SinuCleanse® 

Q. I have suffered from Sinus problems (Sinusitis, Allergies, Post-Nasal Drip, Congestion) for years and have tried many over-the-counter and prescription medications and even surgery, and I am still suffering. How is it possible that washing your nose with the SinuCleanse® system can help me when all these other medications and procedures have not?

A. The nasal wash has been used for centuries but has only recently been rediscovered by modern science as an effective way to treat a wide range of sinus problems. Most sinus problems are caused by thickened mucus in the nose and sinuses. The reason the mucus becomes thick varies, but some common causes are cold, flu, allergies, pollution or dry air.

Once the mucus becomes thick, it can pool in the sinuses or in the nose, leading to the familiar congestion, drainage, headache, cough and post-nasal drip. Mucus that remains stagnant provides fertile ground for infection with bacteria. Some drugs used to treat the symptoms of sinus problems unfortunately have the side effect of causing the mucus to become even thicker.

Nasal washes are the only way that thick mucus can be washed out of the nose. Rather than treating the symptoms of sinus disease, nasal washes actually treat the root problem - thickened mucus. As an added benefit for allergy sufferers nasal washes have also been shown to rinse pollen, dander, and other allergens out of the nose and sinuses and reduce allergy symptoms.

Many users are amazed that a simple, drug free, and inexpensive treatment works when so many other things they have tried have failed.

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Q. What is the SinuCleanse® system saline solution made of?

A. The drug-free solution is a simple saline mixture containing only sodium bicarbonate and sodium chloride. You can download the drug facts information sheet here.

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Q. How often can I use the SinuCleanse® system?

A. Since the SinuCleanse® system is completely drug free it can be used as often as you like. People treating an active sinus problem or allergies often use the SinuCleanse® system twice per day, once in the morning and once before bed. If the problem or allergies are particularly bad they sometimes use it once or twice more during the day in addition to the morning and bedtime use.

Some people also use the SinuCleanse® system every day to help prevent infections or when cold and sinus symptoms begin.

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Q. When I use the SinuCleanse® system I feel pain or a burning sensation, is this normal?

A.  Most people find using the SinuCleanse® system to be comfortable and soothing. If you are experiencing any pain or burning when using the SinuCleanse® system please try the following:

1. Water temperature. If the water temperature is too warm or too cold the nasal wash will be uncomfortable. Adjust the water temperature so it is lukewarm, and try again. Solution entering the upper nostril should feel the same temperature as the body.

2. If stinging or burning or irritation occurs and the temperature of the solution is lukewarm make sure the ingredients are completely mixed up by thoroughly stirring the solution. Any un-dissolved ingredients from the packets will be uncomfortable in the nose.

3. If the temperature of the solution is lukewarm and the solution is thoroughly mixed and you still experience any burning or discomfort, reduce the strength of the solution by one-half (1/2 packet of dry ingredients for the SinuCleanse® neti pot and 1 packet of dry ingredients for SinuCleanse® Squeeze™) and gradually work up to using the solution at full strength..

4. If the solution is lukewarm and thoroughly mixed half strength and you are still experiencing any discomfort discontinue use of the SinuCleanse® system and return for a full refund.

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Q. When I use the SinuCleanse® system the saline solution will not flow through on one or both sides, what is wrong?

A. When the saline solution will not pass from one nostril to the other the usual problem is blockage in the nose. Most commonly, this is due to a deviated septum. The septum is the divider between the two nostrils. If this is crooked, it will narrow the nasal passage on one or both sides.

Another possible reason is swelling in the lining of the nose. This can be temporarily reversed with various over-the-counter nasal sprays containing oxymetazoline. An example is Afrin™,  although the generic versions work as well.

We recommend trying to spray your nose with one of these decongesting sprays, then waiting approximately 10 minutes before retrying the SinuCleanse® system. If the solution still does not go through, there is an obstruction in your nose, most likely from a deviated septum but possibly something else. The only way to be certain would be a visit to your health care provider for a nasal examination.

If the SinuCleanse® system solution does go through after using the decongesting spray, continue to use the SinuCleanse® system regularly to keep the nasal lining healthy. The over-the-counter sprays are clearly labeled to only be safe for use for 3 days... they are very hard on the nasal lining and should NOT be used every day. There are prescription nasal sprays that are safe for daily use that may help you if the SinuCleanse® system does not solve the problem completely.

