Nasal irrigation is the practice of flushing the nose and the sinus spaces around it with warm salt water (saline solution). This is done to clear out mucus, moisturize the nose, and improve nasal hygiene. It is also used to treat sinus infections (sinusitis), allergies, the common cold, post-nasal drip, and other conditions affecting the nose, but there's no good evidence to support these uses.
Saline solutions used for irrigation are usually either "isotonic saline" or "hypertonic saline." Isotonic saline, also called normal saline, is 0.9% salt. This is the concentration that is generally used in intravenous (IV) solutions. Hypertonic saline is usually between 1.2% and 3.5% salt.
Nasal irrigation is a traditional practice in yoga call "Jala neti." It was later adopted by Ayurveda. Practitioners use a small neti pot which looks like a teapot. Saline solution is added to the pot and poured through the nostril.
Coronavirus disease 2019 (COVID-19): There is interest in using nasal irrigation to make COVID-19 less severe. But there is no good evidence to support this practice. If you have suspected or confirmed COVID-19, be sure to wash your hands and disinfect the rinse bottle and surrounding surfaces after nasal irrigation. And follow healthy lifestyle choices and proven prevention methods as well.
Is It Effective?
NatMed Pro rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
- Hay fever. Most research shows that irrigating the nose with salt solutions up to 7 times daily reduces allergy symptoms after 1-12 weeks. Research also shows that nasal irrigation might reduce the need for medications that reduce inflammation.
- Nasal surgery. Early research found that using nasal irrigation for a sinus infection seems to reduce the need for sinus surgery in children with long-term sinus swelling (inflammation). Some research also shows that nasal irrigation after nasal surgery helps decrease the length of hospital stays and the number of physician visits. Nasal irrigation using lactated Ringer's solution might be better than salt water.
- Swelling (inflammation) of the nasal cavity and sinuses (rhinosinusitis). Research shows that nasal saline irrigation reduces symptoms of sinus infections. Combining nasal irrigation with an allergy pill also appears to be more effective than using an allergy pill alone. But there is some concern that long-term use of nasal irrigation might actually increase the chance of getting sinus infections over and over again. It is unclear if this increased risk is due to nasal irrigation itself or to improper use of irrigation such as using contaminated rinse bottles. Nasal irrigation with a higher amount of salt or with a little chlorine in water seems to be better than a lower amount of salt and water. But lower salt and water still seems to work better than inhaling steam. Nasal irrigation might be as beneficial as using an antibiotic along with nasal irrigation for early sinus infection in children.
- Asthma. Early research shows that adding nasal irrigation might make the lungs less irritated in people with asthma and hay fever.
- Swelling (inflammation) of small airways in the lung (bronchiolitis). Early research shows that using saline nasal irrigation improves the amount of oxygen in the blood in infants with this condition. But it doesn't seem to improve symptoms such as wheezing.
- Infection of the airways. Some research shows that nasal irrigation reduces symptoms of the common cold or flu in children. Nasal irrigation also seems to reduce the need for medications used to treat fever and break up congestion and mucus. But other research in children and adults shows that nasal irrigation does not improve cold and flu symptoms.
- Runny nose during pregnancy.
- Other conditions.
More evidence is needed to rate nasal irrigation for these uses.
Is it Safe?
Nasal irrigation involves flushing out the nose and sinuses with salt water (saline). It is done using a variety of methods including application with a bulb syringe or using a "neti pot." No method of nasal irrigation has been consistently shown to work better than another.
Saline irrigation flushes out mucus and irritants from the sinuses, improves the flow of air through the nose, and reduces nasal swelling.
Saline solutions used for irrigation are either "isotonic" (0.9% salt) or "hypertonic" (1.25% and 3.5% salt). Some research suggests that higher saline amounts are more effective; however, other clinical research shows no difference between isotonic and hypertonic solutions.
When applied into the nose: Nasal irrigation is LIKELY SAFE for most adults when used appropriately. Some common, minor side effects include nasal burning, pain, stinging, and irritation, as well as ear fullness, pain, and irritation. Higher concentrations of saline are more likely to cause these side effects. In rare cases, some people might experience a nosebleed, headache, coughing, or nausea.
There has been some concern that long-term use of nasal irrigation might increase the chance of getting sinus infections over and over again. But some scientists think that this might be caused by poor hygiene. There is also concern about nasal irrigation causing other types of infections. There have been reports of brain infection in some people using neti pots for nasal irrigation. But in these reports, people were using neti pots incorrectly with plain tap water.
To maintain good hygiene, use only boiled, bottled, or distilled water for nasal irrigation. Wash out pots or other devices used to administer the water with hot soapy water after every use, and never share these items with other people. Rinse bottles should be switched to a new bottle every month.
Special Precautions & Warnings:
Pregnancy and breast-feeding: Nasal irrigation is LIKELY SAFE when used appropriately. There is no reason to expect nasal saline solution to be harmful to the fetus or newborn.
Children: Nasal irrigation is LIKELY SAFE for most children when used appropriately.
It is not known if this treatment interacts with any medicines. Before using this treatment, talk with your health professional if you take any medications.
There are no known interactions with herbs and supplements.
There are no known interactions with foods.
Practitioners of yoga and Ayurvedic medicine use a pot called a "neti pot" to administer nasal irrigation. It looks a little like a teapot. A solution of sodium chloride (salt) in water (saline solution) is added to the pot and poured through the nostril. Other practitioners instill the saline solution in the nose using a low-pressure spray or rinse bottle.
Nasal irrigation is usually applied once or twice daily. Nasal irrigation is often used as needed for relieving nose irritation or symptoms of sinus infection, colds, hay fever, etc. Or it is used on a routine basis. In scientific research, saline solutions used for irrigation are either "isotonic saline" (0.9% salt), the concentration that is generally used in intravenous drips, or "hypertonic saline" (between 2% and 3.5% salt). Some research suggests that higher saline concentrations are more effective; however, other clinical research shows no difference between normal and hypertonic saline solutions.
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