| Nasal irrigation | |
|---|---|
 Woman flushing her nose with a neti pot | |
| ICD-9-CM | 22.0 |
| MeSH | D055556 |
Nasal irrigation (also callednasal lavage,nasal toilet,neti pot ornasal douche) is a personalhygiene practice in which thenasal cavity is washed to flush outmucus and debris from thenose andsinuses, in order to enhancenasal breathing. Nasal irrigation can also refer to the use ofsaline nasal spray ornebulizers to moisten themucous membranes.
Nasal irrigation can be an effective therapy to relieve symptoms of acute sinusitis caused byupper respiratory tract infections such as thecommon cold.[1] The evidence for effectiveness in relieving chronic sinusitis is weak.[2]
It can also be useful for the temporary relief of the symptoms associated withallergic rhinitis.[3]
Adverse effects include nasal irritation, nosebleeds, headache, and drainage after the irrigation is done. It is generally well tolerated.[2]
There is a risk of infection if the water is not sterile or the device is not cleaned after use. If the device is used improperly this can be harmful.[4] In fact, proper application suggests the use of boiled water orsaline water. In 2018, a patient was reported to have contractedBalamuthia mandrillaris after one month of usingtap water filtered through aBrita water purifier for nasal irrigation.[5]
Rare cases of fatalnaegleriasis have occurred due to nasal insufflation of the amoebaNaegleria fowleri (the "brain-eating amoeba") from untreated tap water. Two people died fromNaegleria fowleri infections tied to using neti pots containing tap water in 2011.[6] ALouisiana man died from the same amoeba in 2013.[7]
Flushing the nasal cavity can soothe inflamed tissue and remove irritants like allergens; it may help clear mucus.[2][3]
Typical use involves the pouring or pumping of saline water through one nostril and letting it drain from the other.
The water should not be tap water, which may contain small amounts of bacteria that are safe to drink but may be dangerous in the nose. The water should be sterile or filtered for micro-organisms; if tap water is used it should be boiled and cooled.[4]Saline solution is also sometimes used.[2]
The U.S.Centers for Disease Control and Prevention has a fact sheet recommending one of four methods to make the water safe:[8]
A number of other compounds may be included in irrigation fluids such as the steroidbudesonide in an effort to treat chronicrhinosinusitis.[9]
Neti pots are commonly used and rely on gravity and head position in order to rinse the outer sinus cavities. Typically they have a spout attached near the bottom, sometimes with a handle on the opposite side.[4]
Various squeeze bottles for nasal irrigation have also been used to apply the water.[4]
Bulb syringes are commonly used for infants and children.[4]
There are also irrigation machines available that utilize electric motor-driven pumps.[4]
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The earliest record of nasal irrigation is found in the ancientHindu practice of IndianAyurveda whose roots are traced to theVedas. It was customary to perform jala-neti daily, as part ofsoucha (personal hygiene according to scriptures).Jala neti, which means to cleanse the nose with water, is an old yogic technique from India. The container used to administer the saline is called a "neti pot". This process removes mucus and dirt and clears the nose. A second neti technique known assutra neti uses a piece of string instead of water.
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