Saline Sinus Rinses: What Good Are They? 2/4

Evidence Supporting Saline Nasal Rinses

medical evidence supporting saline nasal rinsing for treatment of sinusitis

This is part 2 of 4, listed here:

Medical Evidence Supporting Saline Nasal Rinses for Treatment of  Sinus

A study from the University of Michigan (well-designed, and executed as a randomized, controlled trial of over 100 people with chronic rhinosinusitis) found that symptom severity and symptom frequency were significantly reduced in those who used sinus rinses on a daily basis compared to those who did not. Similar results are also reported for a smaller group of children with allergic rhinitis and conjunctivitis (inflammation of the eyes).

Saline Options

I originally used various home recipes for my own rhinosinusitis, and liked some better than others.  More recently I have converted to a commercially prepared saline formula and rinse system.  There are several available.  I use the one made by Nasopure, and this is the one I recommend for my patients.

It is easier than making my own (I’m basically lazy), and I really prefer their squeeze-bottle over the suction bulb-syringe that I was using.  Their formula also does not burn the lining of my nose like all of my home recipes do.  (Disclaimer: I have no financial ties to Nasopure).

Hang in There

Finally, if you are going to do this for your child, be patient, be persistent.  I have a number of children in my practice as young as 4 years old who tolerate this on a daily basis.  Most of these kids are in the very sick category, and if they don’t rinse their sinuses on a daily basis they can end up in the hospital with severe sinusitis, requiring intravenous medications or surgery.

Wrestling Match

Most little kids start out fighting the rinses, making every rinsing session during the first week a wrestling match with you.  This is one of those times when you need to be your child’s parent more than your child’s friend.

It may require two adults to get the job done properly and safely for awhile.  But over time they recognize how much better they feel without their sinusitis symptoms, and resign themselves to making sinus irrigations part of their daily routine.

Anyone out there doing these rinses themselves?  Anyone out there enjoy doing these rinses on a daily basis?  I didn’t think so.  Personally, I detest rinsing my sinuses, but if I don’t, my sinusitis returns immediately.  Being free of sinusitis is worth the hassle.

Thanks for visiting. See you here over the next couple weeks as we review how to make sinus rinses easier and more effective.

Best health and success to you and your families.

Please post a comment so that we can all learn to achieve sinus health, and healthy airways.  And please, “be excellent to one another.”

Until next time, remember … you can pick your friends, and you can pick your nose, but you can’t pick your friend’s nose (unless you’re a boogor doctor ;~D)

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I promise to continue to work hard to provide content that will improve your health and the health of you children. RF

Saline Sinus Rinses:  Part 2 of 4

Next time:  How to do saline sinus rinses … part 3 of 4

Resources:

Nasal saline for chronic sinonasal symptoms: A randomized controlled trial.  Pynnonen, et al.  Archives of Otolaryngology-Head & Neck Surgery. Vol. 133(11): 1115-1120; 2007.

Nasal rinsing with hypertonic solution: An adjunctive treatment for pediatric seasonal rhinoconjunctivitis.  Garavello, et al.  International Archives of Allergy and Immunology.  Vol. 137(4): 310-314; 2005.

Radiographic comparison of three method for nasal irrigation.  Olson, et al.  The Laryngoscope. Vol. 112: 1394-1397; 2002.

Comments

  1. Dr. Faust, as with every medical condition and treatments, there are considerations of litreature/side effects/opinions etc. Would you say that the simplest thing to do to reduce rhinitis is saline rinses? Or do you have 2-3 other very simple solutions? SL

    • Russell A. Faust, PhD, MD says:

      Dear SL,
      Hello, and thanks for visiting our little group of boogor-heads!
      Yes, I would say that saline rinses are the most effective treatment to reduce allergic rhinitis. I would NOT say that they are the easiest, especially for children. They truly can be a wrestling match with kids. If they are sick enough with sinusitis or rhinitis, they usually “get it” after a few days. They realize how much better they feel, and accept or put up with the rinses.
      However, both sinusitis and rhinitis are complex disorders. They are affected by multiple factors, including diet and nutrition, sleep, air quality, and many other factors. Please take a look at my first post back in March (http://wp.me/pR4iB-Q) for some additional tips. And thanks so much for visiting and contributing! RF

  2. Question: You say above “…Personally, I detest rinsing my sinuses, but if I don’t, my sinusitis returns immediately…” Is this true? As in, there is no cure? Despite all the research and given it’s the year 2013, and you’re a doctor? Only something that helps with the symptoms? If it is, it’s very depressing :( I suffer and was in such great hope that eventually I would find a cure, but if you haven’t (a doctor) I don’t think I ever will :( Unfortunately I’ve tried a million things including irrigation with no help at all.

