Dr. Grossan's Ear, Nose and Throat Consultant Pages

      Ear, Nose, and Throat Frequently Asked Questions

What is Pulsatile Nasal Irrigation?

"I've heard about nasal irrigation, but what is it? Is it uncomfortable? Is it Painful? Won't I feel Like I'm drowning? Does it matter how I do it?"

Let's take these questions one at a time:

What is nasal irrigation?
Nasal irrigation is cleaning out your nose with a fluid. When you have a horrible head cold, or your nose is running with allergies, you've probably wished you could just flush your sinuses and nasal passages clean somehow. Well, doctors have done this for many years, it used to be called a "Proetz machine", and it forced a solution of salty water into your nose to clean out the sinuses. (Now there is also the Netti or Neti Pot, the bulb, and the syringe.) The trouble is, it was often only a temporary, symptomatic relief. On the other hand, ancient yogies seemed to have some success with curing their colds and sinus problems by snorting salt water rhythmically. In the late 60's I was experimenting with different ways of irrigating, and measuring the effect on health, and I found that irrigating with a stream of water which varied rhythmically, or pulsated, actually measurably improved the body's ability to fight infection and get well. It wasn't just temporary relief, we measured improvement in the action of the nasal cilia, the body's principle disease-fighting mechanism in the sinuses. This was the big breakthrough for nasal irrigation, pulsatile nasal irrigation, now used by thousands of doctors and tens of thousands of patients around the world. Dozens of journal articles document this benefit. More on pulsatile irrigation and your nasal and sinus cilia.

Will it hurt, or make me feel like I'm drowning?
NEVER put any fluid in your nose without a doctor's instructions. If you get fresh water in your nose, it will indeed be painful and somewhat harmful. This is because the delicate membranes of your nose and sinuses need their own precise saltiness, called "isotonic", or else the membrane doesn't work right and registers pain. However, the correct saline mixture produces NO discomfort, and in fact a warm saline solution cleansing your blocked sinuses is quite pleasant – you will feel relieved.

Does it matter how I do it?
Yes, it does matter. As I said above, using a "Proetz machine" and the like, that is, just running some saline through your nose, doesn't really work. While simply moisturizing your nose and sinuses with saline can be beneficial, the method that shows real improvement in the body's ability to fight off disease and heal is afforded by pulsatile nasal irrigation. When using the yogic rhythmic snorting method, one would have to practice until just the right pressure and rhythm were achieved, one would have to learn to mix the saline just right, etc. It would be a lot of work, impractical for anyone but a yogi really, which is why I don't recommend this. Other methods that do not provide pulsation are inferior. I have a number of patients that come to me and don't want to try irrigation because they used some other method such as the Netti or Neti Pot or similar devices, and had little benefit. Pulsatile irrigation is different! The pulsation action is essential to restoring your body's defenses, the nasal and sinus cilia, to healthy function. Patient's who used the Neti Pot and other methods also complained of a lot of dripping and mess on the clothes. With pulsatile irrigation, you control the flow of saline through a convenient tip which prevents spills, so there is no mess. Other methods reply on pressure alone to remove blockage; sufficient pressure can be very harmful. Use a pulsatile irrigation device that is purpose-built for nasal and sinus irrigation, which delivers only gentle pressure when used as directed, and which relies on the pulsating action for removing blockage.

Salines and similar mixes are NOT all the same. The best solution to use is not simply isotonic saline but an enhanced nasal/sinus moisturizing formula that is more complex, one that is more gentle than pure saline and has other ingredients to make it an improved nasal and sinus moisturizer. Always avoid saline moisturizers and sprays containing preservatives or other additives, which make my patients worse!

Did you know that pulsatile irrigation can prevent colds? No kidding!

If you're an allergy or sinus sufferer, I hope you will start irrigating with pulsatile irrigation so you can get better right away!

Can we help you? - We cannot give specific medical advice, but if you have any other questions or suggestions (Where do I find the items mentioned here...? Is this other resource a good one, you don't mention it....?, etc.) please don't hesitate to ask us at ENTConsult@aol.com. (We answer most questions, but we apologize in advance if we do not get to yours.)

