Worried About Using a Neti Pot? Here’s How to Use One Safely

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During this cold and flu season, many of us are looking for ways to feel our best.
We’re also trying to maintain our health and prevent ailments. One solution can be nasal irrigation.
For the most part, studies have demonstrated that nasal irrigation is an efficacious means of treatment for colds, allergies, and sinus infections,” said Dr. Joseph Dohar, clinical director of the Pediatric Voice, Resonance and Swallowing Center at UPMC Children’s Hospital of Pittsburgh. Dohar is also an otolaryngology professor at the University of Pittsburgh School of Medicine.
But some people might be concerned after seeing news reports of a woman who died from using a neti pot with water containing a brain-eating amoeba.
Is the neti pot dangerous? No. But using it incorrectly can be. Still, the chances of a serious problem are rare, federal agencies say.
Long-term neti pot use is linked to a higher incidence of sinus infections, possibly because using the pot reduces the mucosal lining of the nose, making it more vulnerable to infection.
In the case of the 69-year-old Seattle woman who died from contracting Balamuthia mandrillaris, a rare, brain-eating amoebic infection, she used the neti pot for about a month after suffering from sinus infections. She then developed a rash on her nose about one month after using the pot.
Dohar said that safe neti pot use requires using sterile, distilled, or boiled water. Make sure to boil water for three to five minutes — and let it cool — before using it, he noted. Distilled or sterile water can be purchased in stores.You can use saline nasal sprays instead of a neti pot, as they’ve been shown to be effective in clearing sinuses. Some who practice nasal irrigation use them along with neti pots.
“The saline in the can is sterile and thus is more convenient for use right out of the bottle,” noted Dr. Benjamin S. Bleier, a specialist at Massachusetts Eye and Ear Sinus Center in Boston. “However, those prepackaged nasal saline sprays do not supply the type of volume of irrigation needed for the maximal benefit. Thus for higher volume rinses, we always recommend use of boiled or distilled water.”The U.S. Food and Drug Administration released a statement last year recommending that people use “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,” the FDA stated. “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,” they stated, citing the Centers for Disease Control and Prevention (CDC).
Care for your neti, care for yourself
The water you use is vital for neti pot safety, but so is proper neti pot care, Dohar said.
“You should also clean and dry your neti pot thoroughly using boiled water before and after every use, or use a heavy-duty water filter,” Dohar recommended.
Should you be using a neti pot?
Patients with sinonasal or lacrimal duct abnormalities, or who’ve had sinonasal surgery, should talk to their doctors before using a neti pot. Bleier added that anyone who’s had trauma to the nose, eye, or brain should get their doctor to approve neti pot use before beginning nasal irrigation.
“Patients with chronic conditions should also use neti pots in moderation. The reason for this is that nasal mucus serves a beneficial function, helping to protect the body against infection,” Dohar said. Our mucus is an important defense against infections.
If you use a neti pot, be sure to add the buffered salt packet to the water, which can be sold with or separately from the neti pot.
“The salt packets are specifically designed to provide the optimal salt concentration and pH,” Bleier said. If you experience burning or any discomfort, try warming the solution slightly above room temperature.
The bottom line
Neti pots can help relieve cold or allergy symptoms.
Safe neti pot use requires using sterile, distilled, or boiled water. Make sure to boil water for three to five minutes — and let it cool — before using it. Distilled or sterile water can be purchased in stores.