Should You Use a Neti Pot or Another Type of Nasal Irrigation?  

If you are suffering from sinus or nasal symptoms, a saline wash might bring relief.

The balance of mucus in our bodies—particularly in our noses—is a delicate thing. Too dry, and you can be susceptible to discomfort, nose bleeds and infection. But an overproduction of mucus can make a hospitable environment for bacteria and viruses.

Nasal irrigation is a personal hygiene practice in which the nasal cavity is washed out with a saline rinse (a salt mixture) to remove excess mucus and debris from the nose and sinuses. If you’re fighting a cold, “rinsing infected mucus out and keeping your nose clean is a helpful way to start to feel better,” says Charles Ebert Jr., MD, MPH. “If you are experiencing nasal congestion, whether it’s allergic rhinitis (hay fever), sinusitis (inflamed sinuses), or non-allergic rhinitis (symptoms of hay fever without the allergic trigger), nasal saline irrigation could be potentially beneficial.”

How Do Nasal Rinses Work?

Nasal irrigation systems come in a variety of shapes and sizes, including bulb syringes, neti pots, spray bottles and battery-operated systems. Since there are many options, it is important to read the set of directions for use and care for your particular device.

For the rinse that goes into your nose, you have a couple of options. You can purchase commercially available mixtures, containing sodium chloride (salt) and baking soda, and then you add properly prepared water. If using premade packets, simply pour one packet into your device, add the treated water and then shake. Or you can make your own.

Saline solution for nasal irrigation:

  • 1 heaping tablespoon of salt
  • 1 heaping tablespoon of baking soda
  • 1 quart of treated water

Combine ingredients, shake and pour into your squeeze bottle or neti pot.

Once the rinse is prepared, you want to either stand over the sink or in the shower. Tilt your head, put the spout end of the device in your nose and squeeze or pour.

“High volume, low-pressure systems are the best, like the squeeze bottle or neti pot, for washing things out,” Dr. Ebert says.

Follow the manufacturer’s instructions for regular cleaning of your device and plan to replace it after a few months of regular use.

What Water Should You Use for Nasal Irrigation?

The water used in nasal irrigation is very important to keeping the practice safe and healthy. The CDC recommends that water used for nasal irrigation be boiled or distilled before use. Water should be boiled for at least one to three minutes, and then cooled before using. Distilled water can be purchased at pharmacies; some bottled water is distilled, but be sure to check the label.

“There have been reports of primary amebic meningoencephalitis related to doing nasal rinses in the past, so the CDC recommends that if you are using tap or well water that it must be boiled. And then let it cool,” Dr. Ebert says.

Primary amebic meningoencephalitis (PAM) is an infection of the brain caused by a microscopic organism called Naegleria fowlerithat is typically found in warm, fresh water such as lakes, rivers and hot springs. It infects people when the contaminated water enters the body through the nose and travels to the brain causing PAM, which is typically fatal.

Don’t let that scare you away from performing a nasal rinse. It just “has to be prepared properly,” Dr. Ebert says.

Your Rinsing Routine

Your symptoms will dictate how often you should rinse. People with chronic sinus problems, seasonal allergies or those who have had surgery on their nose will rinse more often than people who develop a cold from time to time.

“In my practice, people with chronic sinusitis who have had surgery do it twice a day, every day,” Dr. Ebert says. “I tell patients to put it beside their toothbrush, and if they’re brushing their teeth they should be rinsing their nose.”

If you’re dealing with a cold or the flu, you can irrigate three to four times a day if it improves your symptoms.

“The evidence has shown that rinsing decreases the length of your acute infection and symptoms. I don’t have allergies or chronic sinus infections, but when I do get a sinus infection, I irrigate a lot,” Dr. Ebert says.

Health Benefits of Nasal Rinsing

Nasal irrigation helps to thin the mucus in the nose, which helps clear the nasal passages of mucus and debris and decreases swelling. For those suffering from environmental allergies, rinsing can decrease exposure to the allergen by rinsing it out of your nose.

If you use a medicated nasal spray, rinsing before using your medication helps to prepare the nose by cleaning and removing any debris. A cleaned-out nose can help make the medicine more effective.

The bottom line? Rinsing can alleviate unpleasant nasal symptoms from a variety of causes.

“You feel better after rinsing, your cold doesn’t last as long and you can breathe better,” Dr. Ebert says.

