Neti Pot Bad, Snot Good

[roster]

Store that neti pot and only get it out when you have acute rhinitis.

ACAAI: Frequent Nose Irrigation May Lead to More Sinus Infections

By Kristina Fiore, Staff Writer, MedPage Today
Published: November 09, 2009
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner


MIAMI BEACH -- 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% decrease in the frequency of acute rhinosinusitis, Talal M. Nsouli, MD, 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 patients are using the Neti Pot to prevent infections because they get them frequently, physicians should find out why they're being infected in the first place.

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

They 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% of patients had a significant drop-off in the frequency of their rhinosinusitis infections after discontinuing the treatment (P<0.001).

Those patients also had 50% 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."

John J. Oppenheimer, MD, of New Jersey Medical School, Newark, N.J., 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.

Action Points
--------------------------------------------------------------------------------

■Explain that patients in this study who stopped using nasal saline wash on a regular basis had a 62% decrease in the frequency of acute rhinosinusitis.
■Note that the authors still believe that nasal lavage may be useful during periods of acute infection.
■Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered preliminary until published in a peer-reviewed journal.

The researchers reported no conflicts of interest.


Primary source: American College of Allergy, Asthma, & Immunology
Source reference:
Nsouli TM, et al "Long-term use of nasal saline irrigation: Harmful or helpful?" ACAAI 2009; Abstract O32.


http://www.medpagetoday.com/MeetingCove ... ent=Group1

[modistee]

*puts her neti pot away for good*

Modistee

[Patrick A]

Does this mean that America should take what Dr.Oz says with a gallon of diluted kosher salt from the Neti Pot ?

[LinkC]

I thought mine was helping, but apparently it's snot...

[SuperGeeky]

Hmm, throwing the baby out with the bathwater! Of course, if you blow out the 'good' snot, you'll never make 'good' snot again.

This must be another Govt. funded study.. Ah, what they'll do to create jobs.

That's snot right...

SG

[tattooyu]

I tend to use mine only when I'm feeling overly congested. Last night I got out a bunch of gunk and slept much better. However, I know people who use it every day and definitely have LESS sinus infections and rhinitis.

[DannyP]

Well, My Initial thought on the Matter is that the Goverment is Getting Kick backs from the Nasal spray Industry to put out such Foolishness. My ENT Dr told me it was perfectly safe to Do the Nasal Irrigation for Congestion. But on the other Hand I don't do it Daily but Like Tattoo I onlt use it when overly Congested and will continue to do so. Just my Input on the Nasal Irrigation.

[SuperGeeky]

Absolutely twice everyday, I use a Rhino Tip on a Water Pik with Neilsmed solution.

Far more superior than a Neti-Pot. I really don't want to rely on a Prescription Drug to shrink sinuses. Prescription Drug is a 'break glass in Emergency' situation...

Were under-insured for a Month or so while we switch Health Insurers. Sinus infection came on , I believe the Sinus Irrigation allowed me to go without a Prescription. I'd prefer to go to the Doctor, but this worked out...


SG

[Demeter_Soul]

I notice that when I've irrigated my nose every night, for more than a week at a time, I do get more mucus production, sinus pressure, and eventually headaches and infection.
Now...I only do it when I've been around irritants like smoke or extreme pollution...or when I've been out-and-about...milling with the crowds, getting all kinds of germs in the wrong places.
I can understand why doing it every day may cause problems.
Almost like when antibiotics do a number on us women...and all of the good bacteria is wiped out with the bad -- that kinda thing.

[Pstars]

I don't buy it neither does my ENT. A percentage of all the dust, dander, pollen, viruses, bacteria that we breathe in daily ends up crusted in the nose. I rince daily with the Neil Med bottle and a home made solution. I've completely gotten rid of my allergies and rarely get a sinus infection. It's a non-chemical way to decongest the nose. There's so many "scientific" studies floating around using a relatively tiny control group and people automatically run it the flag pole and salute it.

[jnmv1969]

I use a neti pot pratically every night before I go to bed, and I do not have any of the problems described in that study.

However, I have found that if I don't use the neti pot correctly, then yes, I will run into problems. A person's forehead should angled just enough to get the water to come out of the other nostril, and not even a slight bit more. If it the forehead is too low, then water ends up going up the nose rather than out,and causes the problems the article describes.

I would never give up my neti pot. It has saved me from severe allergies for the last few years, ever since I started using it.

As for sinus infections, I tend to get them when I have not been getting enough sleep. Ah yes, sleep is the body's medicine.

[john_dozer]

The two worst nasal infections I had were after the two times I tried nasal cleaning. Although it wasn't a neti-pot, the first time was a solution mixed into a squirt bottle. Everything had just been unwrapped. The second time I used a pressurized saline cleaner. Removed the packaging and used it immediately without touching anything.

[SaltLakeJan]

Hey Rooster,
Interesting article . . It was just a year ago a Doctor told me to get a Grossan nasal irrigator & use it twice every day.
I would have done almost anything to get rid of my recurring sinus problems. I got the nasal irrigator used it as prescribed. The sinus infections eventually stopped.
But life situations change, we have been away frequently this summer and fall. It seemed too much bother to drag the Grossan with us. I couldn't see me boarding a plane with Cpap tucked under one arm, & the Grossan under the other. I haven't used a Neti Pot in its place. I haven't had my usual sinus problems, till during one flight home I got a stuffy nose; it turned into a sinus infection. I got the Grossan out and used it a couple of times a day for about 10 days. I got rid of the infection without an antiobiotic. I stopped the rinses asa the infection cleared.
Before I started using the nasal irrigator & a sinus infection started, it would go on for a couple of months and I would have used at least two prescriptions for antiobiotics.

IMHO using nasal rinses to treat a sinus problem has been a wonderful solution for me.

Based on my experience, I think the article has merit. Thanks for posting it.

Jan

[kteague]

I have a Neti Pot to use for congestion as needed, which isn't often. The times I have, it was such a slow gentle stream flowing through and out that I can't imagine it having enough force to scrub mucus off the nasal/sinus linings. Yes, the salt could break it down some I would imagine, but it's only in there for a few seconds. When clearing my nose afterward, I never feel thoroughly cleaned out, just loosened up. I think I leave enough crud in there to protect me.

[shambharwani]

I can't comment on the report (ACAAI: Frequent Nose Irrigation May Lead to More Sinus Infections) other than the title itself is not definitive ("May" Lead to).

I have used JalNeti whenever I have had congestion with excellent results. I have also done SutraNeti and that helped me so much that my nasal congestions which were almost a daily occurrence have reduced to maybe a monthly or bimonthly affair and has been so for the last 2 decades. Its possible it doesn't work for everybody but me, I swear by it.