“Treatment guidelines in both Canada and the United States now advocate use of nasal irrigation for all causes of rhinosinusitis and for postoperative cleaning of the nasal cavity. Nasal irrigation is a simple, inexpensive treatment that relieves the symptoms of a variety of sinus and nasal conditions, reduces use of medical resources, and could help minimize antibiotic resistance.”

Rachelevsky GS, Slavin RG, Wald ER. Sinusitis: Acute, Chronic and Manageable. Patient Care. 131:4, 1997.

“A particularly helpful strategy for acute and chronic sinusitis is saline washing using a nasal irrigator. It is so effective in clearing the blocked passages that, if it is done regularly, some patients with persistent or chronic sinusitis need no drug treatment at all.”

Tomooka LT, Murphy C, Davidson TM. Clinical study and literature review of nasal irrigation, Laryngoscope, 110(7):1189-1193, 2000.

“RESULTS: Patients who used nasal irrigation for the treatment of sinonasal disease experienced statistically significant improvements in 23 of the 30 nasal symptoms queried. Patients had excellent relief by daily irrigation for sinusitis, perennial allergy, seasonal allergy, postnasal drip, and associated fatigue. Improvement was also measured in the global assessment of health status using the Quality of Well-Being scale. Daily nasal irrigation is well accepted by the patients. CONCLUSIONS: Nasal irrigation is effective in improving symptoms and the health status of patients with sinonasal disease.”

Michel O. Nasal irrigation in case of rhinosinusitis. Laryngorhinootologie. 85(6):448-58, 2006

“Nasal irrigation has proven in several recently published articles its clinical effectiveness and its neglectable rate of side effects even in children and during pregnancy. In most guidelines for the treatment of various nasal pathological conditions nasal irrigation is recommended as stand alone or as additional therapy”.

Zeiger RS, Schatz M. Chronic Rhinitis: A Practical Approach to Diagnosis and Treatment. Immunology & Allergy Practice. 4(4):26-35, 1982

“Nasal tissue appears to benefit greatly from warm irrigation with saline. Saline irrigation augments mucociliary flow, liquifies tenacious mucus, soothes irritated tissue, augments repair processes, reduces forceful nose blowing, and improves olfaction. Its use should be considered for all patients with chronic rhinitis; benefit appears maximal for rhinitis medicamentosa, atrophic rhinitis, nasopharyngitis, and sinusitis.”

Brown CL, Graham SM. Nasal irrigations: good or bad? Curr Opin Otolaryngol Head Neck Surg, 12(1):9-13, 2004

“Summary: Nasal irrigations should no longer be considered merely adjunctive measures in managing sinonasal conditions. They are effective and underutilized”

Ivker R. The Complete Self-Care Guide to Holistic Medicine, 1999 (Book).

“Nasal irrigation is extremely helpful for flushing infected sinuses or cleansing the membranes of the nose and sinuses.”

Kaliner, M. and Kenned, D.M.: Management of Sinusitis: Current Clinical Strategies.  Sinusitis Disease Management Guide. PDR 2000.
“If the patient has recurrent disease he may buy a nasal irrigator, particularly effective after surgery (page 121).  Treatment of Chronic Sinusitis – Nasal washing twice a day is recommended (page 122).”

Mabry, RL. Therapeutic Agents In The Medical Management Of Sinusitis.  Inflamma-tory diseases of the sinuses. Otolaryngologic Clinics of North America, 26 (4), pp 561, 1993.

“Not only is the nasal irrigator beneficial for patients with bothersome thick postnasal secretions, but also is especially helpful for postoperative cleansing following nasal surgery.”

Grossan M: Irrigation of the Child’s Nose. Clinical Pediatrics 13,3:229-231, 1974.

“Treatment by nasal irrigation is indicated for chronic purulent sinusitis, chronic adenoid infection, dacryocystorhinitis secondary to nasal infection, and chronic rhinitis. Often stubborn otitis media or serous otitis will not improve until after the nasal pus is removed.”

Harvey R, Hannan SA, Badia L, Scadding G. Nasal saline irrigations for the symptoms of chronic rhinosinusitis (Review), Cochrane Database of Systematic Reviews, Issue 1, 2009.

“The use of nasal irrigation for the treatment of nose and sinus complaints has its foundations in yogic and homeopathic traditions. There has been increasing use of saline irrigation, douches, sprays and rinsing as an adjunct to the medical management of chronic rhinosinusitis. Treatment strategies often include the use of topical saline from once to more than four times a day. Considerable patient effort is often involved.”

Scheid DC, Hamm RM. Acute bacterial rhinosinusitis in adults: part II. Treatment.
Am Fam Physician. 70(9):1642, 1645, 2004.

“Nasal irrigation with hypertonic and normal saline has been beneficial in chronic sinusitis and has no serious adverse effects”.