Dealing with sinus or breathing problems? Talk to your doctor. Find one near you.

Enskanto/iStock/Getty Images

With steadily rising levels of environmental pollutants permeating the air, it is no surprise that, according to the Center for Disease Control, sinusitis currently affects 30.6 million American citizens—and that number is growing daily. Since this and other upper respiratory infections, including hay fever, have become increasingly resistant to antibiotics, many have turned away from pharmaceuticals and have opted for more holistic treatments. While the neti pot is a seasoned, safe and effective therapeutic tool, there are holistic alternatives available.

Nasal Wash Bottles

Similar in concept to neti pots, nasal wash bottles are simply bottles that come in all shapes and sizes and hold saline solution for cleansing the nasal cavity. After tilting the head all the way to one side, the user pours the solution into one nostril, through the sinus cavity, and allows it to come out the other nostril. While adequate for superficial nasal washing, the effectiveness of nasal wash bottles is often limited, as their construction isn’t often conducive to creating the good vacuum seal needed in the nostril to break down biofilm—or thick mucous resulting from chronic allergies or sinusitis—in the nasal passages. Additionally, their imprecise construction can make using them a very messy business.

Nasal Bulbs and Syringes

Nasal bulbs and syringes also use saline solution to irrigate the nasal passages, but offer a more precise nostril fit, thus introducing more positive pressure into the sinus cavity and usually resulting in a more effective cleansing—without the added discomfort of having to hold the head to one side for an extended period of time. These devices, also called nasal aspirators, are especially effective for young children and those new to nasal cleansing, as they are typically made of comfortable, flexible material and come in a variety of sizes.

Pulsatile Irrigation Devices

These devices combine to produce a machine that sends an intermittent, pulsating stream of saline solution through the nasal cavity to clean and restore moisture to the sinuses, massage the inner membranes of the nose, and remove foreign matter. According to a study in the October 2006 edition of the “Journal of Bone and Joint Surgery,” pulsatile irrigation is up to 100 times more effective at removing bacteria and restoring ciliary function than the steady stream irrigation used by nasal wash bottles, bulbs and syringes.

Rock the Neti Pot: 6 Smart Nasal Irrigation Tips to Promote Sinus Health and Minimize Sinus Infections

Whether or not you use medicines or have this surgery, sinus irrigation can be beneficial.

What Is Sinus Irrigation, and Is It the Same as a Nasal Wash or Rinse?

Nasal irrigation is a type of personal hygiene, basically an attempt to use salt-water solutions to force out bacteria and other germs residing in the sinus passages behind the face. Other terms for this are nasal wash, nasal douche, or lavage; some people refer to it by one of the popular devices used to do this, a “neti pot.”

This ancient practice likely got its start in the Indian medical tradition of Ayurveda, according to a review published in May 2017 in the International Journal of Environmental Research and Public Health. (3)

Small Studies Show Nasal Irrigation or Rinsing Helps Sinus Health

Unfortunately, as with most alternative treatments, there are not many large, well-done studies of nasal irrigation. Still, those that do exist generally show a benefit.

Researchers examining the available studies, for example, found just one randomized controlled saline-solution trial with 76 adults meeting their strict criteria, according to their review published in April 2016 in The Cochrane Database of Systematic Reviews. (4) Although even this one study had weaknesses, it did find that after six months, the irrigation group had slightly better results than a control group.

A study by British researchers published in September 2016 in the Canadian Medical Association Journal (after the Cochrane review), also found the method to be effective. (5) More than 800 patients in several physician practices were randomized to use either irrigation, simple steam inhalation treatments, a combination of the two, or neither. Participants did their method daily at home for up to six months. The researchers found patients had more symptoms improve after using the nasal irrigation than the other methods. (Steam inhalation was found mostly to reduce headaches.) People who used the irrigation were also able to reduce their use of over-the-counter medicines and didn’t need to see their doctor as frequently.

How Nasal Irrigation Works to Help Stop Sinus Symptoms and Sinus Infections

Experts aren’t sure of the exact way nasal irrigation works. Some have wondered whether it is something about the composition of the solution used that makes a difference.

