Nasal irrigation with neti works by:
- · Mechanically flushing out bacteria, viruses, dust, and allergens
- · Thinning remaining mucus so that sinuses and ostia don’t clog
- · Decreasing swelling of the nasal mucosa
- · Removing histamine, leukotrienes, and other inflammatory substances
- · Increasing frequency that cilia beat to remove mucus, crusts and debris
Is There Clinical Proof That Neti Works?
Yes, there’s scientific evidence that flushing with salt water works to decrease the symptoms of rhinosinusitis, or inflammation of the mucosa of the nasal cavity and sinuses that occurs in response to viruses, allergens, bacteria and other irritants.
A study published in the Archives of Otolaryngology Head and Neck Surgery in 1997 asked participants a survey of questions known as the SNOT-20. They were asked about 20 symptoms such as the need to blow the nose, sneezing, postnasal drainage, cough, runny nose, congestion, trouble sleeping, and more. Compared to controls that were simply spraying saline into their noses, participants flushing with normal saline (0.9%) using Sinus Rinse irrigations had fewer symptoms, and they experienced those symptoms less often. They achieved a clinically significant improvement in their quality of life as measured by the SNOT-20 while the spray group did not.
In 2002, Rabago and his group in Wisconsin irrigated the noses of study subjects with 150 ml of 2% buffered saline (1tsp heaping of canning salt, one-half teaspoon of baking soda, and 1 pint of fresh tap water) daily into each nostril for six months. They found a statistically significant reduction of symptom severity and an improved quality of life. Use of antibiotics and medical nasal sprays decreased.
Heatley et al also noted that patients reduced their use of medicines significantly due to improvement of symptoms with this natural method of healing.
A study published in Laryngoscope used store-bought dental Water-Pik devices with Grossan nasal adapters (Hydromed or Kenwood Therapeutics) to irrigate both nostrils of subjects with 250 ml of lukewarm tap water with a half teaspoon of table salt twice a day. They reported improved symptoms of congestion, postnasal drainage, allergies and discharge in 23 out of 30 participants after six weeks of use. 92% of the study participants completed the six week program, signifying its practical ease of use.
A 2009 study looked at the common cold in children. On average, kids get 6-8 per year, and the US Food and Drug Administration recently changed the label on all over-the-counter cold medicines to prohibit their use in kids younger than 6 years of age. In this report, 69 children aged 3-12 years first saw a film on neti and witnessed a facilitator perform it. They then demonstrated proficiency using disposable syringes filled with 15-20 ml of normal saline (0.9%) per nostril, and were instructed to perform the action 1-3 times per day. At the end of the study period, the children showed an overall improvement in nasal air flow, decreased symptoms indicating improved quality of life, and an improvement of pathology noted on sinus X-rays.
A small randomized controlled trial in children with lab confirmed pollen triggered symptoms found that saline irrigation in addition to antihistamine pills significantly reduced allergy symptoms and the amount of medicine taken. In comparison, when only antihistamine treatment without nasal irrigation was used, kids were noted to obtain less symptom relief and required more medicine to be comfortable.
Adults with hay fever, have also reported improvement of allergy symptoms when using saline nasal irrigation in clinical trials.
Pregnancy inhibits many women from using cold and allergy medicine for symptom relief. A recent study asked pregnant women with seasonal allergies to irrigate their sinuses with saline containing a higher than usual concentration of salt. They irrigated 3 times daily for 6-weeks as opposed to a control group who used no local therapy. Those irrigating noted a statistically significant improvement in symptoms from 2-weeks on throughout the remainder of the trial. Rhinomanometry, a measure of nasal airway resistance, also improved, an objective measurement of decreased congestion and ease of breathing through the nose.
Woodworkers with chronic symptoms from wood dust demonstrated significantly improved mucociliary clearance and nasal air flow on expiration after a program of nasal saline irrigation.
Neti has also been show to be an effective method for preventing viral infections of the nasal cavity and sinuses. A randomized, controlled study of 60 adults found that those performing daily nasal irrigations had fewer episodes. When they did get infected, their symptoms lasted fewer days.
There’s also a preventative effect in kids. In a randomized, controlled study of 390 children, those irrigating their sinuses with saline had fewer episodes of sinus congestion and runny noses. Those using neti on a preventative basis were less likely to end up being treated with medication.
There are many more scientific studies showing positive and genuine results with neti, too many to write about them all.