Nasal Saline Irrigation and Neti Pots

If you’re one of the millions of Americans dealing with sinus problems, you know how miserable facial pain and clogged nasal passages can be. In their search for relief, many sinus sufferers have turned to nasal saline irrigation, a therapy that uses a salt and water solution to flush out the nasal passages.

Although several methods of nasal irrigation exist, one of the most popular is the Neti pot — a ceramic or plastic pot that looks like a cross between a small teapot and Aladdin’s magic lamp. Although nasal irrigation using the Neti pot has been around for centuries, its use is on the rise in the U.S. The Neti pot originally comes from the Ayurvedic/yoga medical tradition.

Some ear, nose, and throat surgeons recommend nasal irrigation with a Neti pot or other method for their patients who’ve undergone sinus surgery, to clear away crusting in the nasal passages. Many people with sinus symptoms from allergies and environmental irritants also have begun to regularly use the Neti pot or other nasal irrigation devices, claiming that these devices alleviate congestion, and facial pain and pressure. Research backs up these claims, finding that nasal irrigation can be an effective way to relieve sinus symptoms when used along with standard sinus treatments. For some people, nasal irrigation may bring relief of sinus symptoms without the use of medications.

The basic explanation of how the Neti pot works is that it thins mucus and helps flush it out of the nasal passages.

A more biological explanation for how the Neti pot works has to do with tiny, hair-like structures called cilia that line the inside of the nasal and sinus cavities. These cilia wave back and forth to push mucus either to the back of the throat where it can be swallowed, or to the nose to be blown out. Saline solution can help increase the speed and improve coordination of the cilia so that they may more effectively remove the allergens and other irritants that cause sinus problems.

There aren’t any official medical guidelines, but Neti pots usually come with an insert that explains how to use them. You might also want to ask your family doctor or an ear, nose, and throat specialist to talk you through the process so you can get comfortable with the Neti pot before trying it on your own.

Typically, to use the Neti pot or other nasal irrigation device, mix 3 teaspoons of iodide-free, preservative-free salt with 1 teaspoon of baking soda and store in a small clean container. Mix 1 teaspoon of this mixture in 8 ounces of distilled, sterile or previously boiled and cooled water. 

If you experience burning or stinging, cut the amounts of dry ingredients to make a weaker solution. For children, use a half-teaspoon with 4 ounces of water.

Once you’ve filled the Neti pot, tilt your head over the sink at about a 45-degree angle. Place the spout into your top nostril, and gently pour the saline solution into that nostril.

The fluid will flow through your nasal cavity and out the other nostril. It may also run into your throat. If this occurs, just spit it out. Blow your nose to get rid of any remaining liquid, then refill the Neti pot and repeat the process on the other side. It’s important to rinse the irrigation device after each use and leave open to air dry.

In studies, people suffering from daily sinus symptoms found relief from using the Neti pot or other nasal irrigation system daily. Three times a week was often enough once symptoms subsided.

Research has found that the Neti pot is generally safe. A small number of regular users experience mild side effects, such as nasal irritation and stinging. Nosebleeds can also occur, but they are rare. Reducing the amount of salt in the solution, adjusting the frequency of Neti pot use, and changing the temperature of the water may help to reduce side effects. 

To help prevent infection, always use distilled, sterile, or previously boiled water. Also, it’s important to properly care for your nasal irrigation device. Either wash the device thoroughly by hand, or put it in the dishwasher if it’s dishwasher-safe. Follow by drying the device completely after each use.

If you experience side effects or develop an infection, talk to your doctor.

Neti pots are available over-the-counter at many drug stores, health food stores, and online retailers. They usually cost between $15 and $30.

SOURCES:

CDC.

National Institutes of Health.

Rakel, D. Integrative Medicine, 2nd ed, Saunders, 2007.

Rabago, D. Annals of Family Medicine, 2006; vol 4: pp 295-301.

Rabago, D. Journal of Family Practice, 2002; vol 51: pp 1049-1055.

Jean Kim, MD, PhD, Johns Hopkins University School of Medicine.

David Rabago, MD, University of Wisconsin School of Medicine and Public Health.

Harvey, R. The Cochrane Library, 2007.

American Academy of Allergy Asthma & Immunology: “Saline Sinus Rinse Recipe.”

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