That may play a role, but most likely it is the mechanical action of the liquid pouring into the sinuses that are responsible, experts say. The pressurized liquid in the sinuses helps soften and ultimately dislodge some of the mucus lining. Plus, pollen and other foreign substances in these passageways responsible for allergic reactions can be flushed away. (3)

Why It’s Crucial to Rinse or Irrigate the Sinuses Safely

For the most part, irrigating your sinuses produces minimal side effects. Some people experience irritation or discomfort in their nose, and possibly an occasional, short-lasting earache. (3)

But the U.S. Food and Drug Administration (FDA) has warned that improper use of nasal-rinsing devices (such as bulb syringes, squeeze bottles, and battery-operated pulsed water devices) can increase the risk of infection. According to the agency, any bacteria or other organisms in a contaminated device or in the liquid can enter your sinuses, causing harm. (6)

Keep Your Nasal Irrigation Devices Clean

In rare cases, this is very serious. The Centers for Disease Control (CDC) warns that very rarely, people using nasal irrigation with tap water have become infected with the dangerous parasite Naegleria fowleri. (7) While these organisms may not cause harm if swallowed because stomach acid wipes them out, they can live and thrive in the warren of passageways of your sinuses. (7)

Safety Guidelines: Use Only These Types of Water for Nasal Irrigation

To prevent this potentially dangerous problem, the FDA suggests using only carefully selected water:

  • Buy special bottles of water bought in the store labeled “distilled” or “sterile.”
  • Sterilize water yourself, by boiling tap water for three to five minutes, then cooling it until it is lukewarm. You can store this boiled water in a clean, closed container for use the following day (but no longer).

Water coming directly from the tap or shower is not safe to use, the FDA says, because this does not remove potential contaminants. (6)

It’s also important to properly clean the device you use to insert the water (more on that below). The FDA advises washing it according to the manufacturer’s directions and drying it thoroughly either with a paper towel or by air-drying between uses. (6)

Once you’ve mastered the sanitation basics, you can focus on your personal hygiene practice and rinse out your sinuses on a regular basis.

6 Practical Nasal Irrigation Tips for Comfort and Effectiveness

1. Consider Adding Some Salt to Your Nasal Rinse

Because your nasal passages are naturally salty, using a saline solution rather than straight water can feel better.

The American Academy of Allergy, Asthma, and Immunology (AAAAI) suggests a recipe: mix 3 teaspoons (tsp) of non-iodized salt (iodide may irritate your nasal lining), and 1 tsp of baking soda with 1 cup of sterilized water. (8)

2. Get the Right Tools to Get Saline Into Your Nose for Nasal Irrigation

There are several ways to get the water into the passages behind your nose. You can use a squirt bottle, a pump designed for this purpose, or a vessel with a long spout called a neti pot. (4)

3. Find the Nasal-Rinsing Technique That Works for You

You simply fill the device with the solution, then lean over your sink (or, even easier, do it standing in the shower). Tilt your head sideways with your forehead and chin roughly level. Breathing through your mouth, place the container into your upper nostril and allow the water to drain out naturally. (6)

4. Try Rinsing Nasal Passages Again if Necessary

Repeat until your passages feel clearer, then turn your head the other way and work the other side. (6)

5. Keep Turning Your Head to Reach Deep Sinus Passageways

Some experts think it’s best to turn your head further so it is almost upside down. As one physician wrote in a letter published October 2016 in the Canadian Medical Association Journal, since the openings of the deep sinus passageways are at the very top of the nasal cavity, this is the best way to ensure the water gets into these back tubes. (9)

6. Talk to Your Physician About Sinus Washing

If you have questions or concerns about using a saline nasal rinse, be sure to speak with your doctor. You should also do so if you experience pain or any problems after using this treatment.

Heed not Steve

Okay, I have to apologize. There’s going to be some minor talk of mucous. Yes.

For some time, I’ve been curious to try a Neti pot. A Neti pot is a little, teapot-like vessel one uses to pour a saline solution.

Where does the solution get poured, you ask?

Up the nose.

Basically, it’s used to irrigate the nasal passages and clean them out. You tilt your head, put the spout in the uphill nostril, and pour the saline solution into the sinus cavity. Gravity will pull the solution out the other nostril (along with some of the aforementioned mucous).

The Neti pot is old technology and I’ve heard it’s good for you and I’d been curious to try but I’d never gotten around to buying one.

Then, the other day, fighting this cold, I said to myself, “Self,” that’s what I still call myself after all these years, “Self, I bet there’s a do-it-yourself Neti pot out there and I bet you could find it on the web.” So I googled it and, sure enough, there’s a bunch of DIY Neti pots.