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Q. When I use the SinuCleanse® system I feel pain in my ears. Is this normal?

A. There is a small muscular tube, called the Eustachian tube, which connects the air-filled space behind the eardrum (the middle ear) to the back of the nose. There is one Eustachian tube to the right ear and another to the left ear. The Eustachian tubes generally open several times an hour, particularly during swallowing. This equalizes the pressure between the middle ears and the outside environment. Most people can also “force” the Eustachian tubes to open and equalize pressure (for instance, during an airplane flight or when diving underwater) by plugging the nose and blowing pressure to “pop” the ears.

During the SinuCleanse® system nasal wash, saline solution runs through the back of the nose and often directly over the nasal opening of the Eustachian tubes. When blowing the nose to remove the SinuCleanse® solution and mucus from the nasal passages, some of the solution may be forced into the Eustachian tube opening. Particularly with forceful blowing, this can cause a painful stinging sensation in one or both ears. This is generally short-lived. Rarely, individuals have more persistent feelings of ear fullness, pressure and “popping” after using the SinuCleanse® system. Again, this is related to the Eustachian tube and how frequently it opens.

Using the SinuCleanse® system is not harmful to your ears, and having saline solution in your Eustachian tubes is not dangerous. By clearing up the nose, in fact, ear symptoms may improve. However, if you experience ear discomfort when using the SinuCleanse® system, try to blow your nose more gently after the wash. If the problem persists, the openings of your Eustachian tubes may be particularly wide and the SinuCleanse® system use may need to be discontinued.

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Q. Occasionally some saline solution drips out of my nose hours after I used the SinuCleanse® system. Is this normal?

A. When doing a nasal wash, the solution flows throughout the nooks and crevices of the nasal and sinus cavities. Most of the solution drains out or is blown out of the nose immediately after the wash. Sometimes, however, some of the saline solution remains in the nose. This may drain out, generally quite suddenly, up to several hours after the nasal wash is done. It feels very warm, tastes salty, and generally just comes out of one nostril. This experience often follows a change in head position, such as leaning forward or tilting the head.

This is a normal occurrence after using a nasal wash and no cause for concern. Some people who frequently experience this drainage find it more convenient to wash their nose at bedtime rather than in the morning.

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Q. Does the SinuCleanse® system help with Post-Nasal Drip?

A. The nose and sinuses produce about a quart of mucus every day. Normally this is thin and watery. It drains out of the sinuses into the nose, and then runs down the back of the throat where it mixes with saliva and is swallowed.

When mucus is healthy and thin, we don't sense that quart of mucus draining down the back of our throats. However, if the mucus becomes thick, the sensation of "post-nasal drainage" occurs. Instead of flowing easily, the thick sticky mucus remains in the back of the nose and throat, where it may cause discomfort, congestion, cough (particularly when lying down) and bad breath.

Using the SinuCleanse® system thins the mucus in the nose and sinuses, which keeps the mucus flowing easily through its usual pathway out of the sinuses, into the nose, and down the throat. This relieves the sensation of post-nasal drainage in many people.

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Q. If I have a Sinus Infection on one side of my nose/face is it possible for the SinuCleanse® system to spread the infection to the other side?

A. No, a sinus infection will not be spread by the SinuCleanse® system. We can't predict whether it might spread on its own, but likely not. You can safely irrigate both sides and not worry about spreading the infection.

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Q. Can children use the SinuCleanse® system?

A.We have good results with children of all ages using the SinuCleanse® system. Almost all 6-to-7-year-olds will use the SinuCleanse® system on their own. Under 6 years of age it depends on the individual child. Rarely a 4-year-old will willingly use it. If a child fights using the SinuCleanse® system you will have to wait until they are older, as it isn't really something you can force a child to do. One thing we find helpful is to have your child watch the SinuCleanse® system video on the SinuCleanse® system web site. There is an 11-year old boy on the tape who uses the system.

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Q. Can the SinuCleanse® system help my sense of smell or taste?

A. The sense of smell involves transmissions through the two olfactory nerves, which lie along the bottom of the front part of the brain. Fine olfactory nerve endings penetrate through tiny openings in the skull base into the upper recesses of the nose. Odors in the air must contact this area of the nose for us to appreciate their smell.