Yun N, Lee CH, Lee SM. Protective effect of Aloe vera on polymicrobial sepsis in mice.
Food Chem Toxicol. 2009 Mar 16. (Epub ahead of print).
“The increases in the levels of TNF-alpha, IL-1beta, and IL-6 were attenuated by Aloe vera. In vivo administration of Aloe vera also markedly enhanced bacterial clearance”.

Feily A, Namazi MR. Aloe vera in dermatology: a brief review. G Ital Dermatol Venereol. 144(1):85-91, 2009
“It can be effective for genital herpes, psoriasis, human papiloma virus, seborrheic dermatitis, aphthous stomatitis, xerosis, lichen planus, frostbite, burn, wound healing and inflammation. It can also be used as a biological vehicle and an anti-microbial and antifungal agent and also as a candidate for photodynamic therapy of some kinds of cancer”.

“OBJECTIVE: To study the therapeutic mechanism of aloe vera in allergic rhinitis (AR). CONCLUSION: The aloe vera are suggested to be involved in the differentiation of CD4+ lymphocytes, by means of regulating the expression of Th1 and Th2 cytokines. The results suggests that local aloe vera treatment was a selective and non-traumatic method to treat the allergic rhinitis.

Hauptman G, Ryan MW. The effect of saline solutions on nasal patency and mucociliary clearance in rhinosinusitis patients. Otolaryngol Head Neck Surg. 137(5):815-21, 2007
“CONCLUSIONS: Buffered physiological and buffered hypertonic saline nasal sprays both improve mucociliary clearance, which is beneficial for treatment of rhinosinusitis. Additionally, buffered physiological saline improves nasal airway patency, whereas buffered hypertonic saline has no effect. Both solutions provide symptomatic relief, but buffered hypertonic saline is more irritating.”

Talbot AR, Herr MH, Parsons DS. Mucociliary clearance and buffered hypertonic saline solution. Laryngoscope 107:500-503, 1997
“The outcome showed buffered hypertonic saline nasal irrigation to improve mucociliary transit times of saccharin, while buffered normal saline had no such effect.”

Manning SC: Pediatric Sinusitis. Otolaryngologic Clinics of North America. 26,4:623-637, 1993.
“A gentle squirt of saline into each nostril once or twice daily can improve nasal function by mechanically removing sensitizing agents, by enhancing mucociliary transport via increased relative humidity, and by improving sinus drainage and ventilation via a mild vasoconstrictive effect. Compliance can be enhanced by using prepared pH-neutral solutions and by emphasizing to the parents that saline lavage represents a long-term hygiene strategy aimed at prevention of sinusitis, analogous to tooth brushing to prevent cavities.”

Süslü N, Bajin MD, Süslü AE, Oğretmenoğlu O. Effects of buffered 2.3%, buffered 0.9%, and non-buffered 0.9% irrigation solutions on nasal mucosa after septoplasty.
Eur Arch Otorhinolaryngol.  2008.
“A prospective randomized study was designed to compare the effect of different irrigation solutions on mucociliary clearance and nasal patency and to compare the limitations of the used solutions, such as nasal burning by a visual analog scale. On the 20th day, there was a significant difference in saccharine clearance time between the hypertonic buffered seawater group and non-buffered isotonic saline (P = 0.003). Buffered hypertonic seawater improved nasal airway patency more than non-buffered”.

Carbon Dioxide released from Sodium bicarbonate reliefs allergic rhinitis:

Casale TB, Romero FA, Spierings EL. Intranasal noninhaled carbon dioxide for the symptomatic treatment of seasonal allergic rhinitis. J Allergy Clin Immunol. 121(1):105-9, 2008.
“CONCLUSION: Two 60-second intranasal CO2 treatments resulted in rapid (10 minutes) and sustained (24 hours) relief of seasonal allergic rhinitis symptoms”.

Aloe vera: In addition to its well-known moisturizing and wound healing activities that helps prevent dryness of the nose, aloe vera may also provide additional multiple benefits to the nose, as demonstrated in recent research articles:

“The study was to compare nasal irrigation using hypertonic Dead Sea salt (DSS) solution with hypertonic saline in the treatment of chronic rhinosinusitis and improvement of quality of life (QOL).– CONCLUSIONS: We present a short-term study providing level I evidence on the superiority of DSS over saline nasal irrigation for treatment of chronic rhinosinusitis.”

Cordray S, Harjo JB, Miner L. Comparison of intranasal hypertonic dead sea saline spray and intranasal aqueous triamcinolone spray in seasonal allergic rhinitis. Ear Nose Throat J.84(7):426-30, 2005.

“Dead Sea saline solution can be an effective alternative in mild-to-moderate allergic rhinitis, particularly with respect to nasal and eye symptoms. The hypertonicity of the Dead Sea solution may have a positive effect on the physiology of the nasal mucosa by improving mucociliary clearance. In addition, the dominant cation in the Dead Sea solution–magnesium–probably exerts anti-inflammatory effects on the nasal mucosa and on the systemic immune response.”

