Primary Care Physician
Dr. Orrange received her BA in Biology at the University of California, San Diego, and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health. She received her MD from the USC Keck School of…
The Truth About Nasal Irrigation
Posted in Colds & Flu by Dr. Sharon Orrange on Jan 21, 2013
This is the peak time for nasal congestion from colds, and many wonder if they should be rinsing their nose with salt water. The answer is yes and most ear nose and throat doctors are strong believers in it.

Why should you rinse? Rinsing out your nose with salt water (saline rinses) is also called nasal irrigation. Nasal irrigation can wash dirt and mucus from your nose and during allergy season may also help wash away your allergy triggers: pollen, mold spores, and dust.

Who should do saline nasal rinses? Here are the people who should think about nasal irrigation:
- A stuffy or runny nose from a cold or allergies.

- Post-nasal drip: this is when mucus from your nose drips down the back of your throat.

- People with acute or chronic sinusitis: this could be you if you have mucus, a stuffy nose, and pain in the face.
How do I make a saline solution for nasal irrigation?
1. Fill a clean jar with distilled water or tap water that has been boiled and cooled. You will hear stories of people who have gotten serious infections from using tap water that was not clean. These infections are rare, but this is how to avoid them.

2. You can buy premixed packets for making the solution or make your own. It’s way easier to buy it, but if you do have the time here it goes:
- 1 teaspoon of baking soda and 1 to 1.5 teaspoons of salt. Use pickling or canning salt, which dissolves easily. Do not use regular table salt because it contains other chemicals besides salt.

- Mix and store at room temperature for up to 1 week. Throw out any salt water that you don’t use within a week.
How do I get the solution inside my nose? Several good options exist and here are some:
- A squeeze bottle (Neil Med Sinus Rinse is a commonly used one.)

- A neti pot – This is a small pot with a long spout, similar to a teapot.

- Two other options that aren’t as popular are nasal irrigation syringes (Nasaline is an example,) and pulsating irrigation devices (sample brand names: Grossan HydroPulse or a Waterpik Sinusense.) These are battery-powered devices that send a gentle pulse of water into the nose.
How do I do it?
1. Bend over the sink with your head turned slightly to 1 side and squirt the solution into the nostril that is higher. You can also do this in the shower.

2. Aim the stream toward the back of your head, NOT the top of your head.

3. Keep your mouth open. The solution should flow into 1 nostril and out the other. It’s fine if you swallow a small amount.

4. Be prepared: you might feel a little burning sensation the first few times you rinse out your nose. This usually goes away after you get use to it.

5. Once all the solution has run out of your nose, blow your nose gently. Some salt water might drain out of your nose, over the next few minutes, if you bend over.
How often should I do nasal irrigation? Some people rinse out their nose every day. Others rinse only when they have symptoms. You can safely rinse out your nose a few times per day. Some doctors recommend daily rinsing for people with sinusitis that lasts more than 3 months (“chronic sinusitis.”)

How’d it go?

- Dr. O


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Dr. Orrange, what I would like to know is how much water do you use in the recipe you posted?
By Fern RL  Jan 25, 2013
I have actually gotten rid of active sinus infections using irrigations. I have had chronic sinusitis for years. When I tilt my head around on my pillow and I feel stuff sloshing around, and/or a rotten-egg smell, it usually means infection. I use the Neil Med rinse system and their solution, rinse very thoroughly, and lean over my bathtub for drainage. When there is a lot of nasty green drainage, I rinse again. A few days of rinsing and the infection is gone. WITHOUT antibiotics (I'm allergic to a lot of them, so this is important.)
By madbookworm  Jan 23, 2013
Hi there. I would start by buying the above listed pre-made rinses: Neil-med Sinus Rinse is a good example. It comes in a little spray bottle you can use, same thing with Neti-pots you can just fill it with pre-made saline solution and do a couple flushes each side. Dr O.
By DrOrrange  Jan 22, 2013
I was told by my doctor to use Flonase twice a day and Ocean nasal spray "the rest of the time"--whatever that means. (I know not to use the Ocean spray too soon after the Flonase or it would rinse it out, but I'm not sure I am using it often enough.)

What you are recommending sounds like a more thorough rinse, one that I probably need, but in the "recipe" you give, it is unclear how much water we should use for the given amounts of soda and salt. How much should it be? a pint jar, or a quart jar, or what?
By Fern RL  Jan 22, 2013
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