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The Use of Nasal Irrigation for Sinusitis : Understanding its Mechanisms and Benefits

Nasal irrigation has been practiced for centuries without any scientific data to determine its efficacy. Irrespective of its use that is widespread as there is a lot of confusion existing regarding the mechanism of the action, indications, preparations, and therapeutic benefit for nasal irrigations.

There is anecdotal evidence behind the poorly controlled studies adding up to this confusion. The recent evidence offers stronger scientific justification for the perks and benefits behind the use of nasal irrigation as a treatment to offer relief to the symptoms of sinusitis. Or post today will highlight its potential and clinical applications.

Overview Of Nasal Irrigation

Nasal irrigation is an easier, inexpensive process used for treating nasal conditions and sinuses for several years. The process involves flushing the nasal cavities with a nasal solution like saline water, promoting the clearance of mucociliary by removing the encrusted material and moisturizing the nasal cavity.(1) The entire concept behind nasal irrigation has been used for about two centuries.


Irrespective of the earlier discovery of nasal irrigation, it had not been practiced well and developed. It is mainly considered as the upper respiratory conditions, including chronic or acute rhinosinusitis, allergic and non-allergic rhinitis, and viral upper respiratory tract infection being the common disorders that pessimistically affect the quality of a patient’s life.

Nasal irrigation was mainly used at the University of California, San Diego, after the endoscopic sinus surgery and was mainly implemented during the late 1990s(2) in the Nasal Dysfunction Clinic.

Nasal irrigation was mainly offered to the patients post their endoscopic sinus surgery. At the same time, they reported a significant enhancement in the patients who continued irrigating well beyond the prescribed after-surgery period. The outcome led to the generous application of nasal irrigation to treat nasal diseases, including acute and chronic sinusitis.

After that, nasal irrigation was used as the adjunctive treatment modality across varied centers and even by physicians worldwide for treating rhinosinusitis, another type of sinonasal disease,(3) and allergic rhinitis.

The Process of Nasal Irrigation

The respiratory tracts are safeguarded from debris and air pollution by the mucociliary layer, which lines the sinonasal cavity. Therefore, it is the layer comprising the pseudostratified ciliated columnar epithelial and the goblet cells bathing in mucus, constituting one of the first lines of defense of the body against powerful invading organisms.

The Process of Nasal Irrigation

The foreign particles get trapped in this sticky layer of ciliary action and mucus, propelling the whole mucus layer out of the sinuses towards the nasopharynx.(4) Sinus diseases like rhinosinusitis occur during the ciliary transport process fails due to a bacterial, viral, irritant, or allergen effects.(5)

Nasal irrigation is mainly defined as flushing the nasal cavity using a sterile solution through the nostrils.(6) Additionally, the solution might consist of steroid medication or antibiotics, and you can use saline, alkaline, or hypertonic, like seawater. Irrespective of varied studies performed for nasal irrigation, the appropriate mechanism in which nasal irrigation works stays controversial.

The following are the proposed mode of operation for nasal irrigation:(7)

Improving the Ciliary Beating Frequencies

The mucus lining in the nasal cavity mainly consists of the sol or more superficial gel layer. Foreign materials like fungi, viruses, allergens, and bacteria get trapped in the mucus. The cilia project through the nasal pseudostratified columnar epithelium into this mucus.

The beating cilia are more predominant on the gel layer, sweeping the mucus backward towards the nasopharynx and then swallowing it. Therefore, nasal irrigation might improve the transport of ciliary mucus toward the nasopharynx, which might be through the direct physical connection.(8) Consequently, the beating frequency of cilia will result in greater mucociliary clearance.

Softening Result on Thicker Secretions

Nasal irrigation is highly effective on the crusting and thicker secretions by dislodging and softening them along the nasal secretions. Therefore the thicker tenacious secretion might become less dense and improves the clearing of the mucus. A recent study found that forceful irrigation has a higher potential than gentle nose washing, which supports this hypothesis.(9)

Eradicating Inflammatory Mediators

The mucus in the nose consists of several inflammatory mediators like prostaglandins, histamines, and leukotrienes. The defensins are mainly the inflammatory mediator isolated through the sinus cavity mucus, and their concentration appears to rise with the swellings.

These inflammatory mediators mainly got activated in response to the stimulation of the allergens to the nasal cavity mucosa. Therefore, nasal irrigation might act by removing these inflammatory mediators and reducing the acute symptoms in patients suffering from sinusitis.(10)

Which is the Best Nasal Irrigation?

You can easily purchase the ingredients for nasal irrigation over the counter at several drug stores and pharmacies. All you would need is a saline solution and a container for administration. Every container sold for nasal irrigation works adequately well. So, always pick the container which is right for you.

The following are the things that these containers include:

  • Neti pots allow you to pour the saline into your nostril like pouring tea out of a teapot.
  • Rinsing bottles which are squeezed into the nostrils.
  • Containers have unique applicators consisting of prefilled saline solution.

What Kind Of Water Can You Use For Nasal Irrigation?

It is important to use water that lacks substances that can irritate your sinuses or make you fall ill. Water consists of a trace amount of germs, minerals, pesticides, and other substances, and you need not wish to introduce them to your sinuses during nasal irrigation.

You can use the following instead:

Distilled or Sterile Water

Distilled water is generally purified as it goes through processes for the removal of materials that can irritate your nasal passageways and germs that will make you fall ill. Check out the distilled label on the water before purchasing it.

