Advanced More Effective Nasal Irrigation (Jala Neti) Technique

Hip

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Years ago I devised a more effective "advanced" technique of nasal and sinus irrigation.

In this thread I am going provide details of this technique, in case it is useful for anyone with chronic sinusitis or other sinus issues. My technique gets a lot more saline solution (salty water) into the sinus cavities, so this advanced technique should be better at clearing out sinus infections and sinus toxins.

I will call my method inversion technique nasal irrigation, to differentiate it from regular nasal irrigation.

Nasal irrigation has a long history in Indian yoga, where it is called jala neti. Medical nasal irrigation is effectively the same as jala neti. But the standard nasal irrigation / jala neti approach is not very efficient, because although it irrigates the nasal cavity well, it does not get a sufficient quantity of saline solution into the sinus cavities.

The images below show the standard approach to nasal irrigation / jala neti.

Nasal irrigation using plastic bottle.jpg Jala neti using neti pot.jpg
Left: nasal irrigation using NeilMed sinus rinse bottle. Right: jala neti using neti pot

When you irrigate your nasal cavity using the standard technique, not much saline gets into your sinuses because the sinus cavities are separate chambers connected to the nasal cavity by tiny openings or holes. These narrow openings connecting the sinuses to the nasal cavity are called ostia (singular: ostium).

In the nasal cavity image below, the black dots represent the sinus ostia. When you use nasal irrigation, the saline has to pass through these tiny holes in order to enter the sinuses. But because the holes are so small, it is difficult to get the saline solution to pass through them.

Furthermore, several of these ostia are located on the top part of the nasal cavity, which may thus be above the water line in your nose as you irrigate the nasal cavity with salty water. So it may be impossible to get the saline through these higher ostia.

Not only that, but since most of the sinus cavities are positioned above the nasal cavity, standard nasal irritation will get very little saline into these higher sinuses, as water does not travel upwards against gravity. But inversion technique nasal irrigation is able to irrigate these higher sinuses.

The nasal cavity: the black dots represent
the tiny openings (ostia) into the sinus cavities

sinus ostia.jpg
Image source: here

To try to get the saline to flow into these higher ostia in the nasal cavity, my first thought was to invert my head upside down while my nasal cavity was filled with saline.

To do this head inversion, I first filled my nasal cavity completely full with warm saline using a neti pot (done by looking upwards towards the ceiling while pouring in the saline). This I did while breathing through the mouth, because when you breath through the mouth, your nasal cavity becomes sealed off from your windpipe, so the saline you pour remains in your nasal cavity (it does not run down your throat). Once the nasal cavity was filled with saline, while still looking upwards, I then held my nostrils closed by pinching my nose with thumb and forefinger.

Finally, with the nose still pinched closed, I tucked my chin into my chest, and bent downwards until my head was level with my knees. This effectively inverts the head upside down. In this bent downwards body position, your nasal cavity is effectively rotated upside down like this:

Your nasal cavity when your head is inverted upside down
and filled with saline
sinus ostia upside down with blue water line.png

If the nasal cavity is fully filled with saline before you invert your head, the sinus ostia will all then be immersed underwater once you place your head upside down (the blue area in the above image shows the salty water in your nasal cavity; you can see that all the ostia are well below the water line when the head is inverted).

However, even in this upside down position, I found that not much saline gets in to the sinuses. And I realized why: it is because the sinus cavities are full of air, and the air cannot get out very easily, as the sinus openings (ostia) are very small. So if the air cannot escape, this means the saline cannot get in to the sinuses.

But there is an easy fix to this: while in this head upside down position, and with the nasal cavity full of saline, and with your nose still pinched closed, you close your mouth also, and then exert a suction or vacuum within your nasal cavity, by strongly breathing in with your lungs. Note: as long as you are upside down, the saline will not run down your throat.

Hold this suction for say 10 seconds, and then release the suction, re-open your mouth, and continue to breathe normally through your mouth for 20 seconds or so. But remain with your head inverted, down by your knees. And keep your nose pinched shut. Then repeat the process: close you mouth again, and create the suction again. You want to repeat this cycle several times.

