A solution for nasal ills
So your daily attempt at perfection already includes brushing and flossing, exercising, meditating, eating fruits and veggies, and overall clean, healthy living. Here’s one more health habit you might consider: nasal lavage -- also known as nasal irrigation or sinus rinsing.
It’s a simple, low-tech way to wash out the viruses, bacteria, mold, allergens, dust and mucus that land inside the nose and sinus passages, thereby contributing to colds, chronic nasal congestion, postnasal drip, frequent sinus infections, asthma and other respiratory ills.
The basic idea, unappealing as it sounds, is to squirt a slightly salty water solution up your nose, let it drip out, blow your nose gently, then repeat. The mechanical action of flushing out thickened mucus cleanses the nasal passages, making it easier for tiny hair-like cilia that line the nose to push out the remaining mucus.
No matter what product you use, technique matters. Squirt the solution up your nose with too much force and it hurts. Squirt too gently and you’re not accomplishing a thing. If the solution is too salty, it stings. Ditto, if it’s not salty enough.
That said, here’s the case for keeping your nose clean: The practice has been around in many cultures for centuries. And ear, nose and throat specialists swear by it for anyone -- even kids -- with chronic sinus problems.
“Many patients that have sinus disease, allergies or chronic infections are improved tremendously by lavaging their nose out once or twice a day,” says Dr. Gerald Berke, chief of head and neck surgery at UCLA. And for those who have had surgery to open up narrowed sinuses, regular lavage is a must.
“The main improvement they experience is the ability to lavage out the cavity,” Berke says.
Even if antibacterial medications are added to the lavage solution, “most of the benefit is from the mechanical rinsing of the nasal cavity,” says Dr. Eric Holbrook, an otolaryngologist at the Massachusetts Eye and Ear Infirmary. Among other things, the gunk you rinse out in mucus includes natural chemicals called cytokines, which promote inflammation. “If you remove the mucus, you can actually reduce the inflammation,” Holbrook says.
Although large, controlled studies of nasal lavage for treating and preventing colds and sinus infections are hard to come by, the little data that exist seem to support the practice.
One study of more than 200 patients published in 2000 in the journal Laryngoscope found that patients reported fewer nasal symptoms after three to six weeks of nasal irrigation. A 1997 study of 21 volunteers in the same journal found that lavage improved the speed with which nasal cilia were able to move along mucus. A 1998 study in children published in the Journal of Allergy and Clinical Immunology showed that lavage is “tolerable, inexpensive and effective.”
So, how to do it. First, the recipe. To make an isotonic solution (the same saltiness as body fluids), add to eight ounces of water one-quarter teaspoon of salt and one-quarter teaspoon of baking soda. (The baking soda keeps it from stinging.) To make a hypertonic solution, use more salt.
The simplest, albeit messiest, way to get the solution up your nose is to cup it in your hand and sniff, although this lacks a certain elegance. Ceramic Neti pots, popular among the yoga set, work better, although you may not get the water up high enough.
Those blue bulb syringes for cleaning out babies’ ears and noses work too, though, again, it can be hard to get the solution up high enough. Turkey basters also are said to work.
Small, 3-ounce squeeze bottles of prepackaged saline nasal spray available at most drugstores don’t really flush out the sinuses; they just moisten the inside of the nostrils.
Nebulizers also deliver a spray, not a real jet of water, but they work well for kids, says Dr. Sandra Lin, an otolaryngologist at Johns Hopkins School of Medicine, who says she has “seen patients really turn around” on nasal lavage.
Larger squeeze bottles such as the 14-ounce ones made by SaltAire Sinus Relief get the cleaning solution higher up into the sinuses. This system, developed by Drs. Robert Pincus and Scott Gold, co-directors of the New York Sinus Center, is indeed, just as they claim, easy to use, and the buffered hypertonic solution does not sting. (Buffering means the acidity of the solution is adjusted so that it is closer to that of the body.) The SaltAire product costs $12.50.
Dr. Ketan Mehta, a pulmonologist and intensive-care specialist based in Santa Rosa, Calif., has developed a lavage system called Sinus Rinse, made by his company, NeilMed Products Inc.
For $10.95, you get an 8-ounce squeeze bottle with a gently pointed tip and 50 packets of pre-mixed solution to which you add eight ounces of water. The NeilMed product also can be hooked up to a Waterpik or similar system that is electrically powered and delivers pulses of solution.
The Waterpik Technologies Inc. folks, who make oral irrigation devices that squirt water around the teeth under the gums, also have developed an attachment called Gentle Sinus Rinse. The Waterpik irrigators cost $35 to $50 depending on the model, with an extra $10 to $15 for the sinus adapter.
Other nasal hygiene products are becoming available on the Internet and in stores. It may sound weird, but you just might end up with one of the true blessings in life -- clear sinuses.
