Pharmacy2U product guide: how nasal irrigation may help clear allergies and sinus congestion this hay fever season

Causes and symptoms of nasal congestion

The nose is the body’s natural air filter. The respiratory system, including the nose, is lined with tiny cilia (microscopic hair-like parts of a cell), which trap particles and mucus and move them toward the throat to be expelled. 

Nasal congestion is when this natural air filter becomes blocked and inflamed, leading to reduced airflow. It occurs when the number or type of particles become too much for the nose to handle and filter out.  

Modern environments expose us to more airborne irritants than the human nose evolved to handle, which causes nasal congestion. Environmental irritants include: 

• Pollen from trees, plants, and grass 

• Dust  

• Pollution 

• Pet hair and dander 

• Viruses 

An accumulation of these particles can lead to the following symptoms of nasal congestion: 

• Blocked nose 

• Sneezing 

• Sinus pressure and inflammation 

• Catarrh  

• Postnasal drip

What is nasal irrigation?

Nasal irrigation is a process that physically flushes the nasal cavity, and it may help to remove particles and support the nose’s natural cleaning system. 

Nasal irrigation involves gently rinsing the nasal passages with a sterile saline solution. 

Devices such as NeilMed Sinus Rinse allow saline to flow through one nostril and out of the other, carrying mucus and allergens with it. 

The potential effects of nasal irrigation may include: 

• Helping to clear irritant particles, such as pollen, dust, and allergens 

• Helping to loosen thick mucus in the respiratory system 

• Hydrating dry or sore nasal passages 

• Supporting the nose’s natural cleaning function 

Nasal irrigation uses a sterile saline solution that contains no drugs or preservatives, making it generally considered suitable for regular use when used as directed. 

How to perform nasal irrigation

Nasal irrigation is a comfortable and safe process that typically takes less than a minute, which some people find suitable for regular self-care.  

To perform a nasal irrigation effectively, simply follow these instructions:  

1. Wash your hands thoroughly before beginning the nasal rinse.

2. Prepare the saline solution as per the packet instructions. (For NeilMed sinus rinse products, this involves combining the premixed sachet with distilled, micro-filtered, commercially bottled, or boiled and cooled water, but other products may vary.) 

3. Lean over a sink with your mouth open, breathing normally through the mouth. 

4. Place the nozzle or bottle tip into one nostril. 

5. Gently squeeze the bottle so the solution flows in through one nostril and drains from the other.  

6. Repeat steps 4 and 5 for the other nostril. 

To make the process as safe, comfortable, and effective as possible, you should avoid sharing your nozzle or bottle with anyone else. You should also avoid using untreated tap water; instead, use distilled, 0.2 micron micro-filtered, commercially bottled, or boiled and cooled tap water.  

Keeping your mouth open can help make the process more comfortable. It allows for easier, natural breathing while irrigating, as well as protecting the ears by raising the soft palate and blocking the Eustachian tubes, which may help reduce the saline solution from entering the middle ear. 

You may be able to get more information about nasal irrigation from ear, nose, and throat (ENT) specialists. 

What does nasal irrigation feel like?

Many first-time users are hesitant to try nasal irrigation, as the idea can seem unusual and many have reservations about how it will feel. However, once they try the process, which is relatively simple to carry out, some people report finding it refreshing. 

Some people who have tried nasal irrigation find that breathing feels easier afterwards. They also report a cool, clean sensation in the nasal passages.  

What happens to your sinuses during nasal irrigation?

When your sinuses are congested, it’s due to an accumulation of mucus and irritants. 

During nasal irrigation, the saline solution flows through the nasal cavity, fulfilling dual purposes. It can help to loosen thick mucus congesting in the sinuses, and it may help to flush out irritants like pollen, dust, and debris.  

This process may leave nasal passages cleaner and clearer, which can lead to immediate relief from congestion and easier breathing. 

How often and how long to use nasal irrigation

When experiencing moderate sinus congestion because of allergies or otherwise, it’s often used once or twice a day.  

For acute congestion when your sinuses are heavily blocked due to a cold or after related surgery, you can increase this to up to three times a day if you find it helpful. However, frequency should always follow product instructions or guidance from a healthcare professional. 

For general maintenance as part of your regular self-care routine, you can carry out nasal irrigation anywhere from daily to once or twice a week. Saline solutions are generally suitable for regular use when used as directed.

Using nasal irrigation with steroid nasal sprays

Many patients with conditions like allergic rhinitis or chronic sinusitis may use steroid nasal sprays. 

In some cases, a healthcare professional may advise using nasal irrigation before applying a steroid nasal spray to support nasal clearance. 

Is nasal irrigation safe for children?

Under adult supervision, nasal irrigation may be suitable for some children, and certain products are available for use from 2 years of age, depending on the specific device and manufacturer’s instructions. 

Children commonly experience frequent colds, allergies, blocked noses, and thick mucus. In some cases, nasal irrigation may be considered as part of managing these symptoms, where appropriate and in line with healthcare professional advice. 

When going through the nasal irrigation process with children, try these tips to make the experience as positive as possible:

• Use gentle pressure. Don’t squeeze the bottle too hard.

• Demonstrate the process first to reassure your child.

• Encourage them to keep their mouth open and breathe through the mouth during the process.  

Understanding isotonic vs hypertonic saline

For nasal irrigation, it’s important to understand the difference between isotonic and hypertonic saline, which relates to the concentration of solutes (mainly salt). 

Isotonic saline has the same solute concentration as blood and other bodily fluids. In terms of nasal irrigation, that means it’s gentle and suitable for daily use and mild allergies. 

Hypertonic saline has a higher solute concentration than blood and other bodily fluids. It may help draw fluid out of swollen nasal tissues, which can help reduce congestion and loosen thicker mucus in some cases. 

Some people use isotonic saline for routine use and may switch to hypertonic saline when stronger decongestant effects are desired, depending on individual needs.

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