Sinus infections, nasal allergies, or anything else that causes nasal obstruction or swelling of the lining of the nose can temporarily impair the sense of smell. When the nasal lining is swollen, air does not contact the olfactory area of the nose, so smells in the air cannot be detected.

What we call our sense of taste is very dependent on the sense of smell. The actual taste buds in the mouth and their nerve connections to the brain are not affected by sinus infections. Even with no sense of smell, we can distinguish the basic tastes of sweet, salt, bitter, and sour on our tongues. Flavor, however, is a combination of the taste, smell and texture of food. While we eat, the fragrance of the food in the mouth travels up to the olfactory area of the nose. People who have a sinus infection often complain of poor sense of taste as well as smell because the experience of "flavor" is changed while the sense of smell is blunted. Usually, once the sinus infection has cleared and the congestion or obstruction in the nose has resolved, normal smell (and therefore "taste") returns.

It is also possible, although much more rare, to damage the fine olfactory nerve endings as they pass through the skull base into the nose. Generally this is caused by trauma to the face, head or nose area, and the nerves are literally sheared apart. This form of loss of smell, as well as the associated change in appreciation for flavors, is permanent.

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Q. Can I use the SinuCleanse® system with other medications?

A. Yes, the SinuCleanse® system works well all by itself or with other medications. Because it is drug free the SinuCleanse® system will not cause any dangerous drug interactions and in fact helps many other medications work more effectively. Below are some common medications and how they work together with the SinuCleanse® system.

The SinuCleanse® System and Antibiotics

The lining of the sinuses normally produces about one quart of mucus every day. This mucus is thin and watery when the nose is healthy. The mucus drains out of the sinuses into the nose and from there runs down the back of the throat. Here it mixes with saliva and is swallowed. People with healthy noses and sinuses do not sense that they are swallowing a quart of nasal drainage every day.

If the mucus becomes thick, however, things change. The mucus can become trapped in the sinuses because it is too thick to drain through the small openings between the nose and sinuses. Mucus that cannot drain efficiently will stagnate and can become infected with bacteria. Persistent symptoms including headache, facial pain, toothache, nasal drainage, congestion and post-nasal drip with cough may indicate a bacterial sinus infection.

Antibiotics are medications that fight bacterial infections. They can be lifesaving and revolutionized the practice of medicine when they were discovered in the early part of the 20th century. They are available only by prescription in the United States. Antibiotic overuse can and has led to the development of “resistant organisms,” bacteria germs which antibiotics once killed but that have now developed defenses allowing them to live and flourish even when exposed to antibiotics.

Respiratory infections, including those involving the nose and sinuses, are a frequent diagnosis leading to prescriptions for antibiotics. Millions of prescriptions are written every year for respiratory infections in the United States. Sometimes the antibiotics are really needed, but other times the infections may be a viral infection, which will not be affected by antibiotic use.

True sinus infections begin when there is a blockage in the nose that leads to mucus backup into the sinuses and stagnation. This initial blockage may be the result of allergies, the common cold (a viral infection), or even airborne irritants breathed into the nose (smoke, soot, chemicals, etc.) The most effective way to prevent a sinus infection is to treat this nasal blockage, and to keep the sinus drainage thin by using the SinuCleanse® system nasal wash. Antibiotic treatment alone, without also addressing the obstruction present in the nose, is doomed to fail as the obstruction / infection cycle repeats itself. Many people with acute or long-standing sinus and nasal symptoms are able to avoid the need for antibiotic prescriptions by using the SinuCleanse® system when symptoms begin, keeping their secretions thin and flowing.

The SinuCleanse® System and Nasal Steroids

There are small openings, called “ostia,” that connect the sinuses to the inside of the nose. Sinus drainage that is normally produced by the sinus lining must pass through these ostia into the nose. The secretions then drain down the back of the nose, mix with the saliva in the mouth, and are swallowed.

Blockage of the ostia results in build up of secretions in the sinuses. If the secretions cannot drain, they become stagnant and can get infected.

To keep the sinuses healthy, it is important to keep the ostia open. Nasal decongestants are designed to shrink the lining of the nose, thereby opening the sinus ostia. Nasal steroid sprays are one form of nasal decongestant. These sprays shrink the lining of the nose when used regularly.

