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Nasal Irrigation Studies



Nasal Irrigation (nasal wash)


Upper respiratory conditions, including chronic and acute sinusitis, the common cold and allergic rhinitis are common and expensive disorders that have a significant impact on patients, medical resources and society. Nasal irrigation (SNI) rinses the nasal cavity with saline delivered as a liquid or spray. The practice of SNI likely originated in the Ayurvedic medical tradition, in which it is known as "jala neti". This page contains instructions on the use of nasal irrigation. It also describes several nasal irrigation studies done at the University of Wisconsin Department of Family Medicine under the direction of David Rabago, MD.


Nasal Irrigation Instructions

For more info see: Nasal Irrigation Instructions (pdf), or in Spanish:Instrucciones para Irrigación Nasal (pdf).


Study Results


Conclusion: We conclude from these studies, and from a review of the scientific literature, that nasal irrigation is an effective adjunctive therapy for chronic sinus symptoms.6 It may also be effective as adjunctive therapy for symptoms of other upper respiratory conditions that are risk factors for chronic sinus symptoms including acute upper respiratory infection (common cold), acute sinusitis, and allergic rhinitis (allergies).


We conducted clinical studies (Studies 1-4 below) evaluating the effect of daily nasal irrigation (also known as nasal wash) on the quality of life, symptoms, and medication use of patients with chronic sinus complaints. Sinus disease is common, affects quality of life and is a source of significant medication use. Nasal irrigation is an ancient technique in which salt water is allowed to gently bathe the nasal cavity, facilitating a gentle wash of the structures within. Our studies were done from 1999 to 2008 involving a total of 76 subjects.


We also conducted a study (Study 5 below) evaluating the use by family physicians of nasal irrigation for upper respiratory conditions.


Study 1: In a randomized controlled trial, we trained 52 patients with histories of sinus disease to use daily nasal irrigation, and compared their experience to 24 control subjects.1 We assessed quality of life, patients' compliance and satisfaction with nasal irrigation, sinus symptoms, and medication use. The group using nasal irrigation exhibited improved quality of life, less frequent symptoms, and used antibiotics and nasal sprays less often. They were compliant with nasal irrigation, liked using it, and suffered few side effects. Three follow-up studies have been published which add to the parent study.


Study 2: In Study 2, we wanted to determine whether subjects would continue to use nasal irrigation in a less structured setting and whether the control subjects would use nasal irrigation if trained and followed in an unstructured manner.2 We therefore monitored the original intervention subjects for an additional 12 months, and trained the initial control group subjects to use nasal irrigation for their chronic sinus conditions and followed them for 12 months. Both groups experienced similar improvement in quality of life and decreased nasal symptoms. Use patterns stabilized at about 3 nasal irrigations per week, used by some subjects on a strict schedule and by others only as needed.


Study 3: In Study 3, we wanted to know how users of nasal irrigation experienced the process of learning to use the therapy, and how they continued to use it at home. We conducted interviews with 28 subjects from the original study.3 Their comments were consistent across four main themes: 1) nasal irrigation was effective for chronic sinus symptoms and 2) it empowered subjects to care for chronic sinus symptoms on their own rather than always seek a physician's input. 3) There are some barriers to doing nasal irrigation including the time required and the initial sensation of water in the nasal cavity, but 4) these barriers could be overcome by good instruction and integration of nasal irrigation into subjects' at-home daily routines.


Study 4: Some people with chronic sinus conditions also have allergic rhinitis. Therefore, in Study 4, we hypothesized that nasal irrigation might be helpful to subjects with allergic rhinitis.4 We re-analyzed qualitative data to explore the research question "Do subjects using HSNI for chronic sinus symptoms, and who also had allergic rhinitis, experience improvement in allergy symptoms?" More than half of subjects with self-reported chronic sinus symptoms and concurrent allergic rhinitis spontaneously reported positive effects of nasal irrigation on allergy symptoms as distinct from chronic sinus symptoms, suggesting that nasal irrigation may be effective adjunctive therapy for allergic rhinitis.


