Spring Cleaning for Your Nose

The times definitely are changing. I went to visit our family pediatrician recently and he asked if I wanted to see something special. Reaching into a cabinet in his exam room, he revealed a cache of more than 100 nasal rinsing (also called neti) pots, still in their boxes. Why would this conventional medical doctor have a cabinet chock-a-block with little pots from India? Because they work, he told me. After two decades of seeing stuffed-up kids on an apparently endless round of antibiotics, he decided there must be a better way.
He found it. Instead of balloons, he now gives his young patients neti pots. And the kids are getting well.

An Effective, Ancient Technique
Call it spring cleaning for your nose. Nasal rinsing — or sinus irrigation — is a simple, ancient technique. A warm saltwater rinse of the nasal passages takes a tiny amount of time and pays off big. When we are exposed to irritants, such as allergens, pollution, debris, microbes and smoke, the mucus membranes of our sinuses swell, leading to an increase in mucus production; thicker, stickier mucus; clogged mucus flow; and decrease in nose hair function. Next comes congestion, infection and medication use. (Mucus that stagnates is a primary cause of sinus infections.)
A nasal rinse washes out accumulated mucus and debris before they can cause trouble. This simple maneuver washes particles out, shrinks nasal membranes, increases the nose hair function, thins secretions and opens the tiny sinus openings. The salt reduces swelling and the gentle blast of warm water works like a hose rinsing debris off a sidewalk.
The result? Reduced allergy misery, decreased congestion, healthier sinuses and less money spent on drugs.
It may not be pretty, but nasal rinsing opens up the head. Safe and natural, nasal rinsing often does what sinus surgery, antibiotics, decongestants and antihistamines don’t.
Yoga breathing practices require a clear nose, so yoga and its sister medical science, Ayurveda, refined the procedure. Ayurvedic practitioners have utilized the nasal rinse for thousands of years. The Ayurvedic version uses a neti pot. A small pot with a spout, it is designed for efficient, easy cleansing of nasal passages — an Aladdin’s lamp for the sinuses. It will hold around 10 ounces of water to cleanse both nasal passages. Traditionally made of copper or silver, or clay, modern designs are usually made of stainless steel, ceramic or plastic.
The usual solution used in neti pots, called isotonic, is close to the salinity of human tissues. Use 1/2 teaspoon salt for each cup of warm water. Ayurvedic practitioners suggest you may use many types of natural medicines in the neti water, including gentle decocted and strained herbal teas, such as gotu kola (use herbal teas under the advice of a qualified practitioner, as some herbs can be irritating). Or add a teaspoon of anti-inflammatory ghee (clarified butter) to the liquid and stir to dissolve. Commercial herbal liquids for neti pots are also available at health-food stores or from websites .
To rinse your sinuses, bend forward over the sink with the neti pot in your right hand. Tilt your head to the left and insert the pot’s spout into the right nostril, sealing it. Tip up the pot slightly. Breathe smoothly through your mouth. The water should flow gently into the right nostril, out of the left nostril and into the sink. Experiment with the tilt of your head to avoid having the water soak your pajamas! Gently blow your nose when you’re finished.
At the halfway point, switch sides. The routine looks and feels a little odd, but it is simple and painless. Use the nasal rinse daily, just like brushing your teeth. Ayurvedic practitioners recommend rinsing once daily when you’re well. If you’re congested, you can rinse more often — up to several times daily, as desired.
As an alternative to the traditional neti pot, modern devices include various electrical machines that adjust the water pressure. A WaterPik special rubber attachment is available. Some modern procedures recommend using Locke-Ringer’s solution (containing sodium chloride, potassium chloride, calcium chloride, magnesium chloride, sodium bicarbonate, dextrose and water), which may be a little easier on the health of the nasal hairs.
Nasal Rinsing Tips to Try
--Boil the water (ideally purified, or distilled) first.
--Let the water cool to body temperature. It should feel neutral in the nose.
--Use unprocessed, non-iodized salt, if available. Optional: add baking soda, which in- creases the mucus-thinning properties of the rinsing solution. Use 1/2 teaspoon baking soda per cup of water in addition to the salt.
--Use a heaping 1/4 teaspoon to 1/2 teaspoon of salt per neti pot.
--Increasing the salt content creates a slight stinging sensation but cuts mucus better.
--Thoroughly wash the pot before and after each use.
--Neti use might not be advised for those with nosebleeds, a strong gag reflex, or who have had recent surgery.
--Warm milk— soothing (use straight or in any percentage of the solution)
--Glycerin — soothing (add 1 teaspoon to 1 tablespoon to the solution)Ghee — anti-inflammatory (1 teaspoon)
--Triphala decoction — astringent, anti-inflammatory (make a tea using 1 teaspoon herb powder per cup of water; steep and strain)
--Goldenseal decoction — astringent, antimicrobial (same as above)

Science Supports Nasal Rinsing
Several scientific studies have found benefit in nasal rinsing. One study published in the Ear, Nose, & Throat Journal in 1999 showed that nasal rinsing does a better job of reaching the sinuses than standard nebulizers. Numerous studies conducted over the past 20 years have shown that nasal rinsing improves hay fever symptoms and chronic sinusitis. A 2001 study performed at the University of Wisconsin School of Medicine determined that daily nasal irrigation using a bulb syringe or neti pot resulted in improvement in the symptoms of chronic sinusitis in more than 70 percent of subjects. Medication usage was decreased in approximately one-third of subjects.
A German study of 134 patients found that most patients responded positively to rinsing their noses and integrated the practice easily into their daily routines. (Half were still rinsing 36 months after the study.) This research recommends warm salt water in the nasal rinse.
A 2004 study published in The Laryngoscope compared nasal rinsing with metered nasal spray and nebulization, and it determined rinsing was significantly more effective in penetrating the maxillary sinus and frontal recess and should be the method of choice. Another new study (2004) found that nasal irrigation could provide a reasonable and effective alternative to sinus surgery.
A recent Italian study of 20 children with hay fever found that nasal rinsing with a hypertonic saline (high salt) solution was tolerable, inexpensive and effective. The kids had fewer symptoms and required lower doses of antihistamines.
A 2003 review study, published in Canadian Family Physician, concluded that “Nasal irrigation is a simple, inexpensive treatment that relieves the symptoms of a variety of sinus and nasal conditions, reduces use of medical resources, and could help minimize antibiotic resistance.”
And a review paper from the Department of Otolaryngology — Head and Neck Surgery, University of Iowa Hospitals and Clinics, summed it up. “Nasal irrigations should no longer be considered merely adjunctive measures in managing sinonasal conditions. They are effective and underutilized,” said the scientists.