Could nasal douching help prevent swine flu? IRISHTIMES article by Dr Paul Carson

irishtimes.com/newspaper/he...

interesting article.

MEDICAL MATTERS: Nasal douching, common in other countries, seems to stop infections settling in, writes PAUL CARSON .

ADVICE TO the public about A (H1N1) swine flu virus seems to change daily.

In Britain an NHS mail shot has these tips:

Catch it – catch your cough or sneeze in a tissue.

Bin it – dispose of tissues ASAP.

Kill it – hands transfer germs. Wash your hands frequently with soap and water. Clean hard surfaces (eg door handles) using standard products.

That’s fine for the general public but what about those at the front line of treatment? How do they protect themselves from catching the bug? Here the HSE has responded quickly and pragmatically by dispatching a ‘prevention pack’ that includes special face masks, gloves and surgical-type aprons. All to be used when dealing with suspect cases.

Another simple, cheap and possibly effective DIY idea is nasal douching. Using a plastic squeeze bottle (Neilmed Sinus Rinse; neilmed.com) the nose, sinuses and upper part of the back of the throat can be irrigated with a saline and baking soda mixture.

Large, controlled studies of nasal douching for treating and preventing cold, flu and sinus infections are hard to come by. However the little data available seems to support the practice.

A study of more than 200 patients published in the journal Laryngoscope (2000) found that after three to six weeks of nasal douching, patients reported statistically fewer nasal/sinusitis symptoms.

A 1997 study involving 21 volunteers (same journal) found that douching improved the speed with which nasal cilia were able to move mucus along. A 1998 study in children published in the Journal of Allergy and Clinical Immunology showed that douching is ‘tolerable, inexpensive, and effective’.

Contrast this with blowing your nose for relief of head colds. This may be harmful as it reverses the flow of mucus and slows sinus drainage.

University of Virginia investigators evaluated subjects as they coughed, sneezed and blew their noses. Coughing and sneezing generated little pressure whereas nose blowing produced enormous pressure, propelling mucus into the sinuses. During sickness this can shoot viruses or bacteria into the sinuses, and possibly cause further infection. It may even force airborne infection further back into nose and throat. There they could burrow their way into the circulation.

While mucus production from the nose and sinus lining is normal, airborne infections can trigger excessive output. This causes a runny and stuffy nose or post-nasal drip. Common sense suggests washing away (douching) mucus from the nasal passages might be helpful in fighting viral disease.

Douching also reduces inflammation of the nose, allowing you breathe more normally.

Nasal douching:

- Rids allergy provoking material in your nose.

- Rids pockets of infection that might be forming.

- Clears your nose, making it easier to breath.

- Moisturises your nose.

- Feels refreshing.

In Oriental cultures nasal douching is considered an effective, low cost and simple therapy, free of side effects. There they sniff the fluid from the palm of the hand.

Nasal showers are marketed in health food stores.

These are claimed to free the nose of the congested secretions and mucus that create a breeding ground for bacteria. The Neti Pot is a container designed to rinse the nasal cavity.

In the US, hydro pulse systems are popular. Here a pulsating stream cleanses and moisturises the nose and sinuses, removes foreign matter, crusts and other undesirable materials.

One US specialist reported that many patients who have sinus disease, allergies or chronic infections are helped by douching their noses daily.

Nasal douching is now the mainstay of treatment for patients who have had sinus surgery or persisting sinus symptoms.

However it’s something I’m suggesting as a possible method of dealing with airborne infections.

It should not be used by anyone suffering acute flu-like illnesses as it might drive the virus deeper.

However it’s worth considering in those dealing with patients showing swine flu symptoms. This includes GPs, emergency room doctors and nurses, paramedics and community nurses.

So as an update to those NHS tips, having caught it in a tissues, binned it ASAP and washed your hands and hard surfaces you could also:

Wash it – keep your nose clean by douching with a saline/baking soda solution. It may prevent the A (H1N1) virus from settling in.

Dr Paul Carson is a GP with the Slievemore Clinic, in Dublin

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