nasa//sinus irrigation

[Guest guest]

I found the following while surfing the net awhile back and

have found it helpful for patients (2 different sources cut and pasted):

Seitz, DC

Nasal

Irrigation (nasal wash)

This

set of studies evaluated the effect of daily nasal irrigation (also known as nasal

wash) on the quality of life, symptoms, and medication use of patients with

chronic sinus complaints. Sinus disease is common, affects quality of life, is

expensive, and is a source of significant medication use. Nasal irrigation is

an ancient technique in which salt water is allowed to gently bathe the nasal

cavity, facilitating a gentle wash of the structures within. Four studies were

done from 1999 to 2008 involving a total of 76 subjects.

In

a randomized controlled trial, we trained 52 patients with histories of sinus

disease to use daily nasal irrigation, and compared their experience to 24

control subjects.1 We assessed quality of life, patients' compliance and

satisfaction with nasal irrigation, sinus symptoms, and medication use. The

group using nasal irrigation exhibited improved quality of life, less frequent

symptoms, and used antibiotics and nasal sprays less often. They were compliant

with nasal irrigation, liked using it, and suffered few side effects.

Three

follow-up studies have been published which add to the parent study. In the

first follow-up study, we wanted to determine whether subjects would continue

to use nasal irrigation in a less structured setting and whether the control

subjects would use nasal irrigation if trained and followed in an unstructured

manner.2 We therefore followed the original intervention subjects for an

additional 12 months, and trained the initial control group subjects to use

nasal irrigation for their chronic sinus conditions and followed them for 12

months. Both groups experienced similar improvement in quality of life and

decreased nasal symptoms. Use patterns stabilized at about 3 nasal irrigations

per week, used by some subjects on a strict schedule and by others only as

needed.

In

the second follow-up we wanted to know how users of nasal irrigation

experienced the process of learning to use the therapy, and how they continue

to use it at home. We conducted interviews with 28 subjects from the original

study.3 Their discussions centered around four main themes: 1) nasal irrigation

was effective for their chronic symptoms and 2) it empowered them to care more

for chronic sinus symptoms on their own rather than always seek a physician's

input. 3) There are some impediments to doing nasal irrigation such as time

require and the initial sensation of water in the nasal cavity, but that 4)

these barriers were overcome by good instruction and integration of nasal

irrigation into subjects' at-home daily routines.

Some

people with chronic sinus conditions also have allergic rhinitis. Therefore, in

the third follow-up study, we considered whether nasal irrigation might be

helpful to subjects with allergic rhinitis.4 We re-analyzed qualitative data to

explore the research question 'Do subjects using HSNI for chronic sinus

symptoms, who also reported diagnoses of allergic rhinitis? More than half of

subjects with self-reported chronic sinus symptoms and concurrent allergic

rhinitis spontaneously reported positive effects of nasal irrigation on allergy

symptoms as distinct from chronic sinus symptoms, suggesting that nasal

irrigation may be effective adjunctive therapy for allergic rhinitis.

We

conclude from these studies, and from a reading of the scientific literature,

that nasal irrigation is an effective adjunctive therapy for chronic sinus

symptoms.5 It may also be effective as adjunctive therapy for symptoms of other

upper respiratory conditions that are risk factors for chronic sinus symptoms

including acute upper respiratory infection (common cold), acute sinusitis, and

allergic rhinitis.

1. Rabago D,

Zgierska A, Mundt M, Barrett B, Bobula J, Maberry R. Efficacy of daily

hypertonic saline nasal irrigation among patients with sinusitis: A randomized

controlled trial. Journal of Family

Practice. 2002;51(12):1049-1055.

2. Rabago D,

Pasic T, Zgierska A, Barrett B, Mundt M, Maberry R. The efficacy of hypertonic

saline nasal irrigation for chronic sinonasal symptoms. Otolaryngol Head Neck Surg.

2005;133:3-8.

3. Rabago D,

Barrett B, Marchand L, Maberry R, Mundt M. Qualitative aspects of nasal

irrigation use by patients with chronic sinus disease in a multi-method study. ls of Family Medicine.

2006;4:295-301.

4. Rabago D,

Guerard E, Bukstein D. Nasal irrigation for chronic sinus symptoms in patients

with allergic rhinitis, asthma and nasal polyposis: a hypothesis generating

study. Wisconsin Medical Journal. 2008;107:69-75.

5. Harvey R,

Hannan S, Badia L, Scadding G. Nasal saline for the symptoms of chronic

rhinosinusitis. Cochrane Database Syst Rev.

July 18 2007;3(CD006394

This

is a description of how to make it yourself. You will need a neti pot or a

nasal bulb syringe.

Ingredients

·

1/2

teaspoon of non-iodized salt (e.g. kosher, canning, pickling, or sea salt)

·

8

ounces filtered room temperature water

·

1/2

teaspoon of baking soda

Instructions

1. Mix the ingredients together in a clean container.

2. Stand over the

bathroom sink. If using a bulb syringe, tilt your head down and place the

syringe into one nostril. Give it a gentle squeeze so that the water comes out

the other nostril. If using a neti pot, tilt your head sideways and place the

spout into a nostril. Tilt the pot so water out the other nostril. There may be

some mucous in the water that comes out. It is usually done until there is no

more mucous in the water.

3. Repeat for the other nostril.

4. Gargle with water.

Precautions

It's always a good idea to consult your healthcare provider before trying a

home procedure such as a nasal irrigation.

People with acute sinus infections should avoid this procedure, since it may

facilitate the spread of bacteria.

If a nasal irrigation results in gagging or ear pain, it's likely being done

too vigorously.

There may be coughing after nasal irrigation because some of the fluid drains

down the back of the throat.