    • Russell A. Faust, PhD, MD says:

      Hi Kevin,

      First, thanks for visiting, and especially for taking the time to leave comments.

      Next, yes: I do loathe performing nasal rinses, although have become more tolerant over the years. I no longer experience an acute sinusitis if I don’t perform the rinses every day. In fact, I may go for some months without rinsing, although I do pay a price with worsening allergic rhinitis. My nose is much happier and healthier if I do the rinses.

      How did I finally put a stop to the chronic rhinosinusitis? With vigilant daily rinses that included, (1): baby shampoo, to break up the biofilm of chronic infection, (2) including huge amounts of Manuka honey in the rinses, and (3) including Xylitol in the rinses. Both the Manuka and the Xylitol are anti-microbial. They seem to have done the trick. It certainly wasn’t just the rinses, because I had been doing that for years!

      Thanks again, and best success, health, and peace!

      • Doctor, I really appreciate the response, and the ‘correction on false hope’! I’ve literally been researching this for 10+ years with nothing that helps…yet. This illness so greatly negatively affects my life that I NEED a cure, or at least something that will allow me temporary relief, but haven’t even found anything for that (except pseudoephedrine but I believe that destroyed my guts so I don’t take it anymore). I will NOT give up until I’m cured.

        I just recently discovered the biofilm theory, and it makes a ton of sense. Lot’s of great info on that out there. I know antibiotics are bad, but in a case like mine (and maybe a lot of people), if 1 treatment could ‘cure’ this for a while (months,years) I think it would be reasonable to take it. But, do you even know if an antibiotic even exists that would treat or cure CRS infected via biofilm? cefixime dicloxacillin?

        I believe I just discovered something I was doing wrong with my sinus rinses for years: I was putting in 10 heaping tsp of salt into 1 gallon. I believe this makes a beyond hypertonic solution that would probably only dry out my sinuses and make them worse.

        I just started taking a regime like what you mention above, per all the good info on your site, while correcting the salt dosage. Here’s what I do 2x/day:
        Pre-mix Sinus Rinse – 1 Gallon:
        -1 gallon distilled water
        -7.5 tsp baby shampoo
        -4 tsp non-iodized salt
        -8 tsp xylitol crystals
        *Prior to rinsing: Add 2 large heaping tsp manuka honey to warm coffeemug of premixed-rinse to dissolve, then add this to 25oz pulse irrigation container, then fill remaining container with premixed-rinse
        *Take 1 tablespoon orally of manuka honey/day

        Does doing this 2x/day, in attempt to kill once and for all my CRS, make sense? Or is that too frequent? (I’ve been getting acute outbreaks that last for a few days almost every week for months now.) Am I using enough honey (equals about 2 tablespoons)? Also, I make it per the gallon since I buy the distilled water by the gallon. I’m using a 25oz pulse irrigator(~12.5oz/nostril/session). I read people add baking soda – is this necessary? (I never used it and my solution doesnt burn, unless I add the honey it burns a little). And does the solution NEED to be warmed if you can tolerate it being room temperature? And does the solution need to be refridgerated? (I’m thinking my recipe doesn’t have anything that would spoil, especially given the salt content.) One more thing, do my ingredients & dosages look good?

        Also, I’ve been doing this for 1/2 week now and just today got real congested (I’m typically never congested despite my CRS), any ideas why that would happen? Am I doing something wrong? I also woke up with that nasty mouth with a coating on my toungue and malaise…herxheimer reaction?

        Thanks again for all your help and what you’re doing here!

        • Russell A. Faust, PhD, MD says:

          Hi Kevin,
          You can do nasal saline rinses several times per day. However, note that the more hyper-osmolar the rinse that you use (higher salt or other solute concentration), the more irritating it is for the cilia. It is the cilia that normally help clear the mucus and other debris that sticks to the mucus – viral particles, bacteria, mold spores, and – of course – pollutant particles. AKA soot, smog, etc. Even so, when I have an acute sinusitis flair up now, I do rinses at least twice per day, using hyper-osmolar solution. I make my regular saline, and add a couple heaping tbsp of Manuka before using. Sounds like you’ve got that down already :)
          As for the congestion, I have no idea.
          Please keep me updated, and I’ll learn something too!

