Download Nasal Irrigation - Oregon Allergy Associates

SINUSITIS
ACUTE SINUSITIS - This represents an infection within the sinuses. Symptoms usually
include sinus discomfort and pressure with increased yellow or green discharge. Fever,
pain radiating into the upper teeth and headache as well as generalized symptoms may
accompany sinusitis.
Diagnosis: After starting with a history and physical, your doctor may additionally use a
microscopic evaluation of nasal discharge for evidence of bacteria and other infectious
organisms. Because the sinuses are completely encased in bone, CT scans are often
employed to help determine the degree of inflammation and/or infection.
Treatment: The goals include relieving obstruction, improving sinus drainage, and treating
infection. Antibiotics are used to treat the primary infection, nasal decongestants help
promote drainage and relieve congestion. Cortisone either in oral or topical form may be
helpful in decreasing inflammation and mucus production. Increased fluid intake is also
very important in order to help thin secretions, thus making them easier to drain.
CHRONIC SINUSITIS: - As the name implies, chronic sinusitis differs from acute
sinusitis in that symptoms are generally more subtle. Chronic sinusitis may represent sinus
disease which has occurred for many months, or fails to respond to treatment. Causes can
include allergy, nasal polyps, enlarged adenoids, or heartburn. The symptoms of chronic
sinusitis may include nasal obstruction, postnasal drainage, chronic cough, sore throat,
unpleasant breath odor and decreased sense of smell. Some people with sinusitis have
none of these symptoms and some people with these symptoms do not have sinusitis.
Diagnosis of chronic sinusitis involves a complete history and physical as symptoms may
vary greatly from those in acute sinusitis. A CT scan of the sinuses and examination of
nasal discharge is often used to confirm the diagnosis.
Treatment goals are to reduce inflammation, treat associated infection and promote
drainage of the sinus cavities. Antibiotics may be used for up to 4 weeks. Intranasal
steroid sprays are used to reduce inflammation and mucus production. Singulair, another
blocker of inflammation, may also be helpful. Saline nasal washes may be used to
physically remove mucus from the nasal passages that is often not removed by nose
blowing alone.
Nasal Irrigation
Benefits of nasal irrigation:
Decreases mucus thickness and clears mucus due to colds or allergies.
Washes away allergens, inflammatory cells, and chemical mediators.
Increases normal clearance of nasal passages.
Frequency of use, volume and best body position:
Nasal irrigation should be used at least once a day. More applications during
colds or allergy season are safe. The range of volume is from 8 oz. (one cup) to 32
oz. (one quart). Adjust this to your own comfort level and effectiveness. In all
methods mentioned below, it is key to keep your forehead lower than your nose.
This allows the water to escape out the other nostril instead of the back of your
throat. This position is best achieved by standing on a stool over the sink or in the
shower. Although it sounds uncomfortable, you will quickly learn what works and
will become tolerant to it. Do nasal irrigation either before applying medicine or at a
different time of day.
Premade packets can be bought at the pharmacy or solutions can be made by hand:
To mix daily (Can double this recipe for more solution):
¼ to ½ tspn table salt (can adjust to comfort, lower amounts if solution stings)
¼ tspn baking soda
8 oz. warm water (water does not need to be sterile)
To mix and store dry:
½ to 1 cup salt and ½ cup baking soda.
When mixed with warm water use 1 to 1 ½ tspn per cup.
Methods of Irrigation:
Sinus Rinse bottle or neti pot:
Fill bottle with solution and squirt half into one nostril. Switch nostrils and
apply the remaining solution. This method is inexpensive and quick. However, the
volume applied is harder to control. Be sure to rinse the bottle and let it drain and
dry between uses to prevent bacterial growth.
Baby bulb syringe:
Prepare solution in a bowl or mixing cup. Gently squirt solution into nostril
one bulb at a time. Switch to the other nostril after a few squirts. This method is
inexpensive and allows for most control of the volume applied. It is probably the
slowest method.
Teledyne Waterpik with adaptor:
Pour solution into reservoir and insert adapter into nostril. Start at lowest
power and increase as comfort allows.
The adaptor is available at
www.ethicare.com. This method is the most expensive, but is convenient and quick.
After finishing with any method, blow your nose with paper towels as Kleenex will
not stand up to the water remaining in your nasal passages.