FAQs
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NASAL IRRIGATION
Some amount of mucus production from the nasal and sinus lining is normal. Allergies and infections will cause excessive mucus production. This creates nasal and sinus symptoms such as a runny and stuffy nose and post-nasal drip. When you perform a nasal rinse, you wash away excess mucus and irritants such as pollen, dust particles, pollutants and bacteria, thus reducing inflammation of the mucus membrane. Normal mucosa will fight infections and allergies better, and symptoms may be reduced.
For a true nasal rinse (also known as wash, douche or lavage), you need a large volume of saline-at least 60 mL to 120 mL (2 to 4 fl oz)-in each nasal passage, delivered with low pressure or gravity method. You need a total of 120 mL (4 fl oz) to 240 mL (8 fl oz) to wash both sides of your nasal passages. When you squeeze the solution up into your nasal passage, the flow should continue upwards, go over the septum and flow down through the other nasal passage. This ensures that allergens, irritants, excess mucus and other materials in the path of the flow are removed from the nasal passage. Until this flow cycle occurs, you will not achieve a thorough cleansing job.
A large volume of saline solution creates a momentum that sweeps away allergens, excess mucus, pollutants, dust and animal dander in the path of the flow.
A low pressure will ensure that no discomfort is experienced in ears or sinuses.
Yes and no. In the same way that a small spray bottle will never be as effective as a garden hose at cleaning mud off a driveway, a nasal spray cannot duplicate the effectiveness of a volume rinse bottle at clearing your nasal passages of all mucus and nasal irritants. There are various spray products on the market and according to research, they are only moisturizers in most cases and cannot be considered as large volume nasal wash systems. This is due to fact that it is not possible to get a sufficient volume rinse using a spray system.
The exception is our new NasaMist® All-in-One spray, which has a special applicator tip - Dr. Mehta's LVLP (Large Volume Low Pressure™) nasal rinse adapter that provides a full LVLP nasal rinse. For a true large volume nasal rinse, you need from 60 mL to 120 mL (2 to 4 fl oz) in each nostril. With a few seconds of spray from the pressurized cans or a few sequential squeezes on spray bottles with micro tips or actuators, you may get a volume of 0.1 mL to 5 mL, at the most. We recommend sprays be used as Saline on the Go® between nasal washes or when you are experiencing discomfort from dryness and congestion. If you have questions about which method to use, please check with your doctor.
The SINUS RINSE™ easy-squeeze bottle is BPA-free and holds 240 mL (8 fl oz) of saline solution. It is designed to deliver a nasal rinse with sufficient volume and pressure to clean both nasal passages thoroughly. It allows you to control the pressure you use and reduce it if you have inflammation from illness or after sinus surgery. Published medical research shows that this is the most effective delivery system available for nasal irrigation. The bottle has printed instructions on it and also has a custom designed, rounded cap that comfortably fits different size nasal openings.
Our SINUS RINSE™ bottle with our packets is a patented system in USA and several countries. Each SINUS RINSE™ packet contains a preservative free mixture of sodium chloride and sodium bicarbonate that is pH balanced and has a purity level 99% or higher. The packets are easy to dispense and contain enough mixture to make 240 mL (8 fl oz) of saline solution. Thus, you have a large volume available to perform a true nasal rinse. The solution made with the SINUS RINSE™ packet will not burn or sting because it is pH neutral. Moreover, the ingredients in each packet are identical, taking the guesswork out of preparing the solution and giving you the same solution each time you make it.
Nasal rinses can be done at any time of day. However, we recommend that you rinse at least one hour before leaving your home or going to bed in order to avoid the occasional, accidental drainage of the small amount of leftover solution or liquified mucus from the nasal passages, which may drip back or may come out of the nose if you were to lean forward.
Most users fi nd that rinsing twice a day is beneficial similar to brushing your teeth. In our opinion, rinsing 3-4 times or for special circumstances, even rinsing up to 6 times a day is safe. Please follow your physician's advice.
