Should I irrigate my Nose with the Neti Pot?

In the press today are frequent articles about the negative effects of irrigation with the Neti Pot. Is it any wonder that the number one question I get asked is about constant use of the Neti Pot for allergic rhinitis or rhinosinusitis.

In Louisiana they report two deaths from Neti Pot irrigation. Dr Nsouli, prominent allergist in Washington reports that when he had his patients stop daily Neti pot irrigation, they got well! University of Penn reports that within two weeks of use, the Neti Pots become contaminated, even when the patients followed instructions of keeping them clean!

. Dr Oz and dozens of pundits recommend Neti Pot irrigation. What should you do?
Everyone recommends using distilled water for irrigation, yet I tell me patients that regular tap water is fine!

Is it any wonder that patients get confused!

I believe understanding how and why can answer your question.

When you use a Neti Pot or squeeze bottle, it is difficult to control the pressure; it can be too high or too low. Too high a pressure can be harmful.
These devices have flowback: the contaminated mucus from the nose flows back into the spout. Left in place, this is a perfect place for the bacteria to multiply and be reintroduced into the nose and sinuses. You are washing bacteria from one part of your nose to another with bacteria from your own nose. Unless your tap water is contaminated, the tap water doesn’t bring in the bacteria; your own nose does.

Daily irrigation. Daily irrigation can remove some bacteria. But unless you have a full blown bacterial infection, daily irrigation with a Neti Pot also removes the good enzymes from your nose. Your nose produces lysozyme and immune bodies. If you irrigate at 8 AM and get bacteria landing in your nose at 9 AM you are missing the defenders of the nose. So if you don’t have a reason to irrigate, don’t do it! If your nose is normal, it doesn’t do any good to make it more normal.

Neti pot doesn’t remove bacteria from the sinuses. What it can do is introduce bacteria into otherwise healthy sinuses. Worse, when you lay your head to the side, the opening to the ear called the eustachian tube is dependent. If it is open, the infected nasal material can enter the eustachian tube and infect the ear. Laying your head to the side also puts pressure to the olfactory area with openings to the brain. Presumably that is how the amoeba in the Louisiana deaths entered the brain. This may cause the loss of sense of smell that some users get.

What is important:
Most persons with chronic sinus disease, rhinosinusitis, have slow nasal cilia. These are the tiny hairs that move bacteria out of the nose and sinuses. As long as they move at a normal rate of about 12 beats per second, pollen, dust, and bacteria are moved out the nose to the throat and then to the stomach where the acid destroys them. But when the cilia slow down then you get a chronic sinus condition. For example, if you are having a bad allergy season and sneezing for six weeks and not sleeping well, then your cilia are exhausted and slow down. This is why chronic sinus disease can follow a bad allergy season.

Since good cilia movement is best for clearing sinus and nasal problems, why not get them moving? How?

Humming. Hum at a low rate: “oooommmm.” Science actually can measure the cilia moving when you do this!

Jumping jacks. That up and down movement shakes up the thick mucus and helps the cilia movement. Also jump rope.

Hot tea, lemon and honey. Tea contains chemicals that act on the cilia to move them. Lemon thins the mucus, as does honey. Honey helps reduce the bacteria load.

What the Hydro Pulse® Nasal/Sinus Irrigator does is pulse at a rate best to restore nasal cilia, sort of an harmonic effect. That pulsation is best for removing thick mucus too. Best of all, because it is a steady pulsing stream, it acts to remove sinus cavity material by an action called the Bernoulli effect. The pots and squeeze bottles can’t do that.
Most important is that you control the exact pressure as you irrigate; the pressure must be GENTLE, not excessive like it can be with Neti pot or squeeze bottle. With gentle pressure you don’t push bacteria into the healthy sinuses or the ear or the olfactory area.

With the Hydro Pulse® you don’t lean to the side where infected material can get into the ear. Because it goes directly to the main cause –slow cilia, once the cilia are restored, there is no need to continue the irrigation. You don’t need to be more normal. That way you keep the good enzymes in the nose where they belong. For some persons, just two weeks of pulsatile irrigation is sufficient to restore the good nasal cilia movement which is the key to sinus health.

References:
Dr Talal Nsouli showed that about 60% of patients had an increase in nasal/sinus infections when they continued use of pots and bottles over several months time, caused by re-infection and removal of natural healing products such as immunoglobulins, lysozyme and lactoferins.
* Long-Term Use of Nasal Saline Irrigation: Harmful or Helpful?” was presented at the American College of Allergy on Nov 7, 2009.

JM Lee reported that , despite careful instruction of his patients, 50% showed contamination from the irrigation bottles after one week of use. The contamination was due to Pseudomonas aeruginosa. JM Lee. Am J Rhinol Allergy. 2010 May-Jun:24(3) Assessing the risk of irrigation bottle and fluid contamination…

In one study patients with chronic rhinosinusitis were given a fresh bottle every two weeks to irrigate with. After two weeks of use, 97% of the bottles showed contamination and 51% of these showed staph aureus. Four out of six bottles showed biofilm in the bottles after only two weeks of use! *M Keen The Clinical significance of nasal irrigation bottle contamination. Laryngoscope,2010 Oct:120 (10)