Fighting Sinusitis: Rinsing the Sinuses

Sinus Rinsing and Neti Pots

No matter the season, if you are one of the 37 million Americans that report sinus congestion and sinusitis symptoms, twice daily flushing of the nasal pathways with a saline solution may have both positive short term and long-term effects.

The immediate effect of a nasal wash may be relief of your sinus symptoms, including headache, fever, stuffy nose or sinus pressure and pain. In the long-term, it may also lessen the need for antibiotics and the likelihood of developing acute sinusitis.

One of the best and most effective ways in which to rinse your sinuses is with a neti pot. If you’ve ever seen someone using a neti pot, it could seem a bit complicated.

In actuality, the technique of using a neti pot comes from an early yoga sinus rinsing practice called Jala Neti. This practice is rooted in the importance of deep breathing and an overall healthy body. Yogis believe that freeing the nasal passages from blockages is the secret to a healthy breathing technique, which in turn can reduce stress and anxiety in your everyday life.

Neti pots function to flush bacteria. impurities and viruses out of the sinuses. When these germs are detected in the nasal cavity, inflammation results, which causes an automatic response in your body to produce additional mucus to help drain the sinuses. Neti pots not only flush away particles, but also help to maintain moisture in the nasal membrane, which is important for normal sinus draining. Studies have shown that sinus rinsing can be helpful for chronic sinusitis, allergic rhinitis and viral upper respiratory infections.

Recently, neti pots have seen an upsurge in popularity.  They can be found at almost any home goods store or drug store. They look similar to a teapot, but are smaller in size and have an elongated spout.

When shopping for a neti pot, you will have the option of purchasing either the neti pot itself (and making the saline solution yourself), or you can also buy a kit that includes a ready-made solution. If purchasing a kit, look to see if the box indicates that it contains an allergist-approved solution.

Dr. Bennett evaluated some of the most common neti pots you will encounter in your search, and has the following tips for patients who wish to introduce a sinus rinsing routine to their lives:

Most Eco-Friendly

The best places to use your neti pot are (1) over your bathroom or kitchen sink (2) over a medium-sized bowl (3) in the shower, or (4) even outdoors.

Making sure you are near a basin or drain is important because you need a place to catch the stream of water that will flow from your nose.

If this is your first time flushing your sinuses with a neti pot, make sure that you have a few tissues or paper towels on hand to wipe away any excess droplets of water that may spill onto your face or clothing.

Step 2: Use distilled or sanitized water only.

If you choose to make your own saline solution, the first step is to remember to always use distilled or sanitized (boiled) water. As a precaution, tap water is not recommended based on rare reports of people suffering from brain infections after using a tap water-based solution that contained a meningitis-causing bacteria called naegleria fowleri.

Although it has not been scientifically proved that tap water was the root cause of these infections, and cases of naegleria fowleri are few and far between (there were 32 cases reported in 2010), maintaining a level of cautiousness is always recommended when dealing with the delicate tissues inside the nasal cavity. If you use tap water, it should be boiled first. Chlorine in tap water can also irritate the inside of the nose so distilled water is always best.

You should use lukewarm water as the base in your solution. Dr. Bennett recommends testing the temperature of the water for the neti pot flushes by dabbing a drop or two on your arm to make sure the water is not too hot.

Using a solution that is too hot can scald your nostrils and lead to a burning, painful sensation.

Step 4: Mixing the solution

If you purchased a kit, simply mix the packet with your warm water, taking note to use the appropriate ratio listed on the packaging.

If you make your own mixture (often the more cost effective choice) – use 1 teaspoon of Kosher (iodine free) salt for every two cups of warm water. This ratio will match the recommended 0.9% level of saline in the body.

You should add a pinch of baking soda to the mixture. Baking soda buffers the solution and reduces stinging feelings in the nose while flushing the nostrils. Especially add baking soda if you are an individual who tends to have skin sensitivities.

After mixing the solution, pour it slowly into your neti pot. You are now ready to begin rinsins the sinuses!

Step 5: Flush the left nostril

Carefully lean over your basin or sink and turn your head to the left side so that your right cheek is now parallel with the surface over which you are leaning.

Lift the neti pot with your left hand and then slowly insert the long spout into the upper part of your left nostril. Make sure you have placed the spout as far into your nostril as possible (without using force), so that no water can leak out.

Slowly breathe in and out through your mouth only and gently tip the pot so that the solution begins to stream out of the opposite nostril. Keep your face relaxed and your breathing steady. It will take 1-3 seconds before the water begins to stream out.

Once you feel about half of the solution trickle out, stop (you will need the other half of the solution for your right nostril.)

Step 6: Stand up and take a break

In between rinsing the left and right nostrils, you can take a small break. Stand up straight and roll out your neck from side to side. Blow your nose softly to clear out any remaining mucus in the left nostril.

If you happen to feel some of the mixture in the back of your throat, this is okay. You can drink water or tea to clear the taste from your throat, or choose to spit it out. This is common for those who are still neti pot novices. The more you use your neti pot and perfect your practice, the less solution that will drip down into your throat, allowing the solution to flow through your nostrils only.

Step 7: Repeat Step 4 with the opposite nostril

Follow the same steps outlined above in Step 4 by inserting the neti pot into your right nostril. Be sure to gently blow your nose after flushing. Blowing too hard can cause the solution to improperly flow into your sinus cavity or inside ear canals.

Step 8: CLEAN and sanitize your neti pot

Cleaning your neti pot is perhaps the most important step. If you do not take steps to thoroughly clean any excess bacteria and germs, it will be mixed in with the next solution, possibly even growing in the interim.

Clean your neti pot immediately after a flush so that you do not forget to clean it for the next use.

Keep in Mind

 

The frequency in which you flush your sinuses depends on the routine that you and your doctor create. Commonly, those with frequent sinus and nasal congestion and who are prone to sinus infections rinse their sinuses twice a day – once in the morning and again in the evening approximately one hour before bed.

The time of day that you choose to rinse is not particularly important, but if your lifestyle includes rigorous exercise or housework, it’s best to rinse after these activities when your body is ready to purge any existing or additional blocked mucus.

 

By carefully following the steps outlined above, you will be on your way to breathing easier. You may feel a relief of symptoms almost immediately, but remain patient for the long-term effects to settle in. If you are rinsing for sinusitis and do not see an improvement in your symptoms and sinus congestion, you should consult your doctor for a more intensive form of sinusitis treatment.