Joseph R. Anticaglia MD
Medical Advisory Board
In 2011, two Louisiana residents died after using a neti pot and tap water. Their deaths were caused by the “brain eating” amoeba N. fowleri. Once the amoeba enters the nose, it travels to the brain and this bacterial infection is almost always fatal. These residents had symptoms similar to meningitis but within a week both were dead.
The link between them was that both used a neti pot and tap water. What is a neti pot?
A Neti pot (N.P.) looks like a small teapot and is used to irrigate the nasal passages with a
lukewarm salty solution. The sprout is place into one side of the nose and then the other to wash away mucus and irritants. But washing the sinuses and nasal passages goes back centuries.
The practice of nasal irrigation originated with the homeopathic tradition of Ayurvedic medicine in Northern, India 5,000 years ago. This medical tradition emphasizes a balance among the body, mind and spirit. It advocates personal hygiene on a daily basis and jala neti — nasal cleansing — is part of the day-to-day practice.
In the case of the Louisiana residents, it was not the neti pot but contamination of the tap water that caused their deaths. Saying these tragic deaths are rare incidences offers no comfort to their families. To lower the risk of infection, health care workers recommend several precautions be taken before using the N.P.
Use safe water. When you go shopping, look for sterile or distilled water. If you prefer to use tap water, boil it for three to five minutes and let it cool before placing it in the N.P. With regards to filtered water, use a filter with a pore size of no less than one micron.
Certain conditions require special consideration before using the neti pot. For example, people prone to nosebleeds, immune suppressed patients, and those with a decreased gag reflex have need for added attention. Lastly, clean the N.P, and allow it to dry.
There are many testimonials citing the benefits of saline nasal irrigation (SNI) — cleaning the sinuses and nasal passages with salt and water.
Barbara is a 38 year old woman with chronic sinusitis bothered by facial pressure, stuffy nose and headaches. It seems, “All my life, I’ve taken different over-the–counter medications, antibiotics, and nasal sprays.” She started using nasal irrigations that her doctor suggested and on a return visit she said, “It changed my life.”
For many years, Ear, Nose & Throat (ENT) surgeons have successfully used (SNI) to reduce the symptoms of nasal stuffiness and to diminish the severity of facial pressure and pain in patients with sinusitis. This has resulted in the decrease use of decongestants, nasal steroid sprays and lessened the need for antibiotics.
The overall effect of SNI has been an improvement in the quality of life, as well as, a reduction in the number of office visits and cost savings. Saline irrigations may also be useful in patients with allergic rhinitis and the rhinitis associated with pregnancy in eliminating mucus and easing congestion. Proper use of the N.P. has proven to be safe and beneficial to many patients.
Proper Use of Neti Pot
- Follow precautions noted above
- Add one half teaspoon of table salt to eight ounces of lukewarm sterile water
- Fill the Neti Pot with the salty, sterile lukewarm water
- Lean over bathroom sink, tilt your head to the right, insert N.P. spout into right nostril
- Breathe through your mouth
- Let water enter right side of nose and exit the left nostril
- Repeat the same procedure for the other nostril
- After doing both nostrils, lean over the sink, blow your nose; then lean over and try to touch your toes to expel remaining water
- When finished, clean N.P. and allow to dry
Saline nasal irrigations using a neti pot can ease a patient’s complaints of sinus pressure, pain and nasal congestion. It has enjoyed increased popularity and clinical studies have shown the usefulness of incorporating SNI in the treatment of patients with sinusitis and nasal stuffiness. Side effects have been reported to be minimal and transient.
References
Brown, Christopher; Graham, Scot. Nasal Irrigations: Good or Bad? Cur. Opin. Otolaryngology-HNS, 2004.
CDC. Naegleria fowleri — Primary Amebic Meningoencephalitis (PAM). Amebic Encephalitis; Sept. 24, 2015.
This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.