NASAL SALINE IRRIGATION (Nasal Wash)

Why do a nasal wash?

Many people with allergic rhinitis (runny nose and congestion due to allergy), colds, or other forms of rhinitis develop sinus infections. If you have asthma as well, a sinus infection can trigger your asthma symptoms. In addition, even if your sinuses are not infected, mucous and drainage from your nose can drip down the back of your throat, causing cough or asthma symptoms. Lastly, a nose full of mucous is just plain uncomfortable. Just as when you get water in your nose when you swim, a salt-water nasal wash can help remove much of the mucous from your nose and temporarily
decrease the severity of post-nasal drip and nasal congestion. Nasal washes should be done before nasal sprays (if prescribed) because the nasal spray can then land directly on the lining of the nose where it works, rather than landing on the mucous in the nose.

How is a nasal wash done?

Making the saline (salt water) solution.

Start by washing your hands. To make the saline solution, mix one teaspoon of salt (preferably uniodized salt) into 16 ounces (one pint) of warm water. Add a pinch of baking soda to decrease the amount of stinging. If necessary, you may use a little more or less salt to make the nasal wash less irritating. Although left over solution may be used later in the day, we do not recommend prolonged storage (more than 24 hours). Saline solution should only be stored in a sterile, or dishwasher cleaned jar. You will need several ounces for each nasal wash.

Proper positioning for a nasal wash

Adults and older children: Lean far over the sink with you head down.
Younger children: Try to position your child as much like an older child as possible. If a younger child has difficulty cooperating, you may need to hold him. You may find it helpful to wrap him or her in a towel or blanket with the hands at the side while you hold him or her. Although younger children frequently find nasal washes uncomfortable at first, if you stick with it, they usually get used to the procedure and their noses end up a lot cleaner!

Nasal wash techniques

Whichever technique you use, the saline solution may get in your mouth and leave a salty taste. Rinsing your mouth with water afterward will remove the taste.

For adults and older children: Use a large, all rubber bulb syringe (available at most drug stores). Fill the syringe with saline. With your head down, insert the tip just inside your nostril and gently pinch your nostril around the tip to keep the solution from running out of your nose. Gently squeeze the bulb and release it a few times while the tip remains inside your nostril. Then, remove the syringe and lightly blow your nose into the sink. Repeat the procedure in the other nostril. Another less effective method is to put some saline into the palm of your hand and sniff the liquid into your nose, then blow your nose. Repeat for the other nostril.

For younger children who can blow their noses: The same technique is used as for older children, although a smaller amount of saline is necessary. If your child will not cooperate (after trying for a week or so), try using a clean, empty spray bottle filled with the saline solution or buy some salt-water nasal mist at a pharmacy. Squeeze a good amount of the solution into your child’s nose and have him/her gently blow the nose to remove it. Repeat in the other nostril. This method is not as effective as the first, but it’s better than nothing.

For infants and children who cannot blow their noses: Use an eyedropper or syringe to drip 2-3 ml (about ½ teaspoon) of saline into your child’s nostril. Use a bulb syringe to suction it out. Repeat on the other nostril.

After the nasal wash

All equipment must be cleaned well after each use to prevent the growth of bacteria. Fill the bulb syringe with hot water, swish it around, and empty the bulb syringe. Repeat the cleaning. Store the syringe tip down in a clean glass so that it can drain completely. Once a day, clean the bulb syringe in the same manner with isopropyl alcohol or white vinegar before cleaning it well with water.

Complementary treatments

Guaifenesin, and pseudoephedrine (both available in many over the counter preparations), as well as, steam with or without menthol crystals, are often very helpful with sinus drainage.

Your physician will individualize your treatment plan. Please ask us for suggestions.

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