Jan 22, 2010

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

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The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

I have something very important to tell you. Come in really close. Dont tell ANYONE where you heard this. Oprah might be wrong. The reason I dont want my name disclosed is Im pretty sure the Queen of Day Time Talk could make me disappear if she wanted.

Obviously Im kidding (and a little scared) about Oprah. But neti pots were my first introduction into Ms. Winfreys powers. A few years ago, people started coming into the pharmacy demanding neti pots. I had no idea what they were talking about. I few days later I saw a re-run of Oprah on in the evening and low and behold one of her guests, I think it was Dr. Oz, was demonstrating neti pots.

A neti pot looks like a little tea pot. The user fills the pot with a salt water solution. Then they tip their head to the side over a sink. They place the neti pot spout into their top nostril and pour gently. The salt water runs into the top nostril, through the sinuses and out the bottom nostril into the sink. The Oprah guest said the first time you try the neti pot, it will feel like you are drowning. I have tried it, and yes, it does feel like you are drowning.

So after the Oprah Show, everyone wanted a neti pot. The more medical term for what a neti pot does is called nasal irrigation. It isnt a new practice. Some yoga practitioners have espoused the benefits of nasal irrigation for years. I remember a medical resident talking about nasal irrigation. A specialist that had taught during her training actually liked the idea of nasal irrigation. However when the specialist recommended nasal irrigation to patients, the patients usually refused as it was too weird. The resident thought it was funny now that Oprah recommended nasal irrigation, the masses were running to the pharmacy to pour salt water into their noses.

So what does nasal irrigation with a neti pot do? Well, from personal experience, it definitely washes mucus and all the dust, dirt and other assorted gunk out of your nose and sinuses. There are some more interesting claims I read as well. One is the salt water (saline) reduces swelling in your nasal passages and sinuses because the fluid causing the swelling flows into the saline and is flushed out. Another claim is that the saline rinse flushes histamine and leukotrienes out of the sinuses. These chemical messengers that your body produces can cause inflammation and swelling. A negative claim says that the saline rinse gets rid of good stuff like immune globulins from your nasal passages. Immune globulins can help fight infection.

There are some small studies saying that nasal irrigation may be modestly effective in reducing sino-nasal symptoms. The side effects of nasal irrigation are mild and infrequent. They include nasal irritation, stinging or burning in a small number of patients. Nasal irrigation is relatively inexpensive. So it sounds like Oprah hit it out of the park when she sent everyone to the pharmacy looking for neti pots. Well, there might be a fly in the ointment.

There is a small study showing some possible harm from nasal irrigation. Now usually people would irrigate their sinuses for a few days to a couple of weeks because they were stuffed up. This study followed 68 people. These people got that drowning feeling once a day for a year. Then half the people stopped pouring salt water into their sinuses while the other half kept pouring. The non-irrigating group got fewer sinus infections.

Why did the non-neti potters get fewer infections? Is Oprah leading us down the garden path? We dont know. It was a small study, so the results could be a fluke. It could be the neti potters didnt clean their apparatti properly and infected themselves. It could be all that continuous saline washed out important stuff in the nasal passages that should be there to protect us from infections.

So was Oprah wrong? Probably not. If you want to try nasal irrigation, keep your neti pot clean, only use it once or twice a day to prevent dryness and dont use it for more than a couple weeks in a row. If you are also on a prescription nasal steroid, use the neti pot first then the steroid.

When I tried nasal irrigation, I used a product called HydraSense. It is more expensive than a neti pot, but it is an all in one product. You dont need to mix the salt water or use the clumsy tea pot up the nose. It comes pre-mixed in a pressurized nose spraying bottle. Yes I got the water to go all the way from one nostril, through my sinuses and out the other nostril. Yes my nose and sinuses felt clean. Yes it felt like I was drowning. No, I dont think Ill do it again. And Im really sorry I suggested Oprah might be wrong.

As always if you have any questions or concerns about these or other products, ask your pharmacist.


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