A saltwater sinus flush is a safe and simple remedy for nasal congestion and sinus irritation that just about anyone can do at home.

A sinus flush, also called nasal irrigation, is usually done with saline, which is just a fancy term for salt water. When rinsed through your nasal passages, saline can wash away allergens, mucus, and other debris, and help to moisten the mucous membranes.

Some people use a device called a neti pot to help deliver the salt water to the nasal cavities, but you can also use squeeze bottles or bulb syringes.

A sinus flush is generally safe. However, there are a few important safety instructions to be aware of before you try it.

The first step is to create a saline solution. Typically, this is done by mixing warm, sterile water with pure salt, known as sodium chloride, to create an isotonic solution.

While you can create your own saline solution at home, it’s recommended that you purchase over-the-counter premixed saline packets.

It’s crucial to use sterile water for this step. This is due to the risk of a serious infection with a parasitic amoeba called Naegleria fowleri. Once this amoeba enters the sinuses, it makes its way to the brain and causes a fatal infection.

You can sterilize your water by boiling it for a minute and then allowing it to cool.

To clear your sinuses, follow these steps:

  1. Stand with your head over a sink or in the shower and tilt your head to one side.
  2. Using a squeeze bottle, bulb syringe, or neti pot, pour or squeeze the saline solution slowly into the upper nostril.
  3. Allow the solution to pour out your other nostril and into the drain. Breathe through your mouth, not your nose, at this time.
  4. Repeat on the opposite side.
  5. Try not to let the water go down the back of your throat. You may need to adjust your head position until you find the correct angle.
  6. Gently blow your nose into a tissue when you’re done to clear out any mucus.

If you’ve recently had sinus surgery, resist the urge to blow your nose for four to seven days following the procedure.

Shop for a neti pot, bulb syringe, and saline solution.

A sinus flush carries a small risk of infection and other side effects, but these risks can be easily avoided by following a few simple safety rules:

  • Wash your hands before the sinus flush.
  • Don’t use tap water. Instead use distilled water, filtered water, or water that’s been previously boiled.
  • Clean out your neti pot, bulb, or squeeze bottle with hot, soapy, and sterile water or run it through the dishwasher after each use. Allow it to dry completely.
  • Avoid using cold water, especially if you’ve just had sinus surgery. For people who recently had surgery for chronic sinusitis, there’s a risk of developing bony growths in the nose called paranasal sinus exostoses (PSE) if you use a cold solution.
  • Avoid using very hot water.
  • Throw away the saline solution if it appears cloudy or dirty.
  • Don’t perform nasal irrigation on infants.
  • Don’t do a saline flush if you have a facial wound that hasn’t healed or neurologic or musculoskeletal problems that put you at a higher risk of accidentally breathing in the liquid.

As mentioned above, failing to use sterile water carries a small risk of infection with a dangerous parasite called Naegleria fowleri. Symptoms of an infection with this parasite include:

  • severe headache
  • stiff neck
  • fever
  • altered mental status
  • seizures
  • coma

Boiling your water for at least a minute and then allowing it to cool before mixing in the salt should be sufficient to kill the parasite and prevent infection.

If done properly, a sinus flush shouldn’t cause any major side effects. Though you may experience some mild effects, including:

  • stinging in the nose
  • sneezing
  • sensation of ear fullness
  • nosebleeds, though this is rare

If you find that a sinus flush is particularly uncomfortable, try lowering the amount of salt in the solution.

Keep in mind that some bloody nasal discharge may occur for a few weeks following a sinus surgery. This is normal and should improve over time.

Several studies have shown evidence of the effectiveness of nasal irrigation for treating both acute and chronic sinusitis, as well as allergies.

Doctors most often recommend using saline irrigation for chronic sinusitis. In one study, patients with chronic sinus symptoms who used saline irrigation once per day reported a 64 percent improvement in overall symptom severity, and significant improvement in quality of life after six months.

Research supporting the use of saline flush to treat allergies or the common cold is less definitive. One recent review of clinical trials in people with allergic rhinitis found that while using a saline solution appeared to improve symptoms compared to not using a saline flush, the quality of evidence was low, and further research is needed.

It’s fine to do a sinus flush occasionally if you’re experiencing a bout of nasal congestion from a cold or allergies.

Start with one irrigation per day while you have nasal congestion or other sinus symptoms. You can repeat the irrigation up to three times per day if you feel that it is helping your symptoms.

Some people continue to use it to prevent sinus issues even when they don’t have symptoms. However, some doctors warn that regular use of nasal irrigation may actually increase the risk of sinus infection. Routine use may also hinder some protective features of the mucus membrane lining the nasal passages and sinuses.

More research is needed to clarify any long-term side effects of regular saline flushes. At the moment, it’s probably best to limit use to when you’re experiencing sinus symptoms, or to ask for your doctor’s advice.

If your sinus symptoms don’t improve after 10 days or they get worse, see a doctor. This could be a sign of a more serious infection that may require a prescription.

You should also see a doctor if you experience the following symptoms along with sinus congestion, pressure, or irritation:

  • fever of 102°F (38.9°C) or higher
  • increased greenish or bloody nasal discharge
  • mucus with a strong odor
  • wheezing
  • changes in vision

A sinus flush, which is also called nasal or saline irrigation, is a simple method for gently flushing out your nasal passages with a salt solution.

A sinus flush can be effective at relieving nasal congestion and irritation, caused by a sinus infection, allergies, or a cold.

It’s generally safe as long as you follow instructions, especially making sure to use sterile water and to avoid using cold water if you’ve recently had sinus surgery.

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