Neti pot: Can it clear your nose?

That gunk clogging up your head has got to go somewhere, so why not send it down the drain?

That gunk clogging up your head has got to go somewhere, so why not send it down the drain?

That’s the idea behind nasal irrigation systems, including the popular Neti pot, which some people swear by to manage their clogged-up pipes. Folks with allergies and frequently congested sinuses are among the biggest fans of nasal irrigation devices, which use a saline solution to rinse and moisten irritable, dry nasal passageways.

But now the U.S. Food and Drug Administration (FDA) is warning consumers, manufacturers and health care professionals that improper use of nasal rinsing devices can lead to dangerous infections that, in rare cases, can be deadly.

All nasal rinsing devices, including Neti pots, bulb syringes, squeeze bottles and battery-operated pulsed water devices, are generally safe and useful, but they must be used and cleaned properly, says Steven Osborne, M.D., a medical officer in the FDA’s Center for Devices and Radiological Health.

The most important step, which the FDA says many users bypass, is using distilled, sterile or other treated water to prepare the saline solution and clean the device. Tap water can be used if it is properly filtered, treated or processed, including boiling it for three to five minutes and then cooling it to room temperature, according to the FDA and the U.S. Centers for Disease Control and Prevention (CDC).

Some tap water has low levels of organisms, such as bacteria, protozoa and amoebas, which may be safe to swallow because they are killed by stomach acid. However, the CDC says these “bugs” can lodge in the nasal passageways and multiply, causing potentially serious infections.

Researchers think that’s what happened in 2011, when two adults died in Louisiana hospitals of infectious meningoencephalitis, contracted after regular sinus irrigation with home nasal rinsing devices, according to the journal “Clinical Infectious Diseases.” The infection, also known as primary amoebic meningoencephalitis or PAM, occurs when the amoeba Naegleria fowleri enters the nose and migrates to the brain. Investigators found N. fowleri present in the two patients’ nasal rinsing devices and in their home plumbing, which was served by a municipal water service, according to the journal. The organism usually is found only in freshwater ponds, streams and lakes.

These infections raise a concern about using nasal rinsing devices with tap water, even if instructions included with the device suggest it’s safe to do so. Some manufacturers’ instructions provide misleading or contradictory information, such as warning against using plain tap water but showing its use in pictures and videos, the FDA reports.

Federal officials stress that the devices should be used only with distilled, boiled or filtered water.

Using a nasal irrigation device can be tricky to get the hang of, and it doesn’t work for everyone. Some liken the feeling to what happens when you get an ocean wave up your nose. Others say they feel as if the gunk in their nasal cavities just moves to another spot — say, their ears, their throat or even their tear ducts.

“I’m a freak of nature. I can’t use a Neti pot,” said Lynne Choate, a project manager with Norton Healthcare Marketing and Communications. She recently tried nasal irrigation to handle ongoing sinus and upper respiratory issues. After several days of by-the-book attempts, Choate felt like her congestion simply migrated to her ear, where it eventually festered into an infection.

The FDA gives these general guidelines for using a nasal rinsing device: Wash and dry your hands, and check that the device is clean and completely dry. Use the appropriate water as recommended to prepare the rinse solution. Lean over a sink, with your head tilted sideways and your forehead and chin roughly level to avoid having liquid flow into your mouth.

Then, breathing through your open mouth, insert the spout of the saline-filled container into your upper nostril so that the liquid drains through the lower nostril.

Blow your nose to clear any remaining dirt, dust, pollen, debris or mucus.

Tilt your head in the opposite direction and repeat for the other nostril.

Wash the device with distilled, sterile or boiled and cooled tap water. Dry the inside with a paper towel or let it air-dry between uses.

According to the FDA, proper use of a nasal rinsing device can be helpful to relieve symptoms of sinus infections, colds, infections and flu. Consult a health care provider or pharmacist if you have any concerns, if the symptoms are not relieved or worsen, or if you develop fever, nosebleeds or headaches.


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