Sinus rinsing, also called nasal irrigation, is easy and safe.  Sinuses are interconnected cavities that are linked to the nasal passages by small channels. The channels allow air flow into the sinuses from the nose, helping you to breathe easily. These channels also allow the flow of mucus from the sinuses into the nose.

Bacteria and viruses can incubate in the sinuses. Sinus rinsing flushes away bacteria and viruses.  It sterilizes your sinuses to make an inhospitable environment for infectious agents.

Preparing the Rinse Solution

There are some commercially available rinse solutions already bottled and ready to use. Alternatively, you can make a rinse solution yourself by pouring 100 ml (about half a cup) of decontaminated water into a clean container specifically designed for sinus rinsing. Then add three to five drops of liquid iodine, seal the container, and gently invert it.

The antiviral and antibacterial properties of iodine have been long established.

There are different concentrations of liquid iodine readily available. Povidone iodine, a 10% iodine solution, is the type sold in drugstores and is the type generally used in the multiple studies confirming the efficacy of nasal rinsing. Nascent iodine, a 2% iodine solution, is also suitable for use in nasal rinsing.

Don’t overdo the iodine. Three to five drops of either type diluted as above can be quite effective at killing any bacteria or viruses. Too strong a solution of iodine may create an intense stinging sensation.

There is a great deal of contradictory information online about whether to add salt to the solution and what kind of salt to use. Alberta Health says to use non-iodized salt along with some baking soda, while a 2019 study found that iodized salt was more effective at mucociliary clearance (the action of the tiny hairs in the nose in removing mucus). Other sources say to use Kosher or pickling salt. Others say to use Himalayan salt.

There is no definitive study on exactly what type of salt is best to use in a nasal rinsing solution or whether you even need salt. In our experience, it doesn’t matter whether there is salt in the rinsing solution or not. It is the iodine that is the potent antibacterial and antiviral agent.

Whether using a pre-made rinse solution or making your own, be sure to thoroughly wash your hands and the container you’ll be using to guard against contamination of the rinse solution.

Choosing the Water to Use for Nasal Rinse Solutions

Rinsing solutions are all water-based, but if you’re making your own, it is very important to never use non-decontaminated water such as tap water or bottled water. This is very important because tap water and bottled water contain bacteria and other contaminants that can cause infection or further inflame your sinuses, or worse.

Although rare, tap water can contain Naegleria fowleri, also referred to as “the brain-eating amoeba”, a microorganism that occurs naturally in freshwater bodies and in soil. Because Naegleria fowleri is thermophilic (preferring warm temperatures), it is most often found in warm climates such as those in the southern United States, but there have been reported cases much further north. Water contaminated with Naegleria fowleri does not cause an infection if it is swallowed because the amoeba is killed by stomach acids. However, if the contaminated water is introduced into the nasal cavities, it travels to the brain and often causes primary amebic meningoencephalitis (PAM), a brain infection that is almost always fatal.

There are various methods of decontaminating water to use for nasal rinsing, some of which are more effective than others. Whichever decontamination method you choose, the important point is to never use non-decontaminated water such as tap water or bottled water in a nasal rinse solution.

Types of At-Home Nasal Rinsing Systems

There are different ways that sinus rinsing can be done at home. Neti pots are commonly used and are readily available. Neti pots look like small teapots. You use them by tilting your head over the sink then pouring the solution into the uppermost nasal passage. The water then pours out the lower nasal passage. You then tilt your head the other way and repeat.

Other systems have squeeze bottles that you can use without tilting your head. As you bend over the sink, bring the nozzle up to one of your nostrils and squeeze about a quarter to half of the solution in the bottle gently into your sinuses.

Whichever system you use, be sure to take a deep breath and hold it while rinsing. This gives you enough air in your lungs to expel any solution that leaks into your lungs. If you don’t have enough air in your lungs to cough the solution out, you have to inhale which drives the solution further into your lungs. (Taking and holding a deep breath before you eat or drink anything is a good idea, just in case something goes down the wrong pipe).

The sequence is: take a deep breath, hold it in, bend over the sink, gently squeeze a quarter to half of the solution into one nostril (it will go out the other nostril). Then switch to the other nostril and repeat.

After the rinse, blow your nose but without pinching it completely shut as this could put too much pressure on your ears. If there is any remaining solution in the sinuses or nasal passages, tilt your head to the opposite side to help drain it.

You may find that you experience some post-nasal drip after rinsing. If any of the solution drains down from your sinuses to the back of your throat, you can spit it out or you can swallow it. There’s no harm in allowing it into your stomach. Your stomach and bowels are the first line of immune defense and they are going to kill any residual bacteria or viruses draining from your sinuses. There is likewise no harm in swallowing the iodine in the rinse solution. Iodine is not toxic and at the low concentration of the nasal rinse solution, it is not likely to create any health issues. 

Contraindications

Sinus rinsing is not recommended if you have an ear infection, if you have pressure in one or both ears, or if you have a nostril that is completely blocked.

If you have had recent surgery on your ears or sinuses, be sure to consult your doctor regarding when you can start or resume sinus rinsing.

Frequency of Use

Sinus rinsing does not have to be part of a daily routine, although there’s no harm in rinsing daily. 

If you have any questions about what frequency of sinus rinsing will work best for you, ask your doctor.

Green Apple Health Care practices Cause Based Medicine™ which is the systematic process of finding and treating the core cause of health concerns by using a classic naturopathic approach combined with scientific research to optimize patient outcomes.

Our focus is cause-based.  We are relentless in identifying the root cause, the “why” behind the symptoms, and we address our treatment programs to the cause of the health condition, not the symptoms.

Call us at (780) 485-9468 to book a consultation.  If you prefer, online booking is available for both new patients and repeat patients.