What they all mostly consist of is water bottles or soap bottles with spout tops. I happened to have a bottle which fit the bill, so I cleaned it out and gave it a shot.

vanity precludes a photo of the actual irrigation process . . .

In two cups of warm, sterilized water (I boiled tap water) I mixed 1/2 teaspoon of non-iodized salt and 1/2 teaspoon of baking soda. The baking soda is supposed to protect the nasal membranes from being dried out or irritated by the salt. I used pink Himalayan salt. I hope that didn’t have iodine. I’d better check. brb . . .

Okay, I think I’m good.

Anyhow, don’t take this recipe as gospel; it varies from site to site.

So, I mixed it all up and put it in the squeeze bottle and put the squeeze bottle in my nose. I tilted my head and gently squeezed (the bottle, not my head).

Initially, it was a little disconcerting. It felt like, well, it felt like water up my nose! But, really, once things got going, it wasn’t too unpleasant. After each nostril, you’re supposed to gently blow your nose. Oh, and don’t plug either nostril while you’re doing any of this. You don’t want to force anything back into your ear canals.

Overall, it worked pretty well.

The bottle I used is kind of brittle and crunchy and a more flexible bottle would work better, but the next day my sinuses were much clearer. I don’t know that I’d want to do it on too regular a basis; I’d be worried that my sinuses might somehow develop an addiction and who needs to be hooked on nose irrigation?

But, I can see the value of an occasional nasal house cleaning. Maybe, someday, I might even break down and buy an actual Neti pot. Maybe.

Homemade Neti Pot Rinse

I’ve noticed that I’m more likely to use my neti pot when I have a ready-made solution on hand. Plus, keeping this rinse in stock has allowed me to clear the unsightly salt and baking soda containers out from underneath my bathroom sink. When following the below recipe, I mix up enough infused salts to fill a 4 ounce glass jar, which lasts my household about 3 months.


  • 4 parts fine sea salt (should be the consistency of table salt)
  • 1 part baking soda
  • 5 drops essential oil of your choice (I used rosemary, which is anti-fungal, antibacterial, and anti-inflammatory)

Add the sea salt to your storage container and then add 4 or 5 drops of the essential oil of your choice. Stir or shake your container to distribute the oils evenly. Add the baking soda, put the lid on your container, and shake vigorously to mix everything together.

To use: Add ½ teaspoon of the infused salts to your neti pot and then cover with 1 cup of room temperature, distilled water. Lean over your sink and pour half the mixture through one nostril then stop, switch sides, and pour the other half through your other nostril. Clean your neti pot in warm, soapy water between uses.

Warning: Essential oils are extremely concentrated and should be used with caution. Research your essential oil selection carefully before using it and test the diluted oil on the back of your hand to make sure you don’t have any unexpected reactions. To test the oil, dilute 3 drops essential oil in ½ teaspoon of carrier oil (olive oil, sesame oil, almond oil, etc.). Rub a drop of the diluted essential oil onto the back of your hand and watch it for 24 hours to make sure no signs of redness appear. If no patchy red spots appear, then you can assume it’s safe to use on your body and you can add a few drops to your neti pot rinse. If you use too much essential oil or too much salt then your neti pot rinse will burn.


Infused Water Salt Rinse

An even gentler way to incorporate healing plants in your neti rinse is to leave out the essential oils and instead replace the distilled water with an herbal infusion. If you have a runny nose, then an astringent tea made with raspberry leaf, yarrow, or rose, will help tighten tissue and dry up the mucus membranes. If your nasal passages feel raw and sore, then a vulnerary herb, such as calendula, plantain, or chamomile, will help repair the damaged tissues. Finally, if there’s a sense of intense dryness underlying the issue, then demulcent herbs, like slippery elm and marshmallow will provide comfort. For more information on using herbal teas in sinus rinses, I recommend reading The Herbal Academy’s online blog post Natural Allergy Relief: Nasal Rinses, Eyewashes, and Herbal Steam.



  • 1 tablespoon dried herb
  • 1 cup distilled or boiled water
  • ½ tsp salt rinse (follow recipe above for infused salt rinse, but omit the essential oils)

Steep the herbs for 10 to 15 minutes in water then strain. Pour infusion over salt rinse in a neti pot. Wait until it comes to room temperate, then use. Thoroughly wash your neti pot in warm soapy water after each use.