What is Pulsatile Throat Irrigation?

Pulsatile irrigation of the throat removes bacteria from the throat and increases circulation to the throat, making more white blood cells, the body's natural defense against invading contagions, available at the throat. This safe, simple, druggless method is an important alternative at a time when the effectiveness of drugs is diminished by the rapid appearance of drug-resistant diseases. A bibliography of medical and other literature about pulsatile throat irrigation is given here.


Allergies - I've Tried Everything

"I have had allergy tests and shots, cortisone nasal sprays, antihistamine samples including Claratin, Seldane, etc and nothing helps. My nose is plugged and I am miserable for weeks at a time. What can I do ?"

Answer: Your problem could be:

Sounds like you have a situation of exhaustion. The body makes its own cortisone like products, but after sneezing and hacking for so long, the natural body products are simply exhausted and therefore nothing works.

Many years ago before they had our modern Prednisone and antihistamines they would get patients like you well by simply putting you to bed for 1 or 2 weeks at rest, allowing your body to recoup. This is the theme of an excellent book by Dr Robert S Ivker called Sinus Survival published by G P Putman. He, among other things, takes his patients off all medication and puts his patients to rest So one suggestion is to go to bed and rest.

Another factor may be one of anxiety reinforcing your symptoms. The more you sneeze, the more anxious and nervous you get, the more you sneeze, more anxious and so on. You must break the anxiety reinforcement cycle. Bed rest, an antihistamine such as Benadryl which helps you to rest is good, or the doctor may want to prescribe a mood elevator drug to help break the cycle. See Relaxation Exercises

Sometimes a short course of Prednisone or Medrol will put your natural cortisone system at rest and allow a rejuvenation just like going to bed for a week. After the body rejuvenates, then the standard antihistamines will work

Another cause of failure is in diet. Things that prolong an allergy are spicy foods like peppers, chili, hot sauces. Ice drinks make the allergy worse. Switch to hot tea. Avoid all spices. Is the bed room dustproofed? Remove dustmakers, filter the hot air furnace, remove the pets from the bedroom. Hot tea before getting out of bed in the morning is helpful.

If you or your doctor suspect a food allergy, try eating everything cooked or canned - cooking the food breaks down the complex proteins and makes them less allergenic. Try limiting your diet to the foods that you think are "safe" and then add new foods once a week.

Some people have low thyroid and this will cause allergy treatment failure. Ask for a thyroid blood test. Sometimes we give a trial of thyroid medication.

There may be a minimal of infection that causes a lot of allergy symptoms. Many patients report excellent relief of allergy symptoms using pulsatile irrigation. Pulsatile irrigation can be performed at home, by yourself, and clears the infection and removes pollen and dust products from the nose. Just as you clean your hands after handling dirt, allergy patients should use the irrigator to wash out pollen and dust after exposure. In Los Angeles, my patients irrigate to wash out their sinuses after a visit to downtown smog.


What Are Proteolytic Enzymes?

Enzymes break down proteins. They are used in cooking to soften meat, as they weaken tough muscle fibers. Enzymes have been used as a treatment to thin mucous and reduce swelling. They can be great for problems like thick mucous, problems clearing your ears, and for any kind of bruise (boxers like them). They can be very effective, and quite safe as long as you are not allergic to them or the plant they may be derived from, but you have to be careful about where you get them from and how you use them.

A good proteolytic enzyme formula is a bromelain/papain preparation that has calibrated enzyme activity - other enzyme preparations sold as supplements have enzyme activity so low they do no good. Proteolytic enzyme lozenges should be dissolved in the mouth between the cheek and the gums. Many commercial preparations are made to be chewed or swallowed - often this has little effect, since the enzymes are inactivated by stomach acids. Try to buy proteolytic enzymes that have calibrated enzyme activity, and dissolve them between your cheek and gum.

©2001, 2003, 2006

Can we help you? - We cannot give specific medical advice, but if you have any other questions or suggestions please don't hesitate to ask us at ENTConsult@aol.com. (We answer most questions, but we apologize in advance if we do not get to yours.)


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Murray Grossan M.D.