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Doctor, my nose feels stuffy and blocked! How can I wash my nose?

Good morning and TGIF! Welcome to another Euan's ENT Blogpost!


Today's topic is nasal irrigation. Got a stuffy nose from allergies or a cold? Nasal irrigation may help. Let's look at how to effectively rinse out our noses, shall we?



Q: How Nasal Irrigation Works


You pour a saltwater (saline) solution into one nostril. As it flows through your nasal cavity into the other nostril, it washes out mucus and allergens.


Q: Why Nasal Irrigation Helps


Nasal irrigation therefore can be helpful for those suffering from allergic rhinitis, or sinusitis. If you would like to read Dr Euan's advice on these topics, you can read his blog posts on dust mite allergies and sinusitis.


The saline solution rinses out your nasal passages. The saltwater also restores moisture and eases inflammation of the mucous membranes that line your sinuses. Tiny hair-like "cilia" in those membranes pass bacteria and other junk to the throat, where you harmlessly swallow them. With less swelling, it’s easier to breathe.


So, what are the steps involved? here is a handy list for you to follow:


1. Decide What You'll Use

For nasal irrigation, you will need a container and saline solution.

You can buy pre-filled containers, or use a bulb syringe or neti pot. All of these are readily available at pharmacies on retail.


Photo of NeilMed rinse bottle and sinus rinse saline packets that can be bought in pharmacies


2. Mix the Saline Solution

If you choose a pre-filled bottle, skip this step.


Otherwise, you can buy a saline solution powder and follow the directions on the label or make your own. Start with 1-2 cups of warm water that’s distilled, sterile, or that you have boiled to help prevent infection. Add 1/4 to 1/2 teaspoon of non-iodised salt and a pinch of baking soda.


3. Get into Position

If you are using a squeeze bottle, neti pot, or syringe, lean forward over the sink, at about a 45-degree angle. Tilt your head so that one nostril is pointed down toward the sink.


Don't tilt your head back.


4. Pour in the Saline Solution

Place the spout of a neti pot or the tip of a syringe or squeeze bottle just inside your nose.


The tip should go in no further than a finger's width. Keeping your mouth open, squeeze the bulb syringe or bottle, or tilt the pot to pour the water into your nostril.


Remember to breathe through your mouth, not your nose.


5. Let It Drain

The saltwater will run through your nasal passages and drain out on the opposite side, of your other nostril and maybe even your mouth.


You should spit it out and not swallow it. But if some does go down your throat, it won't hurt you.


6. Clear Your Nose and Repeat

Gently blow your nose to clear out the remaining solution.


Repeat the procedure with your other nostril. When you're done, throw away any leftover solution and thoroughly clean the items you have used.


Let the apparatus you used air dry, and then store them in a clean, dry place.


CELEBRITIES WHO USE NASAL IRRIGATION: DAREDEVIL


One interesting example of nasal washing comes from the Daredevil Netflix show, starring Charlie Cox as Matt Murdock/Daredevil.


After being severely injured, Daredevil is on a months-long recovery period and has been bedridden for a long time. After being blinded at a young age, the superhero has learnt to use his other heightened senses to compensate, especially his super sense of hearing.


Following this injury however, in addition to having to learn to walk again, he becomes deaf in his right ear, can't smell anything, and can only taste blood and ash.


One day, he goes up to the sink of his room and finds a Neti pot there.


After feeling around for a bit, he fills the pot up with New York City tap water from the sink and sticks it up his left nostril. Immediately afterwards, he spits out the water and a lot of liquid blood into the sink.


Suddenly, he finds that he can hear rumbling of the subway, and when he puts a finger to a glass of water on a counter, he finds that he can more clearly hear the train going over the tracks, signalling that his senses are restored.

Image from Daredevil, Marvel Television, Netflix


If you would to watch this clip, you can find it on YouTube at this link.


Now in real life, this is actually a great example of what NOT to do.


What happens in the scene is in fact, almost like magic for all the blood to come out cleanly and his senses to be suddenly restored.


To begin with, Daredevil doesn't boil, or distill to prepare the water in any way and uses it straight from the tap. Tap water from big cities such as New York especially can be filled with bacteria. Using it to rinse your nostrils could potentially lead to infections. There also isn't any saline mixed into it, so in real life using "plain" water would probably cause him a lot of pain, especially for someone like him with high sensitivity.


Furthermore, if your nose is full of blood from injuries, it probably would have clotted and congealed a long time ago, becoming solid rather than liquid as shown in the show. The crusting would have to be softened and loosened over time with several washes before coming out as easily as shown in the TV show.


To see lasting effects, nasal washing has to be a regular habit over time.


Another supplementary treatment for nasal obstruction is to use nasal sprays, including decongestants, and nasal sprays. You can read more about Dr Euan's advice in his blog post on nasal sprays.


Q: What If It Stings or Burns?

Use less salt in the saline solution. Make sure the water is lukewarm, and not hot or cold.


Q: How Fast Does It Work?

You may see results after just one or two times. The benefits increase with time as you continue to do it.


One study showed that in the long run, nasal irrigation helped people feel in control of their sinus symptoms and improved their quality of life.


Q: How Often Do You Use Nasal Wash?

Using a saline solution just once a day can help thin mucus, curb postnasal drip, and clean bacteria from your nasal passages.


It can also wash out allergens you may have inhaled. After their symptoms are gone, some people find three times a week is enough to keep them symptom-free.


Q: Is It Right for You?

Nasal Irrigation can benefit people who have sinus problems, nasal allergies, colds, and even flu symptoms. It can help both adults and children.

If you are suffering from constant sinus or stuffy & runny nose, nasal washing can help relieve symptoms


Some people use it every day to stay symptom-free.


You should not use it, though, if you have an ear infection or a nostril that's blocked and hard to breathe through.


Here are some useful references if you are keen to look more deeply into Nasal Irrigation and it's benefits.


Happy Reading!


Here is a link to a video guide on how to perform the nasal wash by UC San Diego.


If you would like a consultation to check on your nose and sinuses, please contact us at Euan's ENT Surgery & Clinic to make an appointment.

References

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