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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 practice is safe and beneficial with no significant side effects.^[1][2]

The simplest technique is to snort water from cupped hands. Spraying the solution into the nostrils is more convenient, but also less effective. The most effective methods ensure that the liquid enters through one nostril and then either runs out of the other nostril or goes through the nasal cavity to the back of the throat from where it may be spat out. The necessary pressure comes from gravity, from condensing a plastic bottle or a syringe, or from an electrical pump.^[3]

Warm salt water is commonly used with a buffering agent such as sodium bicarbonate. Sometimes xylitol is added to help kill bacteria that have accumulated in the nose. Hypertonic solutions which are saltier than the nasal fluids are favoured and one study indicated that salt from the Dead Sea was especially efficacious.^[4]

Contents 1 Benefits and uses 2 Pulsating nasal irrigation 3 Solutions used for nasal irrigation 4 Jala neti 5 See also 6 References 7 External links

[edit] Benefits and uses

Nasal irrigation is used to treat a wide range of chronic sinus symptoms; for chronic rhinosinusitis it has been found to be an effective adjunctive therapy. According to patient self-reports it improves quality of life and reduces use of medication, including antibiotics. It is also an effective measure against chronic sinus symptoms induced by work-place exposure to sawdust.^[5]

There is also evidence that nasal irrigation causes relief for both hay-fever and the common cold. The use of nasal irrigation for the related 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.^[5]

Daily nasal irrigation with salt water is recommended as both an adjunctive^[6] and primary treatment^[7] in such cases and is preferable to the use of antibiotics or corticosteroids except in the most serious cases of acute bacterial sinusitis which should be immediately referred to an otolaryngologist.^[8] In several countries, the sale of over-the-counter medicines for coughs and colds has been banned for infants under the age of two. Nasal irrigation is a useful safe alternative for relieving the symptoms of such young patients.^[9][10]

Flushing the nasal cavity with salt water (saline) promotes mucociliary clearance by moisturizing the nasal cavity and by removing encrusted material. The procedure has been used safely for both adults and children, and has no documented serious adverse effects. Patients treated with nasal irrigation rely less on other medications and make fewer visits to physicians. Treatment guidelines in both Canada and the United States now advocate use of nasal irrigation for all causes of rhinosinusitis and for postoperative cleaning of the nasal cavity.^[11]

[edit] Pulsating nasal irrigation

Pulsatile lavage is more effective than non-pulsating nasal wash products like bulb syringes, neti pots and squeeze bottles which rely simply on gravity and conventional flow at breaking down biofilm, general cleansing and removing bacteria.^{[12] [13] [14]}

[edit] Solutions used for nasal irrigation

The normal concentration of saline solution used for medical purposes is 0.9% which can be made by adding 9 grams of salt to one litre of lukewarm water. This concentration is also known as isotonic.

[edit] Jala neti

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]}

A related technique for nasal cleansing in the yogic tradition, is Sutra Neti. One end of a cord, or rubber catheter, is passed from the nose into the back of the throat where it is grabbed by the fingers and pulled out of the mouth. Holding the nose end of the cord with one hand and the mouth end with the other, the cord is gently pulled to and fro.

[edit] See also

• Douche
• Enema
• Mouthwash
• Nasal spray

[edit] References

• Neti: Healing Secrets of Yoga and Ayurveda, Dr. David Frawley, Lotus Press, Twin Lakes, WI ISBN 0940985853

[edit] External links

• Wikibook about nasal irrigation
• Mayo Clinic instructional video
• University of Wisconsin instructions, study and video