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Monday, December 17, 2007

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Washing away sinus problems

Using neti pot can help keep passages clean, infection free

For 10 years, Nancy Siewart kept a neti pot neatly tucked inside her cupboard.

Though she often talked about its usefulness for cleansing the sinuses, the yoga instructor had never tried one to see if it really worked.

But after watching her husband rid himself of an aggravating sinus infection by tilting the slender, miniature teakettle into his nostrils, Siewart, 66, of Wauwatosa, decided it was time to try it for herself.

Twenty-five years later, she's still touting the neti pot - and she's also using it daily to refresh her nasal passages.

"I'm not a sufferer, but I can tell instantly that I've gotten rid of all the guck in there," she said. "It sounds too simple to be true...but it works."

Flushing the nasal passages with a salt solution, or nasal irrigation, is a yoga tradition that dates back thousands of years.

But though it is already recommended by physicians for cleansing after sinus surgery, the practice is just catching on as an alternative treatment for nasal stuffiness caused by colds, sinusitis and allergies.

A study published last year in the Annals of Family Medicine found that nasal irrigation is safe, well-tolerated, inexpensive and effective.

The study, done by researchers at the University of Wisconsin-Madison, also found that patients were able to do it at home with minimal training.

"It really makes you feel a lot better right away," said Diane Heatley, founder of Med-Systems Inc., a Madison-based company that manufacturers and markets the SinuCleanse nasal wash system.

"It's not part of our cultural norm to put saltwater in your nose, whereas in other parts of the world it's as natural as brushing your teeth," said Heatley, also an associate professor of otolaryngology-head and neck surgery at the University of Wisconsin Medical School in Madison.

The technique, though scary to a lot of people, is simple:

• Lean over the sink with your head looking into the drain.

• Place the spout of the neti pot into one nostril and tilt your head so the solution begins to run through your nostrils.

• Keep your mouth open and breathe normally so the solution doesn't drain into your mouth.

So how do you know if you're washing properly?

"If it goes in one side and comes out the other, you know you're doing it right," Heatley said.

37 million sufferers

The sinuses are the air chambers behind your cheeks, eyebrows and jaw.

Each one makes mucus, which is the fluid that cleans bacteria and other particles out of the air you breathe.

Normally, mucus collecting in the sinuses drains into the nasal passages.

If the nose becomes blocked from a cold, the sinuses become inflamed and don't function properly.

Inflammation of the sinuses, or sinusitis, affects about 37 million Americans each year and is characterized by nasal congestion, thick yellow-green nasal discharge, facial pain and pressure.

"Sinusitis is an ill-defined disease that we don't fully understand," said Todd Loehrl, chief of rhinology and sinus surgery at Froedtert Hospital. "It tends to be overdiagnosed and because it's overdiagnosed, it tends to be overtreated."

Reduces swelling

Though typical treatment includes antibiotics and decongestants, Loehrl said antibiotics are overprescribed because most of the cases are probably viral.

For that reason, nasal irrigation is a favorable treatment because of its ability to reduce swelling in the nose and move particles through the nasal passages, he said.

Earlier this month, a study in the Journal of the American Medical Association found that using antibiotics such as amoxicillin to treat sinus infections likely increased the bacteria's resistance to the drugs.

The researchers found that the number of patients whose symptoms got better within 10 days was about the same whether or not they took an antibiotic.

"I think patient education is important so that they know what to expect and what is likely to work and what isn't, plus especially explaining the pros and cons of antibiotics for them and society - antibiotic resistance," said Ian Williamson, author of the study and a family medicine researcher at the University of Southampton in England.

"We have all probably been over-relying on antibiotics for acute sinusitis, when there are in fact probably more harms than goods associated with their use," he said.

Relieves migraines

Genevieve Vermeulen has used nasal washing to help relieve her migraine headaches her entire adult life.

Her husband uses it to clear up his sinuses, and her 6-year-old son uses it for allergy relief and nasal blockage.

"When you're desperate for relief, you'll try anything," said the 35-year-old Wauwatosa woman who had tried over-the-counter medicines and homeopathy.

Vermeulen says she gets relief within 20 minutes of nasal washing and that her biggest concern is remembering to keep her mouth open so that the solution doesn't drain down her throat.

"It feels strange to have all that water going through your nose," she said. "It doesn't always feel good, but it works."

A study last month in the Archives of Otolaryngology-Head and Neck Surgery found that nasal irrigation provided more short-term relief than saline spray in patients with chronic nasal and sinus infections.

The findings were based on results from more than 100 patients who were randomly assigned to either spray their noses with saline solution for eight weeks or do nasal irrigation for the same period.

All the patients had symptoms for at least one month, with the majority reporting six months, before enrollment, said Melissa Pynnonen, author of the study and a clinical assistant professor in the department of otolaryngology at the University of Michigan Health System.

"This is something that everybody can do," she said.

'Trust me, it'll work'

"When patients come in, they have high expectations, usually for antibiotics," she said. "We need to do a better job of educating patients. As physicians, we have a hard time convincing people to do something like flush their noses because it's simple. But we need to encourage them to do this."

Experts recommend washing nasal passages with either a premixed solution or talking to your doctor about how to mix your own.

For the best results, it should be used twice daily and before any symptoms appear.

"You'll sleep better, think better and breathe better," Siewart said.

"I know everyone is saying it can't be this easy," she said. "But trust me, it'll work."

Source: http://www.jsonline.com/story/index.aspx?id=696775

Robert Brealey

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