Amidst increasing air pollution and the prevalence of allergies, nasal irrigation has become a daily necessity for many people. From those suffering from allergic rhinitis to those recovering from surgery, from protecting against smog to relieving the early stages of a cold, nasal irrigation with normal saline can remove allergens, thin secretions, and reduce mucosal edema. Its effectiveness has been proven in numerous clinical studies. However, the seemingly simple act of "rinsing your nose with water" carries hidden risks: improper water quality can cause nasal infection, irritate the mucosa, and even worsen the condition.
Normal Saline
Composition and Concentration: Normal saline, a 0.9% sodium chloride solution, matches the osmotic pressure of human plasma and is the "safety baseline" for nasal irrigation. Hypotonic saline (0.45%) may cause mucosal edema. While hypertonic saline (1.5%-3%) can relieve nasal congestion, long-term use can damage the mucosal barrier and is recommended only for short-term use under a doctor's supervision. Preparation:
Medical Finished Product: Individually packaged saline spray or rinse (such as Nasal Cola or NosClear) sterilized and suitable for daily use. Use within 24 hours after opening.
Homemade Solution: Boil 1000ml of distilled water, cool it, add 9g of non-iodized salt (iodine may irritate the nasal cavity), dissolve thoroughly, and place in a sterile container. Use within 24 hours.
Advantages: Non-irritating and non-allergenic, it effectively removes particles such as dust, pollen, and viruses while keeping the nasal cavity moist. Clinical data show that twice-daily saline rinses can reduce symptoms of allergic rhinitis by over 40%.
Distilled Water/Purified Water
Suitable Scenario: If saline is unavailable, distilled or purified water can be used as a temporary alternative, but two key considerations must be observed:
Temperature Control: The water should be close to body temperature (around 37°C). Excessive heat can burn mucous membranes, while excessive cold can cause vasoconstriction and lead to nasal congestion.
Container Sterilization: Rinse the bottle with boiling water before use to prevent bacterial growth. Risk Warning: Purified water is a hypotonic solution. Long-term use may cause nasal edema and even "osmotic rhinitis."
Tap Water
Potential Contamination: Although tap water is chlorinated, it may still contain the following harmful substances:
Residual chlorine: Excessive concentrations can irritate the nasal mucosa and cause a burning sensation;
Microorganisms: Chlorine-resistant bacteria such as Pseudomonas aeruginosa and Legionella may enter the sinuses through irrigation, leading to serious infection;
Heavy metals: Lead, mercury, and other metals are leached through aging pipes. Long-term exposure may damage the nervous system.
Special Needs: Precise Use of Medication Solutions
Intended Use: For patients with sinusitis or postoperative conditions, doctors may prescribe irrigation solutions containing antibiotics, steroids, or mucolytics (such as budesonide solution or ambroxol solution). Principles of Use:
Strictly follow your doctor's instructions: Medication concentration and irrigation frequency need to be adjusted individually. For example, a sinusitis patient may require a 0.5% metronidazole solution once daily.
Avoid mixing solutions yourself: Patients have used gentamicin injection directly for irrigation, resulting in ototoxic reactions and irreversible hearing loss.
Advanced Options: Isotonic Sea Saline and Buffered Solutions
Isotonic sea saline: Contains various minerals (such as magnesium and calcium) that can help repair the mucosal barrier and is suitable for patients with dry rhinitis. However, choose a preservative-free solution to avoid ingredients like benzalkonium chloride that can irritate the mucosa.
Buffered solutions: Adjusting the pH to 7.2-7.4 by adding sodium bicarbonate better reflects the physiological environment of the nasal cavity and can reduce discomfort during irrigation. One study showed that patients who used buffered solutions had a 35% increase in irrigation compliance.
The key to safe nasal irrigation lies in its "sterility, isotonicity, and gentleness." Normal saline is the preferred choice for daily care. Distilled water can be used as a temporary substitute in emergencies, but the temperature and container hygiene must be strictly controlled. Non-sterile water sources such as tap water and well water are absolutely prohibited. Medications should only be used under the guidance of a doctor. Additionally, the head should be tilted forward 30 degrees during irrigation to prevent fluid from entering the middle ear and causing infection.