Hannah was inspired to write this blog post during her time enrolled in The Herbal Academy’s online school where she worked her way through the Entrepreneur Herbalist Package. She is managing editor for Heirloom Gardener magazine and senior editor for Mother Earth News. Read all of Hannah’s posts here.


Little teapots with long spouts have become a fixture in many homes to flush out clogged nasal passages and help people breathe easier.

Along with other nasal irrigation systems, these devices — commonly called neti pots — use a saline, or saltwater, solution to treat congested sinuses, colds and allergies. They’re also used to moisten nasal passages exposed to dry indoor air. But be careful. According to the U.S. Food and Drug Administration (FDA), improper use of these neti pots and other nasal rinsing devices can increase your risk of infection.

These nasal rinse devices — which include bulb syringes, squeeze bottles, and battery-operated pulsed water devices — are usually safe and effective products when used and cleaned properly, says Eric A. Mann, MD, PhD, a doctor at FDA.

What does safe use mean? First, rinse only with distilled, sterile or previously boiled water.

Tap water isn’t safe for use as a nasal rinse because it’s not adequately filtered or treated. Some tap water contains low levels of organisms — such as bacteria and protozoa, including amoebas — that may be safe to swallow because stomach acid kills them. But in your nose, these organisms can stay alive in nasal passages and cause potentially serious infections. They can even be fatal in some rare cases, according to the Centers for Disease Control and Prevention (CDC).

What Types of Water Are Safe to Use?

  • Distilled or sterile water, which you can buy in stores. The label will state “distilled” or “sterile.”
  • Boiled and cooled tap water — boiled for 3 to 5 minutes, then cooled until it is lukewarm. Previously boiled water can be stored in a clean, closed container for use within 24 hours.
  • Water passed through a filter designed to trap potentially infectious organisms. CDC has information on selecting these filters.

Safely Use Nasal Irrigation Systems

Second, make sure you follow instructions.

“There are various ways to deliver saline to the nose. Nasal spray bottles deliver a fine mist and might be useful for moisturizing dry nasal passages. But irrigation devices are better at flushing the nose and clearing out mucus, allergens and bacteria,” Mann says.

Information included with the irrigation device might give more specific instructions about its use and care. These devices all work in basically the same way:

  • Leaning over a sink, tilt your head sideways with your forehead and chin roughly level to avoid liquid flowing into your mouth.
  • Breathing through your open mouth, insert the spout of the saline-filled container into your upper nostril so that the liquid drains through the lower nostril.
  • Clear your nostrils. Then repeat the procedure, tilting your head sideways, on the other side.

Sinus rinsing can remove dust, pollen and other debris, as well as help to loosen thick mucus. It can also help relieve nasal symptoms of sinus infections, allergies, colds and flu. Plain water can irritate your nose. The saline allows the water to pass through delicate nasal membranes with little or no burning or irritation.

And if your immune system isn’t working properly, consult your health care provider before using any nasal irrigation systems.

To use and care for your device:

  • Wash and dry your hands.
  • Check that the device is clean and completely dry.
  • Prepare the saline rinse, either with the prepared mixture supplied with the device, or one you make yourself.
  • Follow the manufacturer’s directions for use.
  • Wash the device, and dry the inside with a paper towel or let it air dry between uses.

Talk with a health care provider or pharmacist if the instructions on your device do not clearly state how to use it or if you have any questions.

Nasal Rinsing Devices and Children

Finally, make sure the device fits the age of the person using it. Some children are diagnosed with nasal allergies as early as age 2 and could use nasal rinsing devices at that time, if a pediatrician recommends it. But very young children might not tolerate the procedure.

Whether for a child or adult, talk to your health care provider to determine whether nasal rinsing will be safe or effective for your condition. If symptoms are not relieved or worsen after nasal rinsing, then return to your health care provider, especially if you have fever, nosebleeds or headaches while using the nasal rinse.

Health care professionals and patients can report problems about nasal rinsing devices to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program.

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Can neti pots be dangerous?

Share on PinterestNeti pots are safe when used correctly.

The neti pot is a home remedy for congested noses and sinuses that is available as an over-the-counter (OTC) treatment at most drugstores. It is a type of saline nasal irrigation (SNI) treatment.