Slapak et al. Efficacy of isotonic nasal wash (seawater) in the treatment and prevention of rhinitis in children. Arch Otolaryngol Head Neck Surg. 134(1):67-74, 2008.

“Conclusion: Children who had cold or flu performed nasal irrigation showed faster resolution of some nasal symptoms during acute illness and less frequent reappearance of rhinitis subsequently as compared to children who did not perform nasal irrigation.”

Levine HL, Cordray S, Miner LA. Use of Dead Sea salt solution for chronic rhinitis and rhinosinusitis. Operative Techniques in Otolaryngology. 17, 147-150, 2006

“Conclusions: Dead sea salt is an effective irrigation and spray in the treatment of purulent rhinosinusitis, improving quality of life and rhinosinusitis symptoms. It may have its effectiveness because of the different cation composition from normal or hypertonic saline.”

Süslü N, Bajin MD, Süslü AE, Oğretmenoğlu O. Effects of buffered 2.3%, buffered 0.9%, and non-buffered 0.9% irrigation solutions on nasal mucosa after septoplasty.
Eur Arch Otorhinolaryngol.  2008.

“A prospective randomized study was designed to compare the effect of different irrigation solutions on mucociliary clearance and nasal patency and to compare the limitations of the used solutions, such as nasal burning by a visual analog scale. On the 20th day, there was a significant difference in saccharine clearance time between the hypertonic buffered seawater group and non-buffered isotonic saline (P=0.003). Buffered hypertonic seawater improved nasal airway patency more than non-buffered”.

“CONCLUSION: Nasal irrigations performed with large volume and delivered with low positive pressure are more effective than saline sprays for treatment of chronic nasal and sinus symptoms in a community-based population”.

Olson DE, Rasgon BM, and Hilsinger RL Jr. Radiographic comparison of three methods for nasal saline irrigation. Laryngoscope 112:1394–1398, 2002.

“For each study subject, three methods of irrigation were used: irrigation using positive-pressure irrigation, irrigation using negative-pressure irrigation, and irrigation using a nebulizer. RESULTS: Of the three methods used, two methods, positive-pressure and negative-pressure irrigation, distributed contrast solution widely to ethmoid and maxillary sinuses, but distribution of contrast solution was more uniform using positive-pressure irrigation than using negative-pressure irrigation. The nebulization method distributed contrast solution poorly and resulted in a significantly lower volume of retained contrast solution (P <.05).”

Wormald PJ, Cain T, Oates L, Hawke L, Wong I. A comparative study of three methods of nasal irrigation. Laryngoscope, 114:2224-2227, 2004

“The distribution of radioactivity was assessed on each subject after three different irrigation techniques: metered nasal spray, nebulization with RinoFlow, and nasal douching. Results: The nasal cavity was well irrigated by all three techniques. Compared with the other two methods, douching was significantly more effective in penetrating the maxillary sinus (P = .036) and frontal recess (P = .003). The sphenoid and frontal sinuses were poorly irrigated by all three techniques. CONCLUSION: Nasal douches are more effective in distributing irrigation solution to the maxillary sinus and frontal recess. This should be the method of choice for irrigating these areas.”

“In this cross-sectional study of 45 wood industry workers, a significant decrease in nasal symptoms (such as obstruction, posterior secretions, itching, irritation and sneezing) was seen after a 3-week treatment with Rhinomer, which contains de-ionized, sterilized, isotonic seawater. Nasal peak expiratory flow (NPEF), especially in workers with nasal complaints, and nasal mucociliary clearance also improved significantly. The treatment, according to participants, was simple to perform and there were only a few side effects.”

Rabone and Saraswati. Acceptance and effects of nasal lavage in volunteer woodworkers. Occup Med.49:365-369, 1999

“It is concluded that nasal lavage is an acceptable, effective and inexpensive option with minimal side effects for woodworkers who experience nasal symptoms and who wish to try the procedure.”

Berger ME, Jones OW, Ricks RC and Garrett S. Decontaminating the nasal passages. Health Phys., 84(5 Suppl):S80-S82, 2003.

“Nasal decontamination may be indicated when the anterior nasal passages are contaminated with highly radioactive material or radioactive material with either irritating or toxic properties. Nasal irrigation (wash, rinse, douche, lavage) is an established technique used for other conditions and can be applied in these cases”.

Castano R, Thériault G, Maghni K, Ghezzo H, Malo JL, Gautrin D. Reproducibility of nasal lavage in the context of the inhalation challenge investigation of occupational rhinitis. Am J Rhinol. 22(3):271-5, 2008

“CONCLUSION: The nasal lavage method was shown to be sufficiently reproducible to be considered useful for the monitoring of upper airways inflammation during the investigation of occupational rhinitis by specific inhalation challenge”.

“Conclusion: Rhinosinusitis is a common acute post-radiotherapy complication in Nasopharyngeal carcinoma patients. Our results showed that nasal irrigation was a safe and effective method for the management of this acute complication.”