Frequent Nasal Irrigation May Increase Infections

New evidence suggests that daily nasal irrigation may increase the risk of sinus infections.

Nasal irrigation with warm saline has been promoted as way to cleanse the sinuses and help prevent infections. However, using this therapy too often may not be beneficial.

The latest study, presented at the American College of Allergy, Asthma, & Immunology (ACAAI) annual meeting, included 68 adults who used nasal irrigation frequently for one year and then stopped therapy for one year. The patients were compared to 24 control patients who did not discontinue nasal irrigation.

The researchers found that number of sinus infections decreased by 62.5 percent after the participants stopped using nasal irrigation. Additionally, after stopping nasal irrigation, they were 50 percent less likely to develop sinus infections than those who continued with daily therapy.

Mucus in the nose contains important immune system molecules that help the body fight against infections. Because nasal irrigation eliminates this mucus, the authors suspect that it may lead to an increased risk of infection.

For more information about nasal irrigation, please visit Natural Standard’s Health & Wellness database.

Comments

[YA]

A lot of people use this irrigation technique casually, not realizing that there may be consequences to such practice. I also know that practitioners recommend the use of saline on regular basis over other topical preparations that contain active ingredients due to the fact that they are considered harmless and as close to natural as possible. I even remember being told the same thing in school a few years back. It's good to know there is a price, and I’ll certainly be more careful with my recommendations in the future.

[CJ]

This is really interesting. People nowadays are so overly concerned about being completely bacteria free that they end up depleting their body's natural bacteria that help protect them. Products such as antibacterial hand gels are a great example of this. Our bodies need a certain amount of bacteria to create a protective barrier against harmful toxins. Good old-fashioned soap and warm water are actually the best.

[JS]

I’ve always wondered how long the duration of nasal irrigation therapy should be appropriate to use. A lot of my friends recommend trying nasal spray for sinus infections, but I figured out there were not enough data showing efficacy.

Also, the information above makes sense to me that too much clearing of natural mucus in nose can cause weak immune instead of fighting with bugs. The same mechanism explains UTIs (urinary tract infections) -- too much sterilization can cause irritation and kill good bugs in our bodies.

[adelle]

I actually just went to a conference a few weeks ago and received a free sample of a nasal irrigation product. I have never used saline irrigation, but I feel if it used on occasion, rather than on a daily basis, it would provide relief for cold/allergy symptoms. It is important for healthcare providers to stress that over-use of a natural remedy, similar to medications, is not necessarily beneficial. This is an interesting study and shows how the body has some natural defense against infection (i.e. mucus). Thanks NS!

[YA]

Interestingly, there are data available that suggest that using saline nasal irrigation actually decreases acute sinusitis symptoms (such as rhinorrhea and nasal congestion) and improves quality of life. Therefore, it should be used as an effective adjunct treatment for acute sinusitis. I guess there has to be a balance between how much is actually ok to use and when it becomes dangerous, which is true for anything in the pharmacy, even saline. 'Dose makes the poison.'

[Beri]

Since the neti pot appeared on Oprah, nasal irrigation has become extremely popular. I can understand its use for seasonal allergy relief or short-term relief from a head cold, but I think it should not be used every day for a long period of time. This study just proves that long-term use of nasal irrigation can actually cause more harm than good. An average amount of nasal mucus is a normal part of human physiology, as it creates a barrier to against toxins.

[Jess]

After reading this blog, I looked up nasal irrigation on Natural Standard’s database to find out more about it. I was not aware that there are three different types of nasal irrigation. There is saline lavage, which uses a warm liquid solution; humidified warm air lavage (hyperthermia); and large-particle nebulized aerosol therapy, which uses an aerosolized saline solution. This is interesting, and I wonder if certain types are better for certain conditions.

[Grace Caulfield]

I think it’s important to for people to know that it’s ok to use nasal irrigation for short periods of time. They shouldn’t do it every day, but maybe every couple of days. Or for those people who get seasonal allergies, they may just benefit from doing it during the season.

[katie]

I think that this article is very important, especially for people who think that daily nasal irrigation is necessary long-term. If potential negative effects of over-administration of nasal saline were more publicized, perhaps it would be less of an issue.

[jan]

The finding that frequent nasal irrigation may increase your risk of sinus infections doesn’t really surprise me. By continuously irrigating your nose, you’re disrupting the natural composition and protective properties that may be present in your nasal passages, possibly making you more susceptible to invading pathogens. I have never used nasal irrigation with saline because it has never appealed to me, and I wasn’t familiar with its benefits, but now I’m glad I never went there.

[CD]

This is just one more reason to believe in the "everything in moderation" phrase. Why would one do this on a daily basis, especially if they are clear of sinus issues, congestion, infection, etc? The overuse of antibiotics has led to resistance and superbugs, and the overuse of antibacterials is being looked at as possibly responsible for allergies in some individuals, and now we have people overusing the neti pot? We are a society that has become way too "germ phobic!"

It is best to let your natural defenses work as they are supposed to. Natural resistance and immunity is much better than anything else. Sure, irrigating once per month may be ok, but why would one do this much more often, especially if they are free of nasal issues?