Commercially bottled water or properly maintained reverse osmosis system at home is good.
Rinsing your nasal passages with only plain water without our mixture will result in a severe burning sensation as plain water is not physiologic for your nasal lining, even if it is appropriate for drinking. Additionally, for your safety, do not use tap or faucet water for dissolving the mixture unless it has been previously boiled for five minutes or more, and then cooled to lukewarm or body temperature, as boiling sterilizes the water. Other choices are distilled, micro-filtered (through 0.2 micron), reverse osmosis filtered, or commercially bottled water. You can store boiled water in a clean container for seven days or more if refrigerated. Do not use non-chlorinated or non-ultra (0.2 micron) filtered well water unless it is boiled and then cooled to lukewarm or body temperature.
It can be warmed in the microwave, with the cap left loose to avoid spillage related to air pressure. The time needed to warm the solution can only be determined by trial and error. Try increments of 5 to 10 seconds to find the right temperature and approximate time of warming. Do not overheat, as this may damage the bottle, tube or scald your nasal passages. (It is safe to put both cap and tube in microwave.)
Under normal circumstances, you should not feel any burning or stinging when you use NeilMed® SINUS RINSE® packets. With our product, you should expect a soothing rinse and there should never be any burning. Causes of a burning sensation include:
- Forgetting to put the saline mixture in the bottle.
- Using more than three packets for the specified water quantity.
- Using water that is too cold or too hot.
- Not thoroughly dissolving the mixture in water by shaking or stirring, particularly for Neti Pot users.
If you follow these directions and still feel any burning and the problem continues, please discontinue nasal rinsing and call our office for advice, or write to: questions@neilmed.com.
Nasal rinsing is not recommended when you have an acute or new ear infection or ear discomfort of any kind. We advise that you consult your physician before starting the rinses or wait until symptoms subside. If symptoms recur, stop the rinses and consult your physician as soon as possible. Due to different levels of pain threshold, please use your judgment to decide when to restart rinsing.
Some people experience reflex or rebound congestion with exposure to saline. This condition is usually very transient. If symptoms continue, consider using a Hypertonic (double strength) solution, or use an over-the-counter decongestant for a day or two. This is usually a very benign and mild condition that should resolve with time, and unless severely symptomatic, there is no need to discontinue ongoing irrigation. It will most likely resolve on its own.
Please check with your physician as there are various options available. We will not give any recommendations.
Some physicians do recommend Hypertonic (double or triple the concentration) solutions in certain cases. They believe that a higher concentrated solution will draw the fluid and excessive mucus out of congested nasal and sinus openings. If you prefer higher salinity or Hypertonic solution, you can use 2 to 3 of our blue mixture packets in 240 mL (8 fl oz) of water OR use our green Hypertonic Refill Packet. Each NeilMed® Hypertonic packet will make 240 mL (8 fl oz) of Hypertonic solution or 480 mL (16 fl oz) of Isotonic solution.
All NeilMed® SINUS RINSE® products and Saline Sprays are suitable for use during pregnancy.
It should not do any harm, even if you have high blood pressure or a heart condition. If you follow our directions, tilting your head forward, the chances of solution reaching the back of the throat are very small.
Yes, this is very common, which is why we do not recommend rinsing your nasal passages right before going to bed. This happens in the first 15 to 20 minutes after using the rinse.
Workers who are exposed to large amounts of environmental or occupational dust from construction work, farming, mining and various other occupations may benefit from regular use of the nasal rinse procedure. You should rinse the nose as soon as possible after the exposure. The sooner the irritant is removed from the delicate membranes, the less likely it is that the membranes will become inflamed and congested.
Scuba divers during ascent and descent must equalize the pressure in the ears to avoid pain and other problems. Good nasal and sinus care can help control inflammation, which can improve any pressure discomfort felt in the sinuses and ears during or after diving. NeilMed® nasal irrigation methods by improving nasal and sinus inflammation helps significant number of scuba divers to have less or no pain in the ears and nasal passages and our user comments are quite encouraging.
