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Fundamental functions: ENT
Prairie Doc
Debra Johnston, MD

I confess that occasionally even doctors get squeamish. Or perhaps more honestly, this doctor does. My personal list has gotten pretty short, but one of the things that still makes me squirm is something I nevertheless frequently recommend to my patients. 

So what is this mysterious and rather ominous medical recommendation? Nasal saline irrigation.

The practice of rinsing the nose out with liquid probably originated centuries ago in India, and it remains part of spiritual ritual as well as traditional medicine around the world. However, it isn’t something I learned about in medical school. Western medical research into it began in earnest perhaps 25 to 30 years ago. 

How does this rather torturous sounding practice help? It physically removes germs, allergen and irritant particles, it loosens thick mucous, and it helps the cilia — the tiny hairs lining our airways— clean things out.   

Although the practice is generally safe for almost everyone, there is one very important caveat. Your equipment must be clean, and the solution used prepared with sterile or distilled water, to prevent a very rare, but highly deadly, infection. 

When I tell someone I think they should flush a cup or so of salt water into one nostril and out the other one, and then do it again from the other side, they usually react with dismay. I freely admit that the idea sounds pretty awful, and that it makes my toes curl every time I suggest it. Then I tell them a story. 

I first recommended this for a patient who was all of 7 years old. Her horrible allergies and chronic sinus problems triggered frequent asthma attacks. She had a collection of inhalers and pills from the allergist, her dad had torn up the carpet, and the family dog was bathed twice a week and banished to the back yard. Parents, child, and doctor were all a little desperate. When I rather hesitantly suggested nasal saline irrigation, her mom was willing to try it. 

A month later, my little patient came dancing down the hallway, announcing with glee “Dr. Deb, Dr. Deb, I love my Netti Pot!” The simple act of regularly rinsing the allergens and irritants out of her nose had improved her symptoms so much that she could play outside with her dog. Now I tell my reluctant patients that if a literal child can do it, we can borrow some of her courage and try it too.

If you suffer from chronic sinus problems, or even just the next time a cold or allergies has you stuffed up and miserable, ask your doctor if you should grit your teeth and give it a try.


Richard P. Holm, MD passed away in March 2020 after a battle with pancreatic cancer. He is founder of The Prairie Doc®. For free and easy access to the entire Prairie Doc® ® library, visitwww.prairiedoc.organd follow Prairie Doc® on Facebook.

Debra Johnson, M.D. is part of The Prairie Doc® team of physicians and currently practices family medicine in Brookings, South Dakota.