Nasal cleansing

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Common nose rinse device available at drug stores
Common nose rinse device available at drug stores

Nasal irrigation or nasal lavage is the personal hygiene practice in which the nasal cavity is washed to flush out excess mucus and debris while moistening the mucus membranes of the nose and sinuses. It has been practised in India for centuries as one of the disciplines of yoga. Clinical testing has shown that this is safe and beneficial with no significant side effects.[1][2]

The technique may be as simple as snorting water from cupped hands but more elaborate methods use a pot, squeeze bottle or syringe to pour or squirt the water into a nostril. The water then either runs out of the other nostril or goes through the sinuses to the back of the throat from where it may be spat out.

Plain cold water may be used but this may irritate the sensitive mucous membranes in the nose.citation needed Warm salt water is commonly used with a buffering agent such as sodium bicarbonate. Hypertonic solutions which are more salty than the nasal fluids are favoured and one study indicated that salt from the Dead Sea was especially efficacious.[3]

Contents

Benefits and uses

Nasal irrigation is appropriate for many sinonasal conditions and symptoms including:

The benefits of the treatment include:

Daily nasal irrigation with salt water is therefore recommended as both an adjunctive[9] and primary treatment[8] in such cases.

In several countries, the sale of over-the-counter medicines for coughs and colds have been banned for infants under the age of two. Nasal irrigation is a useful safe alternative for relieving the symptoms of such young patients.[10][11]

The use of nasal irrigation for the similar conditions of asthma, nasal polyposis and rhinitis of pregnancy has not been assessed but the symptoms of these conditions are expected to be alleviated in a similar way.[4]

Yogic breathing practices known as pranayama are enhanced since many of them involve deep breathing through the nostrils.citation needed

Jala neti

Ceramic neti pot; neti pots can also be made from glass, metal, or plastic.
Ceramic neti pot; neti pots can also be made from glass, metal, or plastic.

Nasal irrigation is an ancient Ayurvedic technique known as jala neti, which literally means nasal cleansing with water in Sanskrit, where the practitioner uses a neti pot to perform the irrigation. Because modern medicine has long supported the use of nasal irrigation to clear sinuses and prevent sinus and nasal conditions, physicians also accept jala neti as simply one type of nasal irrigation, which can be performed using a neti pot or syringe.citation needed

Jala neti, though relatively less known in Western culture, is a common practice in parts of India and other areas in South Asia, performed as routinely as brushing one's teeth using a toothbrush.citation needed It is performed daily, usually as the first thing in the morning with other cleansing practices. It may also be performed at the end of the day if one works or lives in a dusty or polluted environment. When dealing with problems of congestion it can be performed up to four times a day.citation needed

Pulsating nasal sinus irrigation

Nasal irrigator that delivers an intermitant pulsating saline rinse.
Nasal irrigator that delivers an intermitant pulsating saline rinse.

Several published medical reports indicate pulsatile lavage which utilizes greater leverage and can effectively penetrate biofilm is more effective at cleansing and removing bacteria than non-pulsating nasal wash products like bulb syringes, neti pots and squeeze bottles, which rely on gravity and do not permit the user to finely control the flow. [12] [13] [14]

A pulsating nasal irrigation device utilizes a piston powered pump assembly that delivers a controlled yet intermittant pulsating flow with pressure control that may be adjusted for individual comfort. Medical reports support that positive pressure irrigation retains a larger volume of solution and irrigates the sinuses more consistently than other methods. [15]

See also

References

  1. ^ Papsin B, McTavish A (Feb 2003). "Saline nasal irrigation: Its role as an adjunct treatment". Can Fam Physician 49: 168–73. PMID 12619739. PMC:2214184. 
  2. ^ a b c d e Rabago D, Zgierska A, Mundt M, Barrett B, Bobula J, Maberry R (Dec 2002). "Efficacy of daily hypertonic saline nasal irrigation among patients with sinusitis: a randomized controlled trial". J Fam Pract 51 (12): 1049–55. PMID 12540331. 
  3. ^ Friedman M, Vidyasagar R, Joseph N (Jun 2006). "A randomized, prospective, double-blind study on the efficacy of dead sea salt nasal irrigations". Laryngoscope 116 (6): 878–82. doi:10.1097/01.mlg.0000216798.10007.76. PMID 16735920. 
  4. ^ a b David Rabago (June 1, 2008), "The Use of Saline Nasal Irrigation in Common Upper Respiratory Conditions", US Pharmacist, <http://uspharmacist.com/index.asp?page=ce/105757/default.htm> 
  5. ^ a b c d Tomooka LT, Murphy C, Davidson TM (Jul 2000). "Clinical study and literature review of nasal irrigation". Laryngoscope 110 (7): 1189–93. doi:10.1097/00005537-200007000-00023. PMID 10892694. 
  6. ^ a b Rhinitis - non allergic, NHS, 16 January 2008, <http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=322&sectionId=11> 
  7. ^ a b c d e Sinusitis Treatment: What Is New Is Old., About.com, April 5, 2004, <http://seniorhealth.about.com/cs/respiratorycond/a/sinus_treatment.htm> 
  8. ^ a b Brown CL, Graham SM (Feb 2004). "Nasal irrigations: good or bad?". Curr Opin Otolaryngol Head Neck Surg 12 (1): 9–13. PMID 14712112. 
  9. ^ Rabago D, Pasic T, Zgierska A, Mundt M, Barrett B, Maberry R (Jul 2005). "The efficacy of hypertonic saline nasal irrigation for chronic sinonasal symptoms". Otolaryngol Head Neck Surg 133 (1): 3–8. doi:10.1016/j.otohns.2005.03.002. PMID 16025044. 
  10. ^ Tracie Simer (August 4, 2008), FDA ban on children's decongestants not a whim, The Jackson Sun, <http://fda-news.newslib.com/story/6960-39012/> 
  11. ^ Infant Cough And Cold Remedies Taken Off Shelves In UK, Medical News Today, 27 Mar 2008, <http://www.medicalnewstoday.com/articles/101874.php> 
  12. ^ Brown LL, Shelton HT, Bornside GH, Cohn I (Feb 1978). "Evaluation of wound irrigation by pulsatile jet and conventional methods". Ann. Surg. 187 (2): 170–3. PMID 343735. 
  13. ^ Anglen JO, Apostoles S, Christensen G, Gainor B (Oct 1994). "The efficacy of various irrigation solutions in removing slime-producing Staphylococcus". J Orthop Trauma 8 (5): 390–6. doi:10.1097/00005131-199410000-00004. PMID 7996321. 
  14. ^ Svoboda SJ, Bice TG, Gooden HA, Brooks DE, Thomas DB, Wenke JC (Oct 2006). "Comparison of bulb syringe and pulsed lavage irrigation with use of a bioluminescent musculoskeletal wound model". J Bone Joint Surg Am 88 (10): 2167–74. doi:10.2106/JBJS.E.00248. PMID 17015593. 
  15. ^ Olson DE, Rasgon BM, Hilsinger RL (Aug 2002). "Radiographic comparison of three methods for nasal saline irrigation". Laryngoscope 112 (8 Pt 1): 1394–8. doi:10.1097/00005537-200208000-00013. PMID 12172251. 

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