We know that chronic rhinitis or chronic sinus symptoms will adversely affect the sense of smell and taste. Nasal rinses will symptomatically improve many nasal and sinus conditions. There are no medical publications at this time to show any correlation between rinses and sense of smell.
If bad breath is caused by chronic nasal and sinus infection, it willdefinitely help.
SINUS, SINUSITIS AND RHINITIS
Sinuses are hollow spaces within the bones of the face. There are three pairs of sinuses: frontal, ethmoid, maxillary and one single sinus at the skull base that is called sphenoid. Each pair connects to the nose through small openings called ostia and acts to humidify and warm the air we breathe, add to our sense of smell and taste, and play a significant role in the quality of human sound. Additionally, these air filled pockets help lighten our heavy skulls, making it easier to keep our heads upright.
Sinuses are lined with a mucous membrane called the mucosa. When your sinuses are healthy, they secrete a thin layer of mucus over the mucosa that drains into the nasal passages through the ostia. The mucosa acts as a filter to trap inhaled germs, dust, pollens, and environmental pollutants before they can reach your respiratory system. When the sinuses are inflamed or irritated, the ostia become blocked. Mucus accumulates inside the sinuses and becomes a breeding ground for viruses and bacteria.
The two most common illnesses that affect our noses are rhinitis and sinusitis. In the United States alone, it is estimated that 30 to 50 million people suffer from one of these conditions. Our goal as a medical product company is to join forces with others in the health care field to help people suffering from these symptoms. Large volume nasal irrigation is supported with very extensive medical research literature, and most ENT and allergists consider it to be the first line of treatment for symptomatic relief of nasal and sinus symptoms due to various causes.
We do not claim that our product SINUS RINSE™ will cure the problem, but we can certainly say that either alone or with other medical therapies, it will reduce symptoms and may reduce or eliminate the need for prescription medications. Recent studies have shown that NeilMed® SINUS RINSE® in conjunction with nasal corticosteroid sprays improve nasal sinus symptoms to a greater extent than corticosteroid sprays alone.
Rhinitis is an inflammation of the mucosa (mucosa = delicate lining of the inner body surfaces) of nasal passages.
Sinusitis is an inflammation of the mucosa of various sinuses.
Due to overlapping symptoms, it may be difficult to differentiate between the two. Usually, symptoms of rhinitis include stuffy, runny or drippy nose, scratchy throat and dry cough. Symptoms of sinusitis are more severe than the symptoms of rhinitis and often include increased nasal secretions and pain around the sinuses, such as facial pressure and pain.
The following are symptoms of acute and chronic sinusitis:
- Nasal congestion
- Headache
- Runny nose
- Night time cough due to post nasal drip
- White, yellow, or green discharge
- Persistent fatigue
- Facial pressure
- Ear pain
- Snoring
- Pain in the upper jaw or teeth
- Loss of sense of smell or taste
- Fever
- Uncommon but serious infections such as meningitis, brain abscess, ear infections, etc.
- Cold viruses
- Allergies including food
- Bacterial or fungal infections
- Grass
- Dust, Smog or environmental pollutants
- Nasal polyps and deviated nasal septum
- Moderate to severe gastroesophageal acid reflux disease (GERD)
- Smoking
TREATMENT OF SINUS CONDITIONS
In the initial stages of a head cold and/or flu, saline rinses in large volume help reduce excess mucus and keep sinus passages clear.
There are various forms of endoscopic sinus surgeries (ESS or FESS) that can often cure or improve symptoms. We strongly advise that you contact your physician. You can request your doctor to refer you to an ENT (ear, nose and throat) or allergy specialist if your symptoms are not improving.
