Introduction:
Upper respiratory conditions are common and include mild to severe sinusitis (inflammation of the sinus lining), allergic rhinitis, and viral infections that affect the nasal cavity and the throat. These conditions are nagging and can have an impact on the daily activities of the person when affected. Nasal irrigation refers to washing the nasal linings with sterile liquid or saline which is used as an alternative treatment for mild to moderate upper respiratory discomforts.
What Is a Neti Pot?
Nasal irrigation has been considered an adjuvant therapy that has its origin in the Ayurvedic medicine system and is recognized as an essential component in the management of sinus and nasal conditions. Nasal irrigation is observed to be safe and effective but is underutilized.
Nasal irrigation can be performed using various devices like sprays, syringe bulbs, or nasal cups. The sprays and syringe bulbs use low positive pressure to drain the nasal cavity. The nasal cups work on gravity-based pressure and are often called a neti pot. The term is derived from the Ayurvedic practice of Jala neti. The neti pot has a long spout that delivers the liquid from the pot. It looks similar to a small teapot.
How to Use a Neti Pot?
Handouts are available that narrate the instructions for the usage of neti pots. There are three steps involved in the application of neti pot which are as follows:
Step 1: The pre-packed salt is commercially available and can be added to water according to the instructions mentioned on the label. Even a home-prepared salt solution can be used by following the proper guidelines. Too hot or too cold water should not be used. Lukewarm or water at room temperature should be used.
Step 2: The opening of the spout is placed on one side of the nose and one should ensure that the other side is over a vessel or a basin. One must avoid pressing or inserting the spout inside the nostril beyond the middle region.
Step 3: One must tilt their head towards the free nostril and pour the solution from the other side. The solution will enter the upper nasal cavity and drain to the other side. Throughout the procedure, one can breathe through their mouth. Once all the solution is drained, the nose should be blown to expel the retained solution and the procedure must be repeated.
There may be some saltwater drainage from the nose for a few hours after the procedure, which is considered normal.
What Types of Neti Pots Are Available?
The neti pots are there in various forms and shapes according to the patient's comfort. The neti pots are made of durable plastic, porcelain, or ceramic. Some of the plastic neti pots are squeezable, while some have a flexible spout tip to fit them into the nostril hole without any discomfort. If it is a plastic neti pot, it is advisable to choose a BPA (bisphenol-A) free product.
Battery and electric operated neti pots are available nowadays, in which the water pressure can be adjusted. The solution is gently pumped into the nasal cavities and these can reach further than the manual neti pots.
Are the Neti Pots Safe?
The neti pots are safe if used with caution and one should know the following:
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The water used in the neti pot should be distilled, sterile, boiled, and cooled.
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Using direct tap water is not considered safe since even small quantities of microorganisms in the nasal passage may cause infection and could be fatal.
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The next important message is to strictly adhere to the manufacturer's instructions.
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The device should be washed each time before and after use. The device should be kept clean and dry when not in use.
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One can consult their health care provider to know if the neti pots are safe and effective for specific conditions.
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It is necessary to seek immediate help in case of an emergency or if the symptoms are worsening or if there is an emergence of any new symptoms like headache, vomiting, fever, or bleeding in the nose.
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One must not overuse the neti pots. It should be used only when necessary for a few days or once a week. In case of bad allergies, nasal rinse or neti pots can be used once or twice a day.
An alternative to neti pots is the use of nasal squeeze bottles.
How Does a Nasal Rinse Work?
A nasal rinse works in the following ways:
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It is proposed that the nasal rinse completely irrigates the nasal lining removing the irritants, allergens, inflammatory mediators, and other infection-causing agents.
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The process also removes the mucus, thereby relieving nose blockages. Therefore, the nasal passages are cleared directly and the physiological functions are improved.
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The continuous ciliary (hairline projections) motion in the upper airways is a biological process that clears the foreign particles from the mucous lining. It is reported that saline nasal irrigation increases the frequency of ciliary beats and hence supplements the natural defense mechanism of the nasociliary lining.
What Are the Indications for Using the Nasal Rinse?
The neti pot nasal irrigation is found to be effective in the following conditions:
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Sinusitis: Studies have demonstrated a significant (around 65 percent) improvement in chronic sinusitis symptoms with saline nasal irrigation. Therefore, patients have been suggested the usage of saline nasal rinse for 12 weeks as a supplement therapy to reduce the symptoms of chronic sinusitis.
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Allergic Rhinitis: With saline nasal rinse, the concentration of inflammatory mediators like histamine and leukotrienes is significantly reduced in the nasal lining, thereby reducing allergy progression. As a result, the symptoms of allergy are alleviated over time.
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Upper Respiratory Tract Viral Infection: Saline nasal rinse has been known to effectively treat and prevent viral infection in the upper respiratory tract. Nasal irrigation has been helpful in post-operative and post-endoscopic care and is also considered safe and effective for rhinitis in pregnancy.
What Are the Contraindications of the Nasal Rinse?
Saline nasal rinses are considered safe and effective. Initially, a sense of discomfort may occur while performing nasal rinsing with a neti pot. Sometimes one may experience irritation and burning sensation in the nasal linings, which may be caused by the water's temperature and salt content. The minor discomforts can be alleviated through practice and technique adjustments.
Patients with facial trauma, neurological problem, and musculoskeletal problems are not suitable for nasal irrigation because of the risk of liquid aspiration into the other spaces.
Conclusion:
Neti pots have become popular and common in the last decade. These are small devices that resemble a teapot and can help clear any blockage in the sinuses. However, inappropriate use can result in bacterial sinus infections. Neti pot usage can be very successful with proper patient education and training. The neti pot should be cleaned thoroughly with hot water after every use, and fresh saline preparation is used each time to avoid contamination. Instruction sheets or handouts are readily available to get an insight into the use of neti pots. One must discuss with their physician about alternative treatment options if the neti pot is ineffective or if it irritates the nasal passages.
