nasal rinse helps to relieve the excess mucus, flush allergens, and reduce the concentration of inflammatory mediators in the nasal secretions. Studies have observed a reduction in the levels of histamine and leukotrienes, which are what causes the inflammatory response to the allergens.

The Common Cold

The common cold, known as an upper respiratory infection, is a viral infection which affects the nasal passages and the throat. It typically lasts between 3 days to two weeks. However, in some cases, it can develop into a more serious condition, such as sinus infections or pneumonia.

The symptoms of the common cold include:

  • Coughing;
  • Sneezing;
  • Nasal congestion;
  • Excess mucus;
  • Discomfort in the nasal passages;
  • Runny nose;
  • Pain or pressure behind the face;
  • Scratchy or sore throat; and
  • Mild fever, more common in children.

Nasal irrigation can work wonders when dealing with the common cold. Its anti-congestive and flushing properties can help relieve the built-up mucus and many of the symptoms of the cold. Using this natural method of rinsing also results in a reduced need for additional nasal decongestant medications.

Better Breathing and an Improved Sense of Smell & Taste

Daily nasal irrigation works excellently in the prevention of many respiratory issues. However, even when you do not generally experience such issues, keeping this hygienic practice as a habit will help to improve your overall quality of life.

Nasal irrigation is an active process of removing any debris, dirt, excess mucus, and it softens the membranes in the nasal passages. Because of this, a daily nasal wash is bound to improve the quality of your breathing as well as your sense of smell and taste.

How to Engage in Nasal Irrigation and Sinus Rinses 

You may think that putting water in one nostril and having it exit through the other is a complicated process. However, rest assured that performing a nasal rinse is much simpler than it looks.

To engage in nasal irrigation, you will need a neti pot (you can use any type – ceramic, electric or otherwise). Alternatively, you can use a squeeze bottle or a bulb syringe – whichever works best for you.

The most important ingredient in nasal irrigation is the saline, which is essentially a mix of pure salt and distilled or sterile water. You can create different mixtures to your preference, which we will discuss shortly, or stick to an over-the-counter variety.

Now, here comes the fun part. You can perform nasal irrigation in a few simple steps:

  1. Mix it. Mix the salt in lukewarm distilled or sterilized water. Pour it in the neti pot (or the alternative);
  2. Position it. Lean over a sink looking directly into the basin. Rotate your head at a 45-degree angle, and insert the neti pot in the upper nostril, forming a comfortable seal;
  3. Pour it. Raise the neti pot, letting the solution enter the nostril. The solution will soon start draining from the lower nostril. You need to breathe through your mouth during that time;
  4. Blow your nose gently. Unless your doctor has specified not to;
  5. Switch and repeat. After some time, switch to the other nostril and repeat the procedure until the pot has emptied.

Some Minor Side Effects

A sinus flush can cause some mild discomfort which passes quickly and without serious consequences.

Do not be surprised if you initially experience the feeling you get when you accidentally inhale water while swimming. It takes some getting used to, but this feeling eventually subsides.

Also, depending on the salt level in the saline, you might feel a burning or stinging sensation. This means that you need to lower the salt level (or increase the water level). 

Other effects of nasal irrigation include:

  • Sneezing;
  • Sensation of ear fullness; and
  • Nosebleeds (in rare instances).

Choosing the Right Saline Irrigation Formula

Depending on your preference, there are different saline irrigation formulas you can choose from. Some of them can be bought from any drug store, and others you can make at home.

The drug store formulas usually come in two types: bottled; ready-made ones, which you can use directly without any further adjustments; and dry mixtures which you can dissolve at home.

These formulas come with a set of instructions you can easily follow. In case you choose to dissolve a store-bought dry mixture at home, make sure you do it in distilled or sterilized water. If you are using tap water, boil it for at least 20 minutes.

Making a Home-Made Saline Irrigation Solution

If you wish to make a saline solution at home, you can use a variety of recipes which have some small differences but which all contain three main ingredients: pure, non-iodized and preservative-free salt (such as kosher, pickling, or canning salt), baking soda, and distilled, sterile, or previously boiled water. 

IMPORTANT: Do not use regular tap water. If you do, make sure you have boiled it for at least 20 minutes

Here are some formulas you can try:

1 cup of lukewarm distilled or sterile water, ½ to 1 tsp. non-iodized and preservative-free salt, a pinch of baking soda. Mix until everything dissolves – Formula by American Academy of Allergy, Asthma, and Immunology (AAAAI)

1 cup of lukewarm distilled or sterile water, 3 heaping teaspoons of non-iodized and preservative-free salt, 1 rounded teaspoon of baking soda. Mix until everything dissolves – Formula by Baylor College of Medicine (BCM)

4 cups of lukewarm distilled or boiled water, 2 tsp. non-iodized and preservative-free salt. You can make a smaller batch with 1 cup water and ½ tsp. salt. Mix until the salt dissolves. – Formula by Medical News Today

1 pint of boiled water brought to lukewarm temperature, 1 tsp. kosher, canning, or pickling salt, ½ tsp. baking soda. Mix until ingredients dissolve. – Formula by University of Wisconsin, Department of Family Medicine

Safety Precautions to Keep in Mind When Engaging in Nasal Irrigation

Nasal irrigation is a technique which requires special attention when it comes to hygiene. This refers to working with clean hands, clean instruments, and in a clean environment.

Most importantly, you should never underestimate the quality of the water. Tap water contains bacteria and other microorganisms which may be safe to drink but can cause a lot of harm and even death if they reach the nose.

Using unfiltered and unsterilized water for nasal irrigation can cause sinus infections from bacteria and parasites. In 2012, two people in Louisiana died after using unsterilized water for nasal irrigation.

The fatal risks of using unsterilized water come as a result of an infection caused by an amoeba called Naegleria fowleri. This parasite is extremely dangerous, causing severe headaches, stiff neck, fever, seizures, altered mental status, coma, and even death.

This is why you should take the hygiene of the practice very seriously and make sure you are doing everything correctly – especially when you are preparing a home-made saline solution.

The Bottom Line

Nasal irrigation can be an extremely beneficial practice. Aside from being useful in treating nose and sinus-related issues, it is also excellent for establishing a healthy hygienic practice that can prevent many of those issues.

However, you need to be careful with the overall hygiene when engaging in this practice. Ensure that everything is clean, and that you are using distilled or pre-boiled water.

To support better health, it can be a great idea to combine frequent nasal irrigation with the use of a copper water bottle. Water stored in a copper bottle or other copper vessel has a variety of health benefits, including the benefit of transforming water into natural alkaline water.

About the Authors: This article was collaboratively written by our team of researchers and writers with the benefit of all available scientific studies and other relevant literature. Our team of researchers and writers include experienced health researchers including a qualified medical professional. Please note that information in this article is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment.

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