The user fills a neti pot with a saltwater solution, tilts their head back, and pours the solution into one nostril. The liquid goes into one nostril and out of the other one.

With its roots in Indian Ayurvedic medicine, nasal irrigation and possible devices for administering the treatment were first introduced to Western medicine by The Lancet journal in 1902. In a survey of 330 primary care physicians, 87 percent advised that they recommend SNI to people that visit for one or more conditions.

The FDA, however, warns that the incorrect use of neti pots and other devices for rinsing out the sinuses, including squeeze bottles, battery-operated pulsed water devices, and bulb syringes, have been linked to a higher risk of infection.

The FDA says it is informing doctors, other healthcare professionals, device makers, and users about safe practices when using these devices.

Users must ensure that the liquid is a dedicated saline nasal rinse. Do not use tap water or any form of unsterilized liquid.

Tap water generally has small amounts of bacteria, protozoa, and other microorganisms, including amebae. These are fine to swallow because stomach acid kills them, but they should not go into the nasal passages. If they do, they can remain alive and eventually cause serious infections.

In 2011, two neti pot users in Louisiana lost their lives after using water tainted with Naegleria fowleri (N. fowleri), a type of ameba. This happened to another individual in 2013.

N. fowleri is naturally found in warm, freshwater lakes and rivers. If the bacteria enter the nose, which most often happens while swimming, they can migrate to the brain through the olfactory nerve. This can cause primary amebic meningoencephalitis (PAM), which is fatal for almost every person with the condition.

Commenting on the tragic deaths, Louisiana State Epidemiologist, Dr. Raoult Ratard, advised:

“If you are irrigating, flushing, or rinsing your sinuses, for example, by using a neti pot, use distilled, sterile, or previously boiled water to make up the irrigation solution. Tap water is safe for drinking, but not for irrigating your nose.”

Click here to choose from a range of neti pots. Following the link will open an external page.


Sweater weather is back, and that means several things: the dog’s going to be a more reluctant walker, I can finally stop worrying about unevenly pedicured toes, and my nose is going to start running every time I leave the house. I haven’t really given much thought to the first two, but the last one is a royal pain.

I’ve heard however, that if your nose does run — whether from seasonal allergies, a cold or flu, or some other reason — using a neti pot might be the trick.

A neti pot a device used for nasal irrigation, and it looks like a little genie’s lamp. (Cute for something you stick in your nostril.) Its origins lie in Ayurveda, or ancient Indian medicine. So here’s the idea: you put a saline solution in the pot, and then you stick the pot in one nostril and tip both your head and the pot forward, forcing the solution into your nasal cavity. The job of the neti pot is to rinse your mucous membranes, not just clearing congestion but also helping to clear any congestion-causing irritants.

The safety of neti pots was recently called into question with two deaths linked to brain infections that were caused by questionably-filtered tap water in rural Louisiana. So I spoke with naturopathic doctor Leslie Solomonian about the dos and don’ts of using a neti pot. Here’s what she had to say:

DO consider the root causes of your congestion. It’s one thing if it’s just a temporary cold, and another if your nose is always running. According to Solomonian, the most common cause of a consistent congestion is actually a food intolerance.
DON’T use a neti pot in isolation. If you’re not at your best, you also need a lot of water and a lot of sleep. Solomonian also suggests a good quality probiotic and immunomodulating herbs, such as ginseng and astragalus, until you’re back to full strength.

DO use it for the whole family – even young children and pregnant women. The only time you need to be concerned is if you’ve experienced nasal trauma or you have open wounds. (Salt water = ouch.)

DON’T worry about choosing the wrong one. Even Shopper’s Drug Mart carries neti pots, and they typically come with sachets of salt to make a solution.

DO customize to your preferences. It might take a few times to figure it out, but you can adjust the amount of salt and the temperature of the water to your preference. Solomonian suggests one teaspoon of sea salt with a little baking soda for every pot of water.

DON’T tilt your head to the left or right while using the neti pot. If you tilt your head to either side, you run the risk of getting water in one or both ears – an unpleasant sensation that could possibly lead to an ear infection.

DO expect relief right away. Solomonian suggests using a neti pot twice a day for a runny nose, and the effects of each session should last at least a couple of hours. But there’s no danger to doing it more often, so use whenever you feel the need.

