Neti Pot: friend or foe?

Are you one of the millions of Americans who suffers from chronic sinus problems? Do the miserable headaches, facial pain and swelling, and blocked nasal passages have you begging for mercy? Many have turned to nasal saline irrigation, a therapy that uses a salt and water solution to flush out the nasal cavity, in hopes of finding sinus relief.

One of the most popular forms of nasal irrigation is the infamous Neti Pot. Although the Neti Pot has been around for centuries in the Ayurvedic/yoga medical tradition, it recently has become a huge fad in the United States—thanks in particular to the publicity from talk shows like Oprah Winfrey.

What is the Neti Pot and how does it work? The Neti Pot helps to thin nasal mucus and flush it out of the nasal passages, resulting in sinus relief for many sinus sufferers. Very simple: the saline solution used in the Neti Pots helps to remove the bacteria, allergens, and other irritants that cause sinus problems. "Neti Pots deliver a stream of sterile saline to the nasal passages to loosen and clear nasal congestion," said Jennifer Warner of WebMD Health News.

Here's what you'll need: mix approximately one pint of lukewarm water with one teaspoon of salt. Some people add 1/2 teaspoon of baking soda to make the solution gentler on the nose, but there's no definitive proof that this improves the experience.

After you've filled the Neti Pot, tilt your head over the sink at a 45-degree angle. Place the spout into your top nostril then gently pour the saline solution into your nostril. Awkward, yes, but it works. The fluid will flow through your nasil cavity and into the other nostril. Blow your nose to get rid of any remaining liquid, then refill the Neti Pot and repeat the process on the other side.

Sounds like a perfect sinus solution, so what's the problem? Many people who have undergone sinus surgery or who suffer from chronic sinus problems have been advised to use the Neti Pot because it's

• cost effective (usually priced between $10-$20)
• easy to use (fill and pour)
• generally safe (few uncommon side effects, such as nosebleeds, nasal irritation, and stinging)

But new research shows that long-term use of the Neti Pot may actually cause more harm than good. The research, which was presented this week at the American College of Allergy, Asthma, and Immunology (ACAA) Annual Meeting in Miami, followed 68 people who used nasal saline solution, such as the Neti Pot, for one year and then discontinued use for another year.

Results: The number of cases of sinusitis—an inflammation or infection of the sinuses and nasal passages that can cause headaches, pressure in the eyes, nose, and cheek area, as well as nasal congestion, cough, and fever—decreased by a surprising 62.5% during the discontinuation phase of nasal saline irrigation.

Researchers of this study also compared the rates of sinusitis between two other groups:

• those who stopped using nasal saline irrigation and
• 24 adults who used daily nasal saline irrigation for one year

The research concluded that sinusitis among daily users was significantly higher (50%) than among non-users. Although use of the Neti Pot may temporarily improve sinus infection symptoms, daily long-term use may result in an increased frequency of acute sinusitis. Remember to contact your family physician or an ENT (ear, nose, and throat specialist) if your sinus troubles persist.