Rinsing Away the Stuffiness

People with allergies and chronic sinus trouble suffer with stuffed nasal passages, especially at times when pollen counts are high. Some try over-the-counter pills and nasal sprays. Others use prescription sprays. Over the last few years, the rise of the “neti pot” has become a popular non-drug intervention for helping those clogged sinuses from allergies, colds and the flu. The neti pot uses a saline-based (salt) solution to bath the nasal passages. (There are other products that also are used to rinse the sinuses such as bulb syringes, squeeze bottles and battery-operated pulsed water devices.) Rinsing the sinuses soothes as well as unclogs the nose. If you choose to rinse your sinuses, you do need to use some caution.

 Bathing the nasal passages with a saline solution would seem like a safe enough action to take. Yet there have been some deaths associated with this practice. Careful use of the neti pot can bring safe, effective relief.            A Food and Drug Administration (US FDA) Consumer Update titled “Is Rinsing Your Sinuses Safe?” (http://www.fda.gov/ForConsumers/ConsumerUpdates/umc316375.htm) provides consumers with the information (and misinformation) that they need to know about neti pot use. Read what they have to say about safe practices for all nasal rinsing products, including neti pots, bulb syringes, squeeze bottles and battery-operated pulsed water devices.

• These devices are generally safe and useful products. But they must be used and cleaned properly.
• Most important is the source of the water that is used with nasal rinsing devices.
• Tap water that is not filtered, treated or processed in specific ways is not safe for use as a nasal rinse. Some tap water contains low levels of organisms, such as bacteria, protozoa and amoebas, which may be safe to swallow because stomach acid kills them. But these “bugs” can stay alive in nasal passages and cause potentially serious infections, according to the Centers for Disease Control and Prevention (CDC.)
• Misleading/Missing Information: Information included with the device might give specific instructions about its use and care. However, FDA staff has found that some manufacturers’ instructions provide misleading or contradictory information or lack any guidelines. Custom products designed by an artist may also lack instruction. 

 The article also addresses some common questions:

What types of water are safe to use in nasal rinsing devices?

Distilled or sterile water (not plain old bottled water.); Boiled and cooled tap water (boiled for 3-5 minutes) then cooled until it is lukewarm. Boiled water can be stored in a clean, closed container for use within 24 hours; or water passed through a filter with an absolute size of 1 micron or smaller. CDC has information on selecting these filters, which you can buy from some hardware and discount stores may carry these filters or you can purchase on line.

 Are nasal rinsing devices safe for children?

Some children are diagnosed with nasal allergies as early as age 2 and could use nasal rinsing devices if a pediatrician recommends it. However, very young children might not tolerate the procedure as well as older children or adults.

 What are some negative effects to watch out for when using nasal rinsing devices? Talk to your health care provider to determine if 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 had any symptoms while using the nasal rinse, such as fever, nosebleeds or headaches.

 Report all complaints about nasal rinsing devices to the FDA’ MedWatch Safety Information and Adverse Event Reporting program. The phone number is 1-800-332-1088; fax number is 1-800-332-0178 or report on line, http://www.fda.gov/Safety/MedWatch/HowToReport/default For general questions about a particular medical product, you can call the FDA Consumer hotline, 1-888-463-6332.

This column is a partial reprint of the full article. It is provided by Quinnipiack Valley Health District, the local public health department serving the towns of Bethany, Hamden, North Haven and Woodbridge. The information provided is intended to give you current health information to assist you in making informed decisions.  It is not to be construed as medical or legal advice or a substitute for recommendations made by your health care provider. District residents who would like written information on this topic can call 203 248-4528.