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FDA Urges Safe Use of Neti Pots to Avoid Infections

Rinsing sinuses with a neti pot.

Little teapots with long spouts have become a fixture in many homes to flush out clogged nasal passages and help people breathe easier. Along with other nasal irrigation systems, these devices — commonly called neti pots — use a saline, or saltwater, solution to treat congested sinuses, colds and allergies. They’re also used to moisten nasal passages exposed to dry indoor air. According to the Food and Drug Administration (FDA), improper use of these neti pots and other nasal rinsing devices can increase your risk of infection.

These nasal rinse devices — which include bulb syringes, squeeze bottles, and battery-operated pulsed water devices — are usually safe and effective products when used and cleaned properly, says Eric A. Mann, MD, PhD, a physician at the FDA.

What does safe use mean? First, rinse only with distilled, sterile or previously boiled water.

Tap water isn’t safe for use as a nasal rinse because it’s not adequately filtered or treated. Some tap water contains low levels of organisms — such as bacteria and protozoa, including amoebas — that may be safe to swallow because stomach acid kills them. But in your nose, these organisms can stay alive in nasal passages and cause potentially serious infections. They can even be fatal in some rare cases, according to the Centers for Disease Control and Prevention (CDC).

What Types of Water Are Safe to Use?
•Distilled or sterile water, which you can buy in stores. The label will state “distilled” or “sterile.”
•Boiled and cooled tap water — boiled for 3 to 5 minutes, then cooled until it is lukewarm. Previously boiled water can be stored in a clean, closed container for use within 24 hours.
•Water passed through a filter designed to trap potentially infectious organisms. CDC has information on selecting these filters.

Second, make sure you follow instructions.

“There are various ways to deliver saline to the nose. Nasal spray bottles deliver a fine mist and might be useful for moisturizing dry nasal passages. But irrigation devices are better at flushing the nose and clearing out mucus, allergens and bacteria,” Mann says.

Information included with the irrigation device might give more specific instructions about its use and care. These devices all work in basically the same way:
•Leaning over a sink, tilt your head sideways with your forehead and chin roughly level to avoid liquid flowing into your mouth.
•Breathing through your open mouth, insert the spout of the saline-filled container into your upper nostril so that the liquid drains through the lower nostril.
•Clear your nostrils. Then repeat the procedure, tilting your head sideways, on the other side.

Sinus rinsing can remove dust, pollen and other debris, as well as help to loosen thick mucus. It can also help relieve nasal symptoms of sinus infections, allergies, colds and flu. Plain water can irritate your nose. The saline allows the water to pass through delicate nasal membranes with little or no burning or irritation.

And if your immune system isn’t working properly, consult your health care provider before using any nasal irrigation systems.

To use and care for your device:
•Wash and dry your hands.
•Check that the device is clean and completely dry.
•Prepare the saline rinse, either with the prepared mixture supplied with the device, or one you make yourself.
•Follow the manufacturer’s directions for use.
•Wash the device, and dry the inside with a paper towel or let it air dry between uses.

Talk with a healthcare provider or pharmacist if the instructions on your device do not clearly state how to use it or if you have any questions.

Nasal Rinsing Devices and Children

Finally, make sure the device fits the age of the person using it. Some children are diagnosed with nasal allergies as early as age 2 and could use nasal rinsing devices at that time, if a pediatrician recommends it. But very young children might not tolerate the procedure.

Whether for a child or adult, talk to your health care provider to determine whether nasal rinsing will be safe or effective for your condition. If symptoms are not relieved or worsen after nasal rinsing, then return to your health care provider, especially if you have fever, nosebleeds or headaches while using the nasal rinse.

Healthcare professionals and patients can report problems about nasal rinsing devices to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program.

Source: FDA

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