Over the last ten years, neti pots have become very popular for people who have problems with their sinuses - they are also used for relieving symptoms of a cold and various allergies. The user fills a neti pot with a salt-based (saline) solution, tilts their head back and pours the solution into one nostril, the liquid goes up their nose and comes out of the other nostril.
The FDA informed today that the improper use of neti pots, as well as other devices for rinsing out the sinuses, including squeeze bottles, battery-operated pulsed water devices, and bulb syringes have been linked to a higher risk of infection.
The FDA says it is informing doctors, other health care professionals, device makers and users about the safe practice of devices used for rinsing the nasal passages.
Steven Osborne, M.D., a medical officer in FDA's Center for Devices and Radiological Health (CDRH), emphasized that these devices are safe and useful overall, as long as they are properly used and cleaned.
Users have to make sure the liquid is a dedicated saline nasal rinse. Do not use tap water or any form of unsterilized liquid. Tap water generally has small amount of bacteria, protozoa and other microorganisms, including amoebas, which is OK if we swallow them, but should not go into our nasal passages. If they do, they can remain there, alive, and eventually cause serious infections.
Last year, two neti pot users in Louisiana lost their lives after using water tainted with Naegleria fowleri, a type of amoeba.
Neti pot manufacturers need better and clearer instructionsAccording to the FDA, some makers of neti pots provide misleading and contradictory data; some have no guidelines at all. The Agency added that neti pots made by artists commonly have no instructions on their use.
A number of instructions have pictures or videos of people using plain tap water, while at the same time write in the instructions that tap water should not be used.
Below are some details of how to go about rinsing your nasal passage with one of these devices (might vary, depending on which product you are using):
- Lean over a sink
- Tilt your head to one side so that your forehead and chin are at approximately the same level, this prevents water getting into your mouth
- Your breathing from now on is done through your mouth
- Place the spout into your upper nostril and pour the solution so that it drains through the lower nostril
- Blow your nose (clear your nostrils) and do it again on the other side
If the instructions on your neti pot are not clear, you should check with a pharmacist or health care professional, the FDA added.
Only use the following types of water for nasal rinses
- Sterile or distilled water. When you buy them, check the label says "sterile" or "distilled"
- Boiled tap water. It must be boiled for three to five minutes, and then allowed to cool down. If you store it in a clean, closed container, it will be good for use for no more than 24 hours.
- Water that has gone through a filter with an absolute pore size of 1 micron maximum.