The SinuCleanse® system nasal wash makes the sinus secretions thinner. Thinner secretions are able to pass through the small sinus ostia more easily than thick, sticky secretions. If your health care provider has recommended nasal steroid sprays to treat your sinus and nasal symptoms, we recommend that you use the SinuCleanse® system before you use your prescription nasal spray. This will remove crusts and thick mucus from your nose, allowing the steroid spray to better contact the nasal lining and potentially work better.

Some people are able to discontinue prescription medications after regular use of the SinuCleanse® system. You should, of course, discuss any change in prescription medication use with your health care provider.

The SinuCleanse® System and Antihistamines

Antihistamines are medications used for treatment of allergies. Antihistamines are available either over the counter or by prescription in the United States.

Millions of adults and children suffer from nasal allergies and the number seems to be growing. Symptoms may either be seasonal (for instance, grass allergy) or may last year-round (dust mite allergy). Inflammatory cells within the nose of allergy sufferers release chemicals when they nasal lining comes in contact with an allergen (the substance the individual is allergic to). These released chemicals are responsible for allergy symptoms of sneezing, runny nose, and itchy eyes.

Antihistamine medications work by keeping the cells from releasing these chemicals, so they are a great choice for allergy sufferers. However, a side effect of all antihistamine medications is thickening of mucus. Mucus that is thick cannot efficiently drain through the small openings between the sinuses and the nose. These thick secretions can become trapped and build up in the sinuses. Secretions that do not drain will become infected. Antihistamines, then, can be both a help and a hindrance.

People who truly have nasal allergies should use antihistamines to treat their allergy symptoms. If they also have frequent sinus infections, using the SinuCleanse® system nasal wash will help keep the nasal mucus thin and flowing and decrease symptoms related to mucus stagnation in the sinuses. Studies have also shown that regular use of a nasal wash decreases the amount of allergen in the nose and decreases the amount of released inflammatory chemicals in allergy sufferers. Regular use of the SinuCleanse® system during an individual’s allergy season may be able to control symptoms enough that other medication use can be decreased or even discontinued.

You should, of course, discuss any change in prescription medication use with your health care provider.

People who do not have allergies should not use antihistamines for their sinus and nasal symptoms. The mucus-thickening side effects can actually worsen the overall health of the nose and sinuses.

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Q. What are the benefits of using 1/2 of the saline packet vs. the full saline packet?

A. For neti pot users, we recommend that children and first time users start with a 1/2 packet until accustomed to the system. After the first few times, we suggest using a full saline packet for best results.  For SinuCleanse® Squeeze™ users, start with a full packet and work your way up to 2 full packets.

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Q. How much water should be added to the SinuCleanse® system neti pot?

A. Lukewarm water should be filled to the top of the SinuCleanse® system logo located on the inside of the plastic neti pot (which makes 1/2 cup).

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Q. How much water should be added to the SinuCleanse® Squeeze™ ?

A. Fill the bottle with lukewarm water.  Leave approximately 1/2” between the water line and the top of the bottle.

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Q. When I use the SinuCleanse® system I swallow some of the solution, what should I do?

A. Having some saline solution pass from the back of the nose into the mouth is not dangerous. It can be swallowed or spit out. Sometimes, though, it is uncomfortable or unpleasant. When the saline solution enters the nose, it passes all the way through the back of the nose before "turning the corner" around the nasal septum and coming out through the other nostril.

The roof of the mouth, or palate, is the structure that divides the back of the nose from the back of the mouth. The palate must seal tightly to the back wall of the throat when we swallow in order to prevent food or liquid from going up into the nose rather than down to the stomach.

When using the SinuCleanse® system, the goal is to keep the saline solution in the back of the nose rather than running into the back of the mouth. Again, this is the function of the palate. Any solution that sneaks past the palate will be tasted in the back of the mouth. Everyone has a slightly different configuration of the palate and throat. Some palates are longer than others and seal more easily. Shorter palates may need to "stretch" a little to fully seal. People with very short palates or who have had surgery on the palate may have incomplete closure and always "leak" a little around the palate.

Concentrating on breathing just through the mouth may help. Some people find saying "k…k…k" while washing their nose pushes the palate more firmly into the back or the throat and seals off small leaks.

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