Study 5: Study 5 assessed the use among family physicians in Wisconsin of nasal irrigation using an electronic questionnaire.5 Physican respondents have used nasal irrigation as adjunctive care for a variety of upper respiratory conditions including chronic rhinosinusitis (91%), acute bacterial rhinosinusitis (67%), seasonal allergic rhinitis (66%), viral upper respiratory infection (59%), other allergic rhinitis (48%), irritant based congestion (48%) and rhinitis of pregnancy (17%). Physicians also reported having used SNI prior to antibiotics for acute bacterial rhinosinusitis (77%). Use patterns varied regarding type of nasal irrigation used, dosing frequency, saline concentration and patient education.


Conclusion: We conclude from these studies, and from a review of the scientific literature, that nasal irrigation is an effective adjunctive therapy for chronic sinus symptoms.6 It may also be effective as adjunctive therapy for symptoms of other upper respiratory conditions that are risk factors for chronic sinus symptoms including acute upper respiratory infection (common cold), acute sinusitis, and allergic rhinitis.



1. Rabago D, Zgierska A, Mundt M, Barrett B, Bobula J, Maberry R. Efficacy of daily hypertonic saline nasal irrigation among patients with sinusitis: A randomized controlled trial. Journal of Family Practice. 2002;51(12):1049-1055.

2. Rabago D, Pasic T, Zgierska A, Barrett B, Mundt M, Maberry R. The efficacy of hypertonic saline nasal irrigation for chronic sinonasal symptoms. Otolaryngol Head Neck Surg. 2005;133:3-8.

3. Rabago D, Barrett B, Marchand L, Maberry R, Mundt M. Qualitative aspects of nasal irrigation use by patients with chronic sinus disease in a multi-method study.Annals of Family Medicine. 2006;4:295-301.

4. Rabago D, Guerard E, Bukstein D. Nasal irrigation for chronic sinus symptoms in patients with allergic rhinitis, asthma and nasal polyposis: a hypothesis generating study. Wisconsin Medical Journal. 2008;107:69-75.

5. Rabago D, Bamber A, Peppard P: The awareness and use of nasal irrigation among family medicine physicians in Wisconsin; Wisconsin Medical Journal; In Press, 2009

6. Harvey R, Hannan S, Badia L, Scadding G. Nasal saline for the symptoms of chronic rhinosinusitis. Cochrane Database Syst Rev. July 18 2007;3(CD006394).

 
     


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sinus irrigation - pulsatile irrigation

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We provide a Pulsatile Sinus and Nasal Irrigator or Sinus Pulse Irrigation system that fights Sinus Infection and Sinusitus. They include the Hydropulse, and Hydro Pulse. Pulsatile Irrigation is a more effective method than a traditional Neti Pot. Nasal Rinsing or a Nasal Wash is similar to a Sinus Douche that is done with a saline solution (see our refill packets). Nasal irrigation can be used to avoid sinus surgery, allergies, and sinus headaches. The Hydro Pulse or HydroPulse by Dr. Grossan are recommended to fight your allergies. Allergy Liberation services customers in the UK and across Europe including Ireland Sweden Finland Austria Germany Denmark and the Netherlands. Doctor Grossan is the published author of "The Sinus Cure" which addresses a range of issues such as how to stop snoring, solving sleep apnia, dealing with blocked sinus and nose, and how to cleanse your sinuses with sinus irrigation. What do doctors say are the benefits of sinus irrigation? Among them are reducing nasal congestion, cleansing and ridding the sinus cavities of allergens, irritants, treating chronic sinusitis and acute bacterial infections, reducing snoring, and alleviating a blocked nose and sinus. We carry Dr. Grossan's products including Pulsatile Irrigation System the Hydro Pulse or HydroPulse Nasal Irrigation System. These products can really help relieve or alleviate sinusitis: Sinus Pulse Nasal Irrigator, Sinus Irrigation System, Clearease or Clear Ease, BreatheEase BreathEaze, Breath Ease Eaze XL, as well as the Nasal Gel. Other products include SinuCleanse, the Sinu Cleanse Squeeze, Neti Pot, and Refill Saline Packets. Dr. Hana's NasoPure & Naso Pure range. SanPharma Homeopathics including Notatum, Quentans, and Subtilis. For Allergies or Allergy such as Pet, Cat, Dog, or Hayfever we recommend using Nasalese or nazaleze (the nasaleze cold and alergy nose spray). Nasal Sprays the contain capsaicin which is also effective for allergies, sinusitus, and cluster headaches and migrines include Sinol and Sinus Buster (SinusBuster).

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