Let me explain what happens during this suction process: while you are holding that suction for 10 seconds, air is pulled out of your sinuses through the ostia, and bubbles out into the saline in your nasal cavity. Then when you later release this suction, the saline in the nasal cavity rushes back through the ostia, into the sinuses to replace the air just sucked out. So in this way, you are able to get saline into your sinus cavities very efficiently.

Once you have repeated this suck-release cycle several times, and your sinuses are then filled with saline, you are nearly done. You can now stand up straight again, and just gently clear the excess saline out of your nasal cavity, and take a break for a minute or two, allowing the saline in the sinuses to do its job of purging and cleaning out the sinus infection or toxins.

After a minute or two's break, the final task is getting the saline out of the sinus cavities. This is easy, all you do is this: continue standing upright, and again pinch your nose closed so it is airtight, and again suck to create a vacuum in your nasal cavity. Create a nice strong suction, and this will pull most of the saline back out of your sinuses and into your nasal cavity. Then you can just blow this saline out into the sink, or into a tissue.

You can also choose to wait a little longer than just a minute or two before you suck out the saline from your sinuses. You might like to wait say 20 minutes or so, to give the saline a longer time to do its job in the sinuses.



I have used this inversion technique nasal irrigation hundreds of times over many years, and find it works well for cleaning out the nasal and sinus cavities.

Note: after doing this advanced nasal and sinus irrigation, you may find little runs of saline occasionally coming out of your nose over the next few hours. This is a good sign, as it means you did a good job in filling your sinus cavities with saline, and it's just the last remaining drips of saline from the sinuses that are coming out slightly later.
 
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Hip

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Great diagram showing the locations of the various sinus cavities:

Sinus Cavity Locations.jpg
Image source: here

Note that several sinus cavities (the frontal, ethmoid and sphenoid) are located above the nasal cavity, and since water does not travel upwards against gravity, standard nasal irritation will not get much saline into these high sinuses. But the inversion technique nasal irritation is able to fill all the sinus cavities with saline.



And this is an excellent YouTube video showing the positions of the various sinus cavities (worth watching the first minute of this video):

 
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One thing I'd like to add to @Hip's suggestion is that, if you do irrigate your sinuses it's a good idea to use either distilled water, sterile water (you can purchase these by the gallon at most pharmacies), or water that you have boiled for at least a few minutes and let cool. There can be small levels of bacteria and other organisms in tap water, and although these are safe to drink it is possible that they could cause infection in the nasal passages and sinuses.

Also, it's good practice to rinse out the neti pot or bottle and dry it completely after each use to discourage bacteria growth. If you irrigate you want to make sure that you're getting rid of infection in your sinuses, not inadvertently causing a new one!
 

Hip

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if you do irrigate your sinuses it's a good idea to use either distilled water, sterile water (you can purchase these by the gallon at most pharmacies), or water that you have boiled for at least a few minutes and let cool. There can be small levels of bacteria and other organisms in tap water, and although these are safe to drink it is possible that they could cause infection in the nasal passages and sinuses.
That's a good point. I've always used tap water (which in my area contains both chlorine and chloramine as disinfectants) in which I place some salt, and never had any trouble, but it's probably wise to use distilled or sterile water.

Looking at the FDA website, they say that nasal irrigation is usually safe and effective products, but they recommend using distilled, sterile or previously boiled water (boiled for 3 to 5 minutes). They say 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. But in your nose, these organisms can stay alive in nasal passages and cause potentially serious infections.



Interestingly enough, about 25 years ago, I managed to completely cure my pretty bad hay-fever by using this advanced inversion technique of nasal and sinus cleaning, along with taking lots of echinacea, vitamin C and gamma hydroxybutyrate (GHB), a supplement which was legal to buy at that time (GHB is also known as sodium oxybate or Xyrem).

Though I suspect GHB did most of the work, as GHB greatly increases growth hormone output, and growth hormone has been shown to prevent autoimmune diabetes, so perhaps may also modulate the immune system to quell allergies.
 