          • OMG :( I found out I’m allergic to manuka honey!!! I thought there was no way doing what I mentioned above (irrigation) would CAUSE congestion since I typically never have congestion (just pain/pressue between eyes & fatigue, minor post-nasal drip, for the most part, and occasional body-aches & malaise – this does NOT seem to be and allergy symptom – you generally dont get body-aches with allergies), and EVERYONE says rinses help! (Not make it worse!) Only me :(

            Previously: I’ve seen a ton of doctors and given I don’t have congestion normally and CT scans look good (except deviated septum and ‘scarring’ from hardened mucus – think that’s what they called it), they have no clue how to fix me. They see no issues, or addressable issues anyway. One doctor thinks its psychological :( You know you’ve lost hope in doctors when they tell you that!

            Anyways, I confirmed my manuka honey allergy suspicions by doing the wrist-scratch test: scratched both wrists lightly, put saline (control) on one wrist, honey on the other and watched the honey-wrist swell up with a small hive around the scrath, but NOT the control/saline wrist. That sucks. But it figures that everything I’ve been through that the single ingrediant that helps people the most I’m allergic to :( Also, I did notice that each time I’d do the rinse with the honey my throat got CRAZY itchy and I sneezed bad and got 100% congested.

            Regarding the congestion, I still have it. I’ve been on zyrtec and I started to get legitimate allergy symptoms JUST NOW (well, after the manuka honey). Scratchy throat, sneezing, congestion, itchy eyes. I learned a lot though about symptoms – what are allergy symtpoms and what are NOT. Previously, and my chronic issue is NOT allergies. That was a big leap forward for me regarding “what” my issue is. I think my previous/chronic issue is in fact an infection of some type (biofilm?) What I just acquired via the honey are in fact allergy symptoms. It seems it spun out of control though, my immune systom. It’s been 8+ days since I stopped the honey and the allergy symtpoms persist. I was wondering if some strange coincidence with outside allergies are lining up perfectly, timing-wise, but I doubt it. I have really good inside air filtration so I don’t think it’s anything outside (I’m desperate so got good filtration). I think my other allergies are now bothering me since I aggravated myself bad with the honey. Now I really wish I would stabilze and get back to my old disease!!! Just today I saw my allergist again and got some singulair & nasal spray. Hopefully this will put me back to where I was a couple weeks ago. Once I do, I’ll start experimenting again!! BTW my allergist had no clue about the biofilm theory. Figures. I’m going on vacation in a week so I really need to get back to “normal”.

            Ugh, what a disaster! Anyways, I’ll definitley keep my status up-to-date so we can make some progress on understanding this extremely complex myriad of diseases. Hopefully someone can learn from me – and hopefully I’ll figure myself out some day (soon)!

            BTW: One bit of advice I may shed to the readers/sufferers is to see if you are allergic to manuka honey BEFORE you use it for irrigation!! If you are, give it away as a gift!! lol(Test for allergies using the skin test I mention above – its basically how allergists test for allergies if you didn’t know already.)

          • Russell A. Faust, PhD, MD says:

            Wow! And bummer! Please be careful with other honeys – your reaction may be limited to antigens that are unique to Manuka, but you may be globally allergic to other honey, and even to other bee “products.” In fact, be alert to potential for allergy to bee sting!!
            Sounds like it’s time for you to visit with an ENT doc who practices integrative medicine, or visit a naturopath. The underlying root of these issues lie outside of your nose (as did my own).
            Thanks for sharing, and please keep me updated.
            Best success!

  3. Hi Dr. Russell! Thanks again for the response. Unfortunately I already saw 2 ENTs. One said he cannot help – go see your allergist. The other said surgery is 50/50 – those aren’t good odds for me given I read a lot that surgeries often don’t help and the issue just comes back.

    When you say “underlying root of these issues lie outside of your nose”…what are examples of this? (Causes outside of the nose that could cause these symptoms) I try my best to ‘throw’ new ideas at my doctors to try and get some progress, but nothing has equated to anything yet, unfortunate for me.

    Thanks Again!

    • Russell A. Faust, PhD, MD says:

      Hi Kevin,
      Please take a look at articles on “unified airway,” here and elsewhere. Also consider immunity issues that may be affecting your ability to fight acute and chronic infections. Your immune response is extremely complex, and depends on the activity of many enzymes; each of those, in turn, requires various vitamins and minerals as “co-factors” for their activity. Etc. I urge you to seek counsel of a naturopathic doctor (ND), who will look at you as a whole person, not focus on your nose, or your lungs, etc. Holistic healthcare.
      Best success!

  4. Should I use distilled water? To mix

    • Russell A. Faust, PhD, MD says:

      Kim:
      I generally use store-bought distilled water, or boiled tap water. Safest is boiled distilled.

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