# Ethnomedicine/Home Remedies/Saline Nasal Wash

What are the Benefits of Nasal Irrigation?

### Simple Nose Washing

It is simple learning to wash your nose and nasal passages using only a bathroom sink. If the procedure is unpleasant, you're doing it wrong. First, learn to blow your nose into the sink instead of a tissue or handkerchief. Second, learn to push water into your nostrils/nasal passages by brushing wet hands along the sides of your nose. Use warm water. Afterwards, you may wait 10 seconds at first, blow your nose into the sink. Lastly, you can learn to get water further into your nasal passages by wetting your nose and tilting back your head.

### Saline Nasal Wash

This remedy is used to treat any symptoms of mucus build-up in the nasal passages, caused by the common cold or chronic sinusitis. It consists of warm water (not too hot or it will burn your nose!) mixed with regular table salt. It can be applied through the nose using either a little spray bottle, or using a neti pot. A neti pot (often made of porcelain) resembles a tea pot that is used for nasal irrigation. It is used often in South Asian Culture and is known as Jala Neti, but is starting to be used more and more in Western Culture. To use this, one mixes the salt and water in the pot and sticks the spout through one nostril, head tilted slightly forward so the water may enter the nose, and the salt water is poured through one nostril and out the other nostril. Repeat on the other side, and make sure to gently blow your nose after using to get rid of excess water and mucus in the nasal passages. This method may be used as often as needed, up to about four times a day when you are sick. Some risks associated with using this remedy are not adequately draining all of the water out, which may lead to breathing problems later, or irritation of the lining of the nasal cavity.
See also: Wikipedia article on nasal irrigation.

## Steps
### Prepare isotonic saline solution

Please Note: The Mayo Clinic web site, in the directions for nasal irrigation, specifies using 1/4 tsp. salt to 2 cups (about 1/2 litre) of water - an isotonic solution. This is significantly less salt than is contained in the directions below. One of the mixtures is not an isotonic solution.
Prepare isotonic saline solution. This solution matches the concentration of salt found in the blood and natural tears. A warm saline solution is prepared to a 0.9% salinity (9g of salt (about 1 1/2 teaspoons) per litre of water). Non-iodized salt is better. The water should feel slightly warm to the touch. It is important to stir the mixture thoroughly in order to dissolve all the salt. The following are the stages of the ancient Jala Neti:
The salt is sometimes replaced with half salt and half sodium bicarbonate (baking soda). According to http://www.doctorhoffman.com/, sodium bicarbonate improves the mucus-solvent properties of the solution.

### Stage one

Many people only practice stage one of Jala neti. This stage should always be performed whether it is the only stage you do or if you plan to do any of the more advanced stages. Each stage should eventually use about 1/4 litre (8 US fluid ounces) per nostril though a person may have to work up to this.
* Lean over a sink and tilt your head to the side and slightly down toward the sink. Ideally, the chin and the forehead should be level with each other.
* Place the spout of the neti pot in the upper nostril creating a complete seal and allow the saline solution to flow into that nostril, through the nasal passages, and out the other nostril.
* Continue to breathe deeply through the mouth. This allows the water to flow from one nostril and out the other.
* When the pot is empty, refill it and repeat on the other side. Beginners may prefer to use only half a pot on each side.
* If the water seems to be blocking, switching back and forth several times may be needed.
* If you will be doing only Stage One, follow the instructions under "After Stages are completed" to clear the nasal passages of remaining water.
If you are doing this for the first time, try to keep your soft palate closed. To find what this feels like, imitate how a congested person with a cold talks. They might say, "I cad't say adythig dorbally because by dose is codgested" instead of "I can't say anything normally because my nose is congested." Intentionally breathing only through your mouth, and not through your nose, also causes you to keep the soft palate closed. If you can keep the soft palate closed during stage one, this will prevent the irrigation solution from getting into your nose or throat.

### Stage two

Since stage two washes the deepest parts of the nasal passage, it should only be performed after a round of stage one. If infections or large obstructions are present in the outer nasal cavity and not cleared by stage one, they could be driven deeper into the nasal cavity.
Beginners should use only stage one for the first few weeks to make sure they are comfortable with the process and to make sure that major blockages are clear.
Stage two involves lightly sniffing the water through each nostril and spitting it out the mouth. It is important not to swallow the water.
Though this stage is more difficult, it has a much deeper effect. People with chronic sinus infections may not see major improvement until this method is used.

### Stage three

Before this stage, a round of both stage one and two is performed. It involves actually taking the water in the mouth and directing it out the nose.

### After stages are completed

Once jala neti has been performed, it is important to eliminate any remaining water from the nose. The techniques may vary but it usually involves bending over from the waist to let the remaining saline solution drain out, breathing quick breaths out the nose in quick repetition, and gently blowing the nose. It is important not to close off one nostril or squeeze the nose in any way as this may cause water to be forced into areas that do not dry easily. A tissue may be used but is just held lightly surrounding the nose.

## Pulsating nasal irrigation

Several medical reports indicate pulsatile nasal irrigation with a water pik type device is more effective than non-pulsating nasal wash products like bulb syringes, neti pots and squeeze bottles which rely simply on gravity and conventional flow at breaking down biofilm, general cleansing and removing bacteria.