DON’T use while completely clogged. If your nose isn’t actively running, you might not see any benefits from using a neti pot because the saline solution won’t be able to penetrate the nasal cavity. Instead try steam inhalation (head covered with a towel over a bowl of steaming water) first to loosen up the congestion.

Have you ever used a neti pot? Did it work?

Photo by William Brawley.

With warm weather comes pollen, and that means seasonal allergies for a lot of people. Nasal sprays are an effective way to treat the symptoms, but over reliance with some varieties can actually make you feel worse in the long run.

Topical decongesting nasal sprays, like Afrin or the generic oxymetazoline, work by shrinking inflamed blood vessels in the nasal passages, thus unclogging your sinuses so more air can flow through. But, as Dr. Madeleine Schaberg of the New York Eye and Ear Infirmary of Mount Sinai explains to Women’s Health, frequent use of these nasal sprays cause more problems than they resolve. After a few days of continual use, those blood vessels develop a slight addiction and come to rely on the drug, which causes them to swell beyond their normal size when they don’t get that next hit. This causes your congestion to rebound and get even worse, or what’s known as rhinitis medicamentosa. The more you rely on the spray, the worse it can get over time.


But don’t fret, it’s pretty easy to avoid rebound congestion. Schaberg says that topical nasal sprays can still be used sparingly, but you should included other decongestants in your anti-allergy arsenal. Nasal saline rinses, neti pot flushes, and antihistamines can be thrown into the mix. You can also try an over-the-counter steroidal nasal spray like Flonase or Nasacort that won’t give you the same problems.

Update: A medical expert contacted me and provided clarifications regarding the various types of nasal sprays. The content above has been updated to reflect this new information.

Nov. 11, 2009— — MIAMI — Contrary to popular belief, irrigating the nose every day with the help of a Neti pot may actually make patients more susceptible to sinus infections, researchers said here.

Those who stopped using the nasal saline wash on a regular basis had a 62 percent decrease in the frequency of acute rhinosinusitis, Dr. Talal M. Nsouli, of Watergate Allergy & Asthma Center in Washington, and colleagues reported at the American College of Allergy, Asthma, & Immunology meeting here.

“I don’t have anything against short-term nasal saline irrigation — even aggressive nasal saline irrigation for three, four days or one week is totally fine,” Nsouli said. “But when we are doing it on a daily basis, we are modifying the immunological biochemistry of the nose.”

That, he said, can result in a “depletion of immune elements” — hence, recurrent sinus infections.

“This will lead us to a vicious cycle,” Nsouli said. “More infections, more nasal saline; more nasal saline, more infections. We need to cut this cycle.”

If people are using the Neti Pot to prevent infections because they get them frequently, investigators said, physicians should find out why they’re being infected in the first place.

This type of nasal irrigation has ancient roots, and the form most popular today has stems from an Ayurvedic technique known as jala neti.

The container used to administer the saline solution, which typically has a long spout and resembles an oil lamp, is called a Neti pot, from the Sanskrit term for “nasal cleansing.”

Nsouli and colleagues said they conducted the study because, despite its popularity, this type of nasal saline irrigation had not been assessed for efficacy.

The researchers recruited 68 patients who had used nasal saline irrigation frequently for a year, then discontinued the practice for a year. A total of 24 control patients who continued to wash out their noses with salt were also included.

The investigators found that 62 percent of people had a significant drop-off in the frequency of their rhinosinusitis infections after discontinuing the treatment.

Those patients also had 50 percent fewer sinus infections than those who remained on the nasal saline irrigation therapy.

Nsouli said the likely explanation is that irrigation depletes the nasal mucus, which contains several key defense mechanisms — including immunoglobulin A, immunoglobulin G, lactoferrin, and lysozyme.

This “good mucus,” Nsouli said, contains “antibacterial, antifungal, and antiviral agents that clear any microorganisms from the nose.”

Dr. John J. Oppenheimer, of New Jersey Medical School, said the results don’t mean nasal saline irrigation is “not something to consider if you have a cold.”

It’s just “not necessarily good on a day-to-day basis,” he said.

Still, it needs to be studied when applied to acute situations, he said, and he’d “feel more comfortable seeing the results replicated.”

But Oppenheimer noted that the study is an example of how taking the time to ask patients questions about their history and current habits can potentially be a key to treatment.

Alternative to neti pot

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