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I tried this technique 3 times with 0.5% NAC. It helps noticeably, but It's really hard to keep my head inverted between knees, I have to support myself with a chair, but last time I gave up after 10 sec in that position. Also, I feel pressure and pain on forehead and sinuses for about an hour after. Have you experienced something like this too? And is 0.5% NAC supposed to taste salty?
 

Hip

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Also, I feel pressure and pain on forehead and sinuses for about an hour after.
I have not experienced any side effects like that myself, but the Wikipedia article on nasal irrigation says:
Adverse effects include nasal irritation, nosebleeds, headache, and drainage after the irrigation is done. It is generally well-tolerated.
Are you using saline for your nasal irrigation, or just water? Water alone can be slightly irritating to the mucous membranes, because of the osmotic effects. Fluids within the body have the same salinity as physiological saline (physiological saline has 9 grams of sodium chloride per liter). So to minimize irritation it is best to make up some physiological saline and use that for nasal irrigation.

Then if you also want to add the NAC to the saline, you can do so. But it might be an idea to start with pure saline first, and see how that goes for a few weeks, before adding NAC.


You do not have to stay a long time in the inverted head position, just enough time to allow the saline to be sucked into your sinus cavities. Even 10 seconds I think should be enough.
 
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I tried this with only sodium chloride 0.9% and didn't feel any side-effects at all, also standing with my head inverted was easy this time. later the day I tried 3 more irrigation solutions:
1)sodium chloride with salt - it was the same as with sodium chloride only.
2)Boiled water only - also the same as sodium chloride only.
3) sodium chloride with NAC - I got immediate reaction, a very salty and acidly feel in nose. I immediately had to stop.

Ether I can try NAC 0.2% solution or problem is in NAC that I'm taking (this one), one capsule has:
NAC 600mg
Selenium (from L-Selenomethionine) 25 mcg
Molybdenum (from Sodium Molybdate) 50 mcg

Maybe Molybdenum or Selenium are causing side effects?
What NAC would you recommend for this? I though of this one.
 
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gbells

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One thing I'd like to add to @Hip's suggestion is that, if you do irrigate your sinuses it's a good idea to use either distilled water, sterile water (you can purchase these by the gallon at most pharmacies), or water that you have boiled for at least a few minutes and let cool. There can be small levels of bacteria and other organisms in tap water, and although these are safe to drink it is possible that they could cause infection in the nasal passages and sinuses.

Also, it's good practice to rinse out the neti pot or bottle and dry it completely after each use to discourage bacteria growth. If you irrigate you want to make sure that you're getting rid of infection in your sinuses, not inadvertently causing a new one!
According to the neti pot instructions they recommend tap water sterilized in the microwave.
 

Hip

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I got immediate reaction, a very salty and acidly feel in nose.
Anything that is acidic (has a tart taste) will sting like hell if the pure compound is placed in the nose (I once experimentally snorted a small amount of ascorbic acid powder into my nose, and had to immediately rush to the bathroom in excruciating pain to try to wash it out!).

If you taste N-acetyl-cysteine (NAC) powder from a capsule, it has a strong acidic taste, so you know this will sting in the nose unless greatly diluted. It may be that your 0.5% dilution is not sufficient. Perhaps try 0.05% or lower and see if that is better tolerated.

Remember with this "advanced" nasal irrigation technique, you get a lot of liquid into the sinus cavities, and this liquid can remain in these cavities for hours afterwards. When I have finished doing this nasal irrigation, I usually blow most of the liquid out of my sinuses. I do this by turning my head through various angles (especially ear-facing-towards-the-floor angles) and blowing my nose, which flushes a lot of the liquid out. Even then, you still get small runs of liquid coming out of your nose in the subsequent hours.

But you can also choose to leave the saline liquid in the sinus cavities for some hours afterward, by omitting this flushing step. So then the liquid will be present in your sinuses for some hours. So although you may use a low concentration of NAC, it will be working for some time in the sinuses.


I would not have thought the molybdenum or selenium would be an issue, as these are not acidic. But it might be better to obtain a pure NAC supplement like the one you linked to.
 
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