In What Conditions Should You Use Sinus Rinses & When Does Sinus Rinsing Becomes Dangerous?

Also known as nasal irrigation, sinus flushing or nasal rinsing; sinus rinsing refers to the method of using sterilized water to clean and clear the blocked sinus passages.^{(1, 2)}

Patients use sinus rinses for cleaning out the clogged sinuses caused by sinus infections, flu and cold. Sinus rinses are also done to relieve nasal congestion caused by allergies.

Sinus rinsing is mostly safe when it is done in a correct manner.^{(1, 2)} However, when sinus rinsing is done improperly and is done excessively, then side effects can occur which can vary from minor to serious.

There are different types of nasal irrigation devices that can be used for doing sinus rinses. Some of these devices need to be filled with saline or sterile water; whereas, some come prefilled with sterile solution.

Some of the common nasal irrigation devices are: Neti pots, bulb syringes, squeeze bottles and battery-operated devices.^{(1, 2)}

The job of nasal irrigation devices is to flush out the nasal cavity where saline or sterilized water is poured into one nostril, so it can pass through the nasal cavity and come out the through the other nostril. Doing this removes the dust, bacteria, allergens and mucus. Another benefit of sinus rinses is they help in thinning out the thick mucus which makes it easy to cough it up or blow out.

Sinus rinses when done in a correct manner are safe and effective and provide relief for many. However, there can be some side effects, which are temporary and minor and they go away in few hours to a day. Some of the common side effects of sinus rinses are: slight nasal irritation and stinging or burning sensation within the nose. There can also occur a slight nosebleed and this is often when the nasal irrigation devise is overused, as it makes the nasal passages dry.

When there is impure water used or when there is excessive nasal rinsing done, then it can cause serious side effects. Nasal rinsing should only be done with water, which is: Filtered, sterile, distilled and boiled for about 3 to 5 minutes and used after it has cooled down to room temperature.^{(1, 2)} If the boiled water is not cooled down sufficiently before doing nasal rinsing, then it can cause internal burning and blistering in the nose. Saline solution can also be used for sinus rinsing as it is sterile as well.

If the bulb syringe or the neti pot is not clean, then there is danger of reintroducing the bacteria into the sinuses. Always follow directions to clean the nasal irrigation devices correctly. Do not share your nasal irrigation device with anyone as you can transmit your germs to others.

It is only when you are suffering from a stuffy or congested nose, then only nasal rinse should be done. The sinuses become congested and filled with mucus when one is sick with cold and flu. Sinus or nasal rinsing helps in removing and making the mucus thin or loose, so that it can be easily expelled to relieve congestion and increase your comfort levels.

However, long-term use or overuse is not safe and not recommended also, because the lining of the mucosa in the sinuses is there for your protection. This mucus lining is sticky in nature, so it can trap germs and irritants that enter the nostrils and traps them so they do not reach further into the respiratory system. The mucus lining also has proteins, which destroy the bacteria before they can reach the lungs.

Continuous nasal or sinus rinsing removes the mucus lining and makes you prone to more sinus infections and other illnesses.

Rarely sinus rinsing can be fatal or cause serious infections when the water used is unsterilized water, such as tap water.^{(2, 4)} Tap water is mostly safe for drinking and washing; however, it has many microscopic organisms, which can cause fatal infections in the nasal passages.^{(1, 2, 4)} When the tap water is drunk, then the stomach acid kills these organisms, but such is not the case with sinuses, as they are devoid of any acid to kill these germs, which results in growth and thriving of the germs and can even travel into the brain resulting in life threatening consequences.

Once these microorganisms have entered the brain, they can cause amoebic meningitis or primary amoebic meningoencephalitis, which is a potentially life threatening condition caused by single-celled amoeba known as Naegleria fowleri.^{(1, 3, 4)} This amoeba is found in damp soil and fresh water and is responsible for causing inflammation and destruction of the brain lining and the brain itself.⁽³⁾ This condition needs immediate medical treatment to avoid fatal consequences.

The symptoms of amoebic meningitis can develop between 1 and 7 days after the infection and consist of: high fever; sleepiness; persistent and acute headache; sore throat; nausea and vomiting.

Children under 2 years of age and infants should stay away from nasal rinses. If your child is suffering from a congested nose, then consult the pediatrician about medications and treatments to help relieve the congestion.

Children who are bit older can tolerate a sinus rinse; however, it is better to consult with your healthcare professional before doing any sinus rinses on your child and to make sure that it is effective and safe for the condition one is thinking for using the rinse for. Other than this, child-sized nasal device made specifically for children should be used. The FDA recommends that people with weak immunity or immuno-compromised people should consult doctor before using any sinus rinse device to prevent or cut down the risk of any infection.⁽²⁾

There are many home treatments which help in relieving sinus congestion or infection and these are:

• Using a humidifier in the room when sleeping.
• Taking over-the-counter nasal sprays and decongestants.
• Inhaling an essential oil from a diffuser helps.
• A menthol chest rub also helps in relieving congestion.

If your sinus infection is not responding to the home treatments, then consult your doctor for medications.

Sinus rinses are safe majority of the times for majority of the people. Sinus rinses are an effective way to alleviate the sinus congestion and remove the irritants and allergens present in nasal cavity. However, important things to keep in mind when using nasal rinses are to use sterile water always, as the use of unsterilized tap water can cause harmful microorganisms to enter into the sinuses resulting in serious infections. ⁽⁴⁾ It is also important to use them as described and not to over use it, as overusing it can damage the delicate mucosal lining of the nose, which then creates its own set of problems.

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