The nasal douche may be just what you need this winter
By Angela Lashbrook
Every year for the last 7 years I have spent the Northeast winters in an eternal battle with my nasal passages. Colds are as predictable and unpleasant as tax season. Even though I spend mid-November through March with a tissue in hand and my nose in a big cup of tea, I may have been refusing to use one of the best treatments: a neti pot. No way a water fountain for my nostrils could ease my misery. My only other help came in the form of chicken soup.
Turns out my suspicions about the efficacy of the over-the-counter nasal wash were unfounded, because the neti pot is a pretty good treatment if you’re congested.
What is a neti pot?
A neti pot is usually a plastic, ceramic or porcelain container that flows a saline or salt water solution through the nostrils and helps flush out allergens and mucus residing in the nose. It is typically used to relieve nasal congestion and symptoms of sinus infections, colds, the flu, and seasonal or dust allergies. Water enters through one nostril and exits through the other. Neti pots have been used for thousands of years as part of Ayurveda, a traditional health system with historical roots in India.
Nasal lavage became somewhat more common in the West in the 19th century, but it wasn’t until 2007, when Dr. Mehmet Oz extolled the benefits of the neti pot on “The Oprah Winfrey Show,” so much so that the device entered the mainstream. American conversations really took off: Yahoo searches were up 12,325% on the day of Oprah’s show, and neti pot sales skyrocketed, according to Yahoo.
When should a neti pot be used?
“I have recommended it to many of the patients I treat for certain nasal conditions, such as chronic sinusitis,” says Dr. Samuel Helman, ENT, head and neck surgeon at Weill Cornell Medicine in New York. “In fact, nasal washes, when used in large volumes, have been shown to be very helpful in improving symptoms in patients” with upper respiratory tract infections and chronic sinusitis.
Research shows that smaller devices, such as nasal syringes that hold about 10 mL of saline, don’t work very well, but larger containers, that hold 250 mL of saline (about the same as a glass of water), can improve symptoms such as runny nose and postnasal drip.
The humble little gadget that squirts water out of your nostrils can be applied to a wide variety of nasal problems. “Almost all conditions that cause mucus and irritants to build up inside the nose benefit from salt-water washes with a neti pot or similar device,” says Dr. Richard Orlandi, a sinus and nasal specialist. sinuses and professor of surgery at Utah Health University in Salt Lake City. “These include allergies, non-allergic irritation of the nose, colds, and sinus inflammation and infections.”
And it doesn’t really matter which particular brand of neti pot you buy, according to Dr. Anthony Del Signore, director of rhinology and endoscopic skull base surgery at Mount Sinai Beth Israel in New York. Some super entry-level models are as low as $10, while others, like the Naväge with motorized suction, can go well over $100. “Some people find the Naväge a bit easier to use because it has two different ports, one that sucks in and one that supplies the irrigant,” Del Signore says. “He pushes the irrigant and sucks it in at the same time.”
If it happens to you like me, that you have a blocked nose for months, do not hesitate to use the neti pot quite frequently. Side effects are usually mild and temporary (and may include a burning or stinging sensation). Be sure to read the manufacturer’s instructions carefully and refer to the section “Can I use tap water in a neti pot?” to avoid more serious problems.
“I have some patients who use it twice a day almost every day,” Helman says. Keep in mind, however, that this is a treatment, not a cure. And while it can help clear mucus and allergens from your nasal passages, it’s not going to kill off the allergy or infection that caused the problem in the first place. (And if it did, it would be front-page news, because as most of us know, there’s no cure for the common cold.) If you suspect your problem is an untreated allergy, it’s worth seeing your primary care doctor, ear, nose, and throat doctor or allergist to see if there’s a more specific treatment for your situation, Helman says.
Using a neti pot can help clear mucus and allergens from your nose.
Photo: South Agency/Getty Images
When should the neti pot not be used?
Many people can safely use a neti pot, although there are some situations where it is necessary to abstain and go another route to relieve a stuffy nose. If your nose is completely blocked in one or both passages, Orlandi says a neti pot might not help, and you should talk to a doctor to find out the reason and a proper solution to the problem. Also, people with weakened immune systems should discuss the relative risks and benefits of neti pots with their doctor, Orlandi says. That includes very young children. Helman, who treats pediatric patients, says he sometimes discusses the use of neti pots for children, but “convincing them to use a neti pot can be very difficult, honestly.”
Can you use tap water in a neti pot?
You should never use water straight from the tap in your neti pot. “It is important to use distilled water or previously boiled tap water,” says Orlandi. You can buy distilled water at a drug store, but keep in mind that it’s not the same as regular bottled water. And if you use boiled water, be sure to cool it down to lukewarm or room temperature before putting it up your nose.
“Tap water, and especially well water, has been implicated in very rare cases of aggressive, and even fatal, infections of the nose and sinuses,” says Orlandi. Two people in Louisiana reportedly died in 2011 after using neti pots that had been filled with tap water containing a brain-eating amoeba.
Be sure to follow the instructions included with your neti pot for safe use and care. You can also read what the Food and Drug Administration (FDA) says about the safety of neti pots.
Symptoms may take some time to improve
While some people experience immediate relief, for others it can take a couple of days of twice-daily use for symptoms to improve, Del Signore says. “When treating allergic rhinitis or allergies, the relief is really appreciated after consistent use of nasal washes and sprays for several days or a week or so,” he says. And unlike nasal decongestants, which shouldn’t be used more than 3 days at a time, “patients can use the neti pot basically every day.” Assuming you don’t experience any nasal irritation, “you can’t overdo it,” he says.
According to Helman, some people find that using a neti pot can cause ear discomfort, especially when using “hypertonic” saline, or saline with a high concentration of salt. It can also sometimes irritate the Eustachian tubes, which connect the ears to the back of the nose and throat.
But generally, “patients do pretty well on the neti pot, and they tolerate it well,” Helman says.
As of this writing, it has yet to snow in New York; I’ve miraculously stayed sane, but only time will tell when I’ll have to cast aside my misguided doubts and jump on the nasal wash train. Still, I imagine it will take some getting used to.
“For me, it’s kind of like, when you’re in a pool and you jump in the water without covering your nose,” Helman says. “Sometimes I almost feel a little nostalgic.” I tell you. Summers past he used to jump into the brook from a trembling tree branch evokes an almost painful longing for childhood. While I don’t think the neti pot is as much fun as screaming while plummeting 10 feet down, it will at least clear my sinuses.
Consumer Reports is an independent, nonprofit organization that works side by side with consumers to create a fairer, safer, and healthier world. CR does not endorse products or services, and does not accept advertising. Copyright © 2023, Consumer Reports, Inc.
Consumer Reports has no financial relationship with the advertisers on this site. Consumer Reports is an independent, nonprofit organization that works with consumers to create a fair, safe, and healthy world. CR does not endorse products or services and does not accept advertising. Copyright © 2023, Consumer Reports, Inc.