Nasal irrigation

Nasal irrigation, (also called nasal lavage or nasal douche) is a personal hygiene practice in which the nasal cavity is washed to flush out mucus and debris from the nose and sinuses. The practice is reported to be beneficial with only minor side effects. Nasal irrigation can also refer to the use of saline nasal spray or nebulizers to moisten the mucous membranes. Nasal irrigation can be an effective therapy to relieve symptoms of both chronic sinusitis as well as acute sinuitis caused by upper respiratory tract infections such as the common cold. The evidence for use in chronic sinusitis is weak. It can also be useful for the temporary relief of the symptoms associated with allergic rhinitis. Adverse effects include nasal irritation, nosebleeds, headache, and drainage after the irrigation is done. It is generally well-tolerated. There is a risk of infection if the water is not sterile or the device is not cleaned after use. If the device is used improperly this can be harmful. In fact, proper application suggests the use of boiled water or saline water. In 2018, a patient was reported to have contracted Balamuthia mandrillaris after using tap water during nasal irrigation. Rare cases of fatal naegleriasis have occurred due to nasal insufflation of the amoeba Naegleria fowleri from untreated tap water. Flushing the nasal cavity can soothe inflamed tissue and remove irritants like allergens; it may help clear mucus. The water should not be tap water, which may contain small amounts of bacteria that are safe to drink but may be dangerous in the nose. The water should be sterile or filtered for micro-organisms; if tap water is used it should be boiled. Saline solution is also sometimes used. A number of other compounds may be included in irrigation fluids such as the steroid budesonide in an effort to treat chronic rhinosinusitis.