Functional Endoscopic Sinus Surgery (FESS) is a commonly used term for endoscopic sinus surgery (ESS) and generally involves very little post-operative discomfort. Current technology including fiber optics, video cameras, high resolution video monitors and high resolution advanced CAT scanners allow excellent examination of all openings of the sinuses, nasal turbinates and nasal septum. When required, surgery will restore the anatomy to as normal as possible or more likely as functional as possible by removing obstructions and improving drainage. FESS or ESS can help improve or, in many, cases cure the symptoms of chronic sinusitis.
You may need to rinse more carefully, and you may find that a larger amount of rinse solution will be necessary. For best results, after you finish rinsing, you may need to take a little more time to change head positions to allow more complete drainage from the sinuses. While bending over the sink, tilt your head sideways to help improve the drainage of any residual rinse solution. A lot of the post sinus surgery population may require more frequent rinsing and in some cases, need double volume (16 oz or 480 mL) nasal irrigation. Consult with your physician about safe and effective post-operation nasal irrigation.
Synthetic or pharmaceutical corticosteroids are anti-inflammatory drugs. They are not anabolic steroids so please do not confuse these two. Physicians prescribe corticosteroid nasal sprays to reduce chronic inflammation of the mucosa (mucus membrane) of nasal passages and sinuses.
Nasal decongestants constrict the dilated blood vessels and reduce nasal and sinus congestion. You can ask further advice about when to use them from your doctor or pharmacist.
Antihistamines are the most common medications used to treat allergies. They work by blocking the effects of histamine, which is released during an allergic reaction, and help relieve the symptoms of sneezing, itchy nose and eyes and runny nose. However, they are not as helpful with nasal congestion.
Some individuals may get skin flushing and nasal congestion with the use of alcohol. Alcohol worsens these symptoms and it is recommended that you check first with your doctor or do not use alcohol while these symptoms persists.
Yes, smoking can lead to rhinitis and sinusitis due to constant irritation.
It has been established that there is a definite correlation between the symptoms of rhinitis, chronic sinusitis and asthma. This is based on the unified or united airway disease as all the areas are contiguous. Curing or reducing rhinitis or sinusitis may improve the symptoms of asthma significantly. Approximately 80% of the patients suffering from allergic asthma have coexisting allergic rhinitis.
ALLERGIES
Allergens are usually organic particles that attach to the nasal mucosa or respiratory mucosa and lead to the development of an antibody, which creates a series of chemical reactions leading to allergic symptoms. Everybody's reaction to allergen exposure is different. The same amount of exposure to allergy particles can cause mild, moderate, or severe reactions in different people. Some may not have any reactions at all. Those with moderate to severe reactions will have symptoms.
There are indoor allergens as well as outdoor allergens. Examples of indoor allergens include dust mites, molds, pet dander (from animals and birds) and pests. Examples of outdoor allergens are pollen, grass, wood dust, and mold. Other substances such as cigarette smoke, perfumes and aerosol spray can be irritants and worsen allergy and sinus symptoms, or can act as allergens themselves.
Most individual allergens are not visible. Dust mites are a typical example. They are not visible to the naked eye, yet they are present in every house. Dust mites are microscopic creatures that feed on human skin flakes and are present in mattresses, pillows, carpets and upholstery.
Clean all the areas where dust may be collecting. Carpets and sofa upholstery should be vacuumed on a regular basis. Wash pillow cases, sheets and blankets in hot water. Enclose mattresses and pillows in special allergy proof encasements. You can also contact an allergy care or supply company for more details.
Mold is a fungus. It can be present in any area where it is damp and warm, especially in basements, bathrooms, kitchens and water damaged areas, such as wood, carpets, water coolers and heater fans.
Any pet with hair or feathers will shed dander. These tiny particles come from its skin. Dander is a very common cause of indoor allergies in the home and in other areas where animals and birds are raised.
Allergy symptoms that bother you only at certain times of the year, such as spring or autumn, are commonly called hay fever, or seasonal allergic rhinitis. These symptoms are commonly caused by pollens and occasionally molds.
This occurs when a person develops symptoms throughout the year whenever he or she is exposed to specific allergens, such as dust or cat dander.
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