I do believe in the neti pot and will still recommend it, but only to those who seem clearly in need and if someone just wants one, I will now make sure to let them know about occasional rinsing as compared to daily or weekly. Thanks for updating!

[TMP]

This makes sense, similar to the findings with using hand sanitizers too much. Too much of anything is not good. I’m concerned with this new information because Oprah started a craze with neti pots several months ago. I usually have one patient a day asking for this product. It’s a great alternative product for patients not able to use over-the-counter products. Like any product, we need to counsel our patients on excessive use.

[karina gordin]

I wonder what the frequency referred to is. I have a neti pot, which suggests I irrigate every morning with salt, but now I'm rather concerned that this routine may lead to long-term sinus infections. The practice of nasal cleansing, known as neti, has been used by practitioners of Ayuverda and Yoga in India for thousands of years, but it's unclear to me how frequently they carried out the procedure and if a simple mix of water and salt would affect the mucus differently from a special nasal irrigation solution often used by patients with acute allergies.

Health practitioners like my father consider the nasal passages to be the doorway for most diseases. The nasal passage has a finely tuned mechanism of hairs and mucus membranes, which catch and restrain bacteria from entering the body. It's one of the ways nature protects us from diseases.

Quite unfortunately, this filtering mechanism can become overloaded through high exposure to pollution, chemicals, fragrances, pollen, dust, among other irritants, so cleansing the filter regularly permits the passage to operate more efficiently.

[EH]

I’m surprised no one thus far has mentioned colon irrigation. Personally, I think the same principles would apply if a person had colon cleansing too often -- the good bacteria and some precious nutrients would be washed away. At the end, our bowels would become more susceptible to bacterial infections. We should all learn to listen to our body signals. If they are working well, why bother adding something abruptly?

[Connie S]

I'm really interested in all of the new information out there about overuse of products and replacement with natural products.

As an authority on integrative medicine, and I assume natural products, what to you think of nonprofit sites like EWG and for-profit sites like The Soft Landing? I'm also really interested in some of the newer natural products sites out there like Repurify.com, which seems like a for-profit site but with some sort of built-in social responsibility aspect.

How do I know who/what to trust and believe? Is there a way to tell? I've found blogs like Prue Mavens and Natural Product Insider to be really helpful, but even those I'm a little skeptical of.

[St]

This is an important article, because many people may not be aware of the consequences of too much nasal irrigation. As with everything else, it is always important to use therapies in moderation.

[maddy]

I think this finding that frequent nasal irrigation may increase infections is another wonderful example of what can happen by overusing a product or treatment. A lot of people think that if a little works, then a lot must be better, but that is generally not the case. Anything foreign we apply to our bodies is slightly unnatural, so it’s not surprising that by overdoing things we run the chance of disrupting the balance of our bodies and potentially causing more harm than benefit.

I think as a healthcare professional, this is an important point that needs to be stressed to patients when recommending, prescribing or dispensing a treatment because some people may not be considering this since when one is sick all one wants is to feel better, faster.

[T.b.]

As mucus is the first line of defense in the immune system, the elimination of all excess mucus is not at all necessary, even during infection. Frequent washing out of mucus may deplete mucus propagation and expose the body to pathogens.

In the case of cystic fibrosis, where mucus produced contains less water, the process for cleaning the lungs is inefficient. One may resort to frequent washing out with nasal irrigation, but some supplements, such as vitamin C, E, cod liver oil and zinc citrate and herbs like Echinacea and calendula, act as natural antibiotics that help in treating or preventing infections that cause the production of excess mucus. At least these help mucus thrive.

[DF]

If I can’t shake a head cold and my sinuses feel totally clogged, using a neti pot with saline solution once or twice a day for a few days really seems to help. (Sudafed never does much for me except make it more difficult to sleep.) Unfortunately, the need to blow my nose after nasal irrigation seems to increase my odds of developing an ear infection. So I won’t use a neti pot for a cold unless it really lingers.

[Grace Caulfield]

I think nasal irrigation shouldn’t be used for more than 3 to 6 weeks for allergic rhinitis. It’s an even shorter duration when used for the common cold and sinusitis. In these cases its about 2 to 4 weeks.

[SS]

It is unfortunate that people are not aware that over-irrigation can be detrimental. It is great that this article has been published to increase awareness and that Natural Standard is helping to prevent this issue.

[TF]

According to a Natural Standard professional monograph which analyzed the available scientific studies, nasal irrigation is likely safe when used by the general population if the technique is performed properly and used by children older than age 6-7.

[Nina]

The nasal mucus contains glycoproteins, lyzozymes and secretory IgA, which serve as the first-line defense against inhaled allergens, bacteria and viruses. I can see how the constant clearing of the mucus would eliminate this defense system. Irrigation may be rather beneficial as an adjunct treatment for sinus infections compared to a daily hygiene routine.

[BioVeda]

It's frustrating as an allergy sufferer to find out you might be doing the wrong thing and that something you thought was helping might actually be hurting you. As if allergies aren't frustrating enough! Thanks for the great post!