Boiled Water

Boiling water can destroy harmful organisms such as bacteria. You should boil water for about five minutes to ensure that you have killed almost every germ. If you cannot use them immediately, you can place a lid on the container and use them within 24 hours.

Filtered Water

A few specific water filters can help remove harmful organisms, making the water safe to use. The CDC, or the Center for Diseases Control, offers detailed guidance regarding the type of safer filters for nasal irrigation.

Process of Nasal Irrigation

  • Wash Your Hand Thoroughly With Soap and Water: Wash the container if you are using a nasal rinse bottle, a neti pot, or some other container which do not consist of a prefilled solution. Irrigate on a sink as it will make cleaning easier.
  • Prepare The Solution For Nasal Irrigation: If you use a container sold with saline powder, ensure that you follow the instructions for preparing the solution. Mix around one or two cups of distilled boiled water and about half a teaspoon of non-iodized salt to prepare a homemade solution. Also, try using table salt in place of iodized salt.
  • Prepare the Container: Pour this saline solution into the container you will use for rinsing your nose. If you are using boiled water, wait until it becomes lukewarm before using it for nasal irrigation.
  • Get Into Your Position: Look down as you lean over the sink. Turn your head to one side so that one ear directs toward the sink while the other is toward the ceiling. Refine your position by considering how you wish this water to flow. Consider the water flowing from the top of your nostril and spilling it out from one of the bottoms.
  • Irrigate: Always breathe through your mouth. Place the tip of the container or spout inside the top nostril until it forms a gentle seal. Tilt this container or squeeze the bottle allowing the water to flow through the top of your nostril into the bottom.
  • Blow Your Nose: Forcefully breathe the air through the nose to remove any leftover solution or mucus. You can blow your nose right over the sink into tissue and repeat the process with the other nostril.

Use of Nasal Irrigation for Acute & Chronic Rhinosinusitis

Rhinosinusitis is the mucosal swelling of the paranasal and nasal sinuses. It affects around one to eight adults in the US, leading to 30 million people getting screened each year and increasing prevalence.(11) The despair of chronic rhinosinusitis is almost identical to other chronic diseases like heart failure, chronic obstructive pulmonary diseases, and chronic back pain.

It is revealed that more than 70% of patients suffering from chronic sinusitis displayed better improvements in the symptoms after the nasal irrigation. One hundred fifty patients were included in the trial, and they were split up into 3 groups. Each group received one of three treatment regimens for four weeks: nasal irrigation with a bulb syringe, nasal irrigation with a pot, or the control regimen.

In those patients who had good compliance, the study’s findings showed a substantial improvement in the symptoms of chronic rhinosinusitis and a decrease in the need for nasal medication. The authors concluded that nasal irrigation is an easy-to-use adjuvant in treating chronic rhinosinusitis, helping to lessen symptoms and improve quality of life.

Health Benefits Of Nasal Irrigation

Nasal irrigation, also known as nasal lavage or nasal douching, is a simple yet effective method of cleaning the nasal passages and sinuses. This technique involves using a saline solution to flush out mucus, dirt, and other debris from the nasal cavity. Nasal irrigation is a simple, low-cost method for easing the uncomfortable symptoms of common upper respiratory infections and allergies. After a single application of nasal irrigation, many users reported feeling better. According to studies, nasal irrigation can reduce allergy symptoms in children and adults for up to three months.

Nasal irrigation has been found to be highly beneficial for individuals suffering from sinusitis, a condition characterized by inflammation of the sinuses.

One of the main health benefits of nasal irrigation related to sinusitis is that it helps to reduce inflammation and swelling in the sinuses. This can help to alleviate symptoms such as nasal congestion, facial pain, and headaches. Nasal irrigation can also help to improve the overall function of the sinuses by breaking up mucus and promoting drainage.

Additionally, nasal irrigation can help to remove irritants and allergens from the nasal passages, which can help to prevent sinus infections and reduce the frequency of sinusitis flare-ups.

Another significant health benefit of nasal irrigation related to sinusitis is that it can help to improve the overall health of the nasal passages and sinuses. Regular use of nasal irrigation can help to maintain a healthy balance of mucus in the nasal passages, which can help to prevent dryness and irritation. It can also help to improve the overall function of the nasal cilia, which are tiny hair-like structures that help to move mucus and debris out of the nasal passages.

Overall, nasal irrigation is a simple and effective way to improve the health of the nasal passages and sinuses, and can be especially beneficial for individuals with sinusitis.

Side Effects Of Nasal Irrigation

Mainly, there are no noticeable side effects. There are a couple of individuals experiencing stinging or burning in their noses after performing nasal irrigation. If it happens to you, reducing the salt amount you use in the saline solution is recommended. Additionally, ensure that the boiled water has cooled to being lukewarm before using it.


Nasal irrigation or sinus flush is the most ancient therapeutic practice, gaining an immense reputation in the modern world with a few specific amounts of evidence backing it in this medical community.

The consensus seems to be that the sinus flush can help reduce symptoms of the common cold, chronic sinusitis, and allergies.

The consensus might appear as if sinus flush will help reduce the symptoms of chronic sinusitis, common cold, and allergies. But, there are possibilities for severe infections, and an individual might require medical attention if they experience any abnormal symptoms.


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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:January 28, 2023

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