Introduction
Flushing or washing out the nose is used to restore the normal flow of mucus or to clear away crusts from inside the nose. Routine nasal washes may help to clear infections, keep infections from starting, control nasal odors, decrease nasal stuffiness or promote healing after nasal or sinus surgery. You will need special tools to do this well. Here in the dry climate of Colorado, nasal saline washes will often help alleviate many nasal symptoms.
Solutions Used for Nasal Washes: Be sure to ask which formula and flushing method is best for you.
A. Salt Water (Saline) -
1. The Salt - Pickling ("canning" ) salt is best because it is free of iodine and other preservatives. Regular table salt is OK if you cannot get the pickling salt.
2. The Water - Use distilled or bottled water if at all possible. Tap water often picks up stuff from the pipes in your home, even though it has been treated by the city. If you must use tap water, be sure to boil it before mixing. (Start with more water than you need and re-measure before mixing the salt since some water will evaporate with boiling.)
3. The temperature - Use the saline at body temperature (98.6 degrees Fahrenheit or 37 degrees Centigrade) or slightly warmer - BUT NOT HOT.
B. Formula for Saline (Be sure to ask which one to use)
1. Hypertonic Buffered Saline: Mix 2-3 heaping teaspoons of salt. with 1 teaspoon of baking soda plus 1 quart (1 liter)of water. If this is irritating, decrease the amount of salt.
2. Isotonic Saline: Mix 2 tsp. of salt to 1 quart (1 liter) of water. (Use this one after surgery.)
3. For a more moisturizing effect, add 100 cc. (6-2/3 tablespoons) of Karo syrup to the above.
4. For a mild antiseptic effect, add 5 cc. (1 teaspoon) of white vinegar to the above.
[If you mix up large amounts for multiple uses, store in a new or clean airtight bottle in the refrigerator. Make up a new batch every 2-3 days.]
Bulb Syringe Method
Buy a small rubber bulb syringe (these are packaged as 2 oz. ear syringes, about $5) from your local drug store. Fill it with the solution and place the tip into your nose while holding your head over a sink. Squeeze the bulb to flush your nose. The saline will flow back out from the nose and mouth. If the force of fluid seems too weak, you can use scissors to trim back the syringe tip and widen its opening. This will make the flushing more forceful when you squeeze. Trim off just a little piece of the syringe tip at a time until you find the right amount.
Netty Pots have become a popular way to wash the nasal and sinus cavities. These can be found in many drugstores. You may have to try several different methods before finding the one that is best for you.
Water Pik Method
Use a regular dental WaterPik, but take off the dental tip and put a special nasal tip in its place. Mix the irrigant in the WaterPik basin or fill it from a storage container. Set the water pik on LOW. Put the nasal tip into the nose while holding your head over a sink or basin with your chin tipped down nearly touching your chest, then turn on the water pik. Slowly increase the force of the flow until debris comes out in the return. The saline will flow into your nose, then back out from your nose and mouth.
There are several different tips for nasal irrigators. They can be found in most drug stores and online at sites like drugstore.com.
Commercial Solutions (These can be bought in a store)
1. Saline drops, spray or mist, from the local drug stores (Pretz, Salinex, or Saline are good brands. Avoid ones with alcohol or thimerosal in them.)
2. Pretz Irrigation - Lubricating solution in an 8 oz. bottle with irrigating spout. (Available from Parnell Pharmaceuticals)
3. NeilMed makes a system that comes with an irrigating bottle and pre-packaged packets that can be added to water.
How Much For How Long?
For all of the methods above, keep flushing one side of the nose until the return is clear. Then, switch to the other side and flush until the return is clear. The entire session should last for about 10-15 minutes.
STOP IMMEDIATELY If you have severe pain or brisk bleeding. Call the doctor's office.
SOME DO'S AND DON'TS WHILE FLUSHING
DO breathe through your mouth or hold your breath while flushing
DO take the tip out of your nose if you have to sneeze or cough
DO NOT speak or swallow during the flushing. This could change the pressure in your ears or nose, and could cause infectious mucus to be drawn into the sinuses or middle ear.
CLEAN UP
Keep the devices very clean, especially the tips used in the nose. Wash the tips and flush the devices through with hot, soapy water after each use. Then flush them with plain water and allow them to air dry. About once a week, flush the device and tip with a weak bleach mixture (1 part Clorox bleach to 100 parts water). Then flush them through a few times with water to clear out the bleach. They may air dry or be dried with a hair dryer.
IF YOU HAVE ANY FURTHER QUESTIONS, PLEASE CALL THE OFFICE AT 867-7800.
J. Lewis Romett MD