Nasal irrigation:
Although nasal irrigation is an age-old technique used in yogic and Ayurvedic traditions, in the past few years it has come into the western world spotlight. Several studies have shown nasal irrigation to be a safe and effective way to flush away allergens and sinus mucus. For chronic allergy sufferers, it has been shown to significantly reduce the amount of topical steroid used, and is a safe therapy for pregnant women. Neti pots have made their way onto Oprah, NPR, the New York Times and many other news broadcasts… because they work!

How it works:
Our noses and sinuses are lined with a thin layer of mucus, which is one of our body's first lines of defense against disease. Pollen, dirt and other allergens that we breathe in attach to the mucous lining, cleaning the air as it makes its way to our lungs. However, these particles can irritate the mucus membrane and cause allergy symptoms. There are also small hairs in our nose and sinuses that move back and forth pushing the allergen particles trapped on the mucus membrane backwards into the area where our nasal passage meets the throat. Nasal irrigation keeps the mucus layer moist and clean while encouraging the small hairs to move faster, further clearing the nose and sinuses.

How to irrigate your sinuses:
There are several ways to irrigate your sinuses: a neti pot can be found at most health food stores, a water bottle that can be squeezed, or a saline nasal wash that can be found at most drug stores.  Environmentally, I recommend using a reusable neti pot or water bottle and making your own saline solution. Neti pots tend to be the most comfortable to use and can be easily cleaned.

To make saline solution, add a rounded ½ teaspoon of non-iodized salt such as kosher salt to your neti pot or water bottle. (If you use a finely ground salt, use a rounded ¼ teaspoon) Add 8 ounces of warm water and mix until the salt is completely dissolved. If the water is too cold or hot, it may increase congestion and irritate the lining of the nose.

Head position is important to properly wash out the sinuses and not have the saline trickle down the back of your throat. Lean over the sink so you are looking directly into the basin, then rotate your head to one side so that one nostril is directly above the other. Your forehead should remain level with the chin. Gently insert the spout into the upper nostril so that it forms a comfortable seal. Keep your mouth open and raise the handle of the neti pot (or water bottle) so that the solution enters the upper nostril and drains out through the lower. If using a water bottle, gently squeeze the bottle to create a slow flow of saline. If your head is rotated correctly and tilted at the proper angle, you should be able to breathe comfortably through your mouth while the saline flushes the nose and sinuses. If your forehead is higher than the chin, the saline will drain into your mouth, so keep your forehead down to avoid this. When the neti pot is empty, rotate your head down so you are looking into the sink and exhale through both nostrils to clean them of excess mucus and water. When both nostrils are clear, make more saline solution in the neti pot (or water bottle) and repeat the procedure on the other side. After the container is empty, clear the nostrils as before.

Wash the container with soap and water and allow to air dry.

For an instructional video, see the Himalayan Institute. 

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Approximately 20 percent of people are affected by allergies. They are caused by an overreaction of the immune system to allergens, which are divided into four main categories: pollens, insects, animal dander and molds. Along with working with your doctor, identifying allergic triggers and avoiding them is the most reliable way to treat seasonal allergies.

At home, the best ways to decrease allergens is to keep a clean house. Dust mites live on the floor, on surfaces as well as in bedding. Regular dusting and vacuuming with a HEPA filter, as well as removal of carpet in the bedroom will greatly reduce dust mites. Encasing mattresses and pillows in allergen-impermeable covers, using finely woven bedding and washing sheets weekly is helpful. Upholstered furniture is more allergenic compared to leather or wood. If pet dander is a trigger, avoid pets with feathers or fur in the home. If you have an indoor pet, keep them out of the bedroom and cover air ducts that lead to the bedroom with filters. Avoid mold allergens by fixing water leaks, reducing indoor humidity to less than 50%, cleaning moldy surfaces with a dilute bleach solution and limiting houseplants. Dehumidifiers can also help with mold problems. An estimated 35 million Americans suffer from pollen allergies, so keeping windows shut and clean can help reduce indoor pollen. HEPA air filters or running the air conditioner and regularly cleaning the filter is very helpful in riding indoor air of allergens.

Consider environments outside of the home as well: classrooms and cars can be prime allergy locations. Keep cars clean and vacuumed; turn on the air conditioner or heater before getting into the car and travel with the windows up. Outdoor air quality is typically better in the morning and in the evening.

There are several options for treating allergies if symptoms persist. Antihistamines and decongestants are the most common medications used for allergies. Though useful, antihistamines can cause drowsiness, and decongestants may actually worsen nose stuffiness if used for more than 3 days. Allergy shots may be helpful for those with severe allergies, but the best treatment is still identifying and avoiding your child’s allergy triggers. Twice daily nasal irrigation with a neti pot or saline rinse has been shown to significantly reduce allergy symptoms. Over the counter Similasan Allergy Eye Relief drops are also helpful for itchy eyes. Dietary changes may be useful: avoiding dairy can thin nasal secretions, and in some children, avoidance of gluten or other foods can decrease hyperactive immune response to allergens. Several herbal medicines have also been studied and shown to help with allergy symptoms.

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