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What is Pulsatile Irrigation?


The most important mechanism your body uses to maintain good upper respiratory health is the cilia of the sinuses and chest.

Cilia are microscopic hair-like cells which line the sinuses and chest. They are covered by a mucous blanket which contains all sorts of disease-fighting elements such as enzymes and good white cells. Normally bacteria and toxins are trapped in this liquid blanket. The cilia then move in one direction - a snap forward and a slow return - much like oars on a row boat - that moves this mucous blanket. Normally the bacteria enters the nose. It gets trapped in the mucous blanket and the cilia move that liquid to the back of the throat. It gets swallowed and the stomach acid disposes of that bacteria. In the chest it is moved up out of the chest.

Unfortunately, sometimes the cilia slow down. When they do, the bacteria can multiply and result in an infection.

Cilia can also speed up. In acute allergy, when the pollen starts, the nose drips because the cilia are moving much faster. Many people get this when they take spicy soups. In allergy, the cilia speed up at first, but in the late stages - after sneezing for several weeks, they can be exhausted and slow down and that is when infection can take place.

Doctors were measuring cilia speed many years ago by putting particles of carbon paper in the nose and measuring the speed of those particles. Later, sophisticated counters measured the speed of movement of radio-active particles. A simpler, alternative method, "the saccharin test", can be performed in any doctor's office: Place a particle of saccharin in the nose and time how long it takes to be tasted. Normally the saccharin is tasted in 5-8 minutes. In sinus disease due to slow cilia, it is tasted in 25 minutes or longer.

Today we know that the benefits of tea ( black or green), and chicken soup are largely due to the cilia-stimulating effect that they produce. The ancient yogas used sound, "OOOOMMMMM" and the vibration of the air also stimulated cilia. There is even a device, similar to a toy kazoo, that is used to produce a vibration that helps cilia movement.

Another excellent method of the yogi is to gently and rapidly sniff salt water in and out the nose. This in-and-out movement can match the normal cilia speed and stimulate cilia movement. However, learning the exact gentle pressure, and the correct rhythm is very difficult. Instead of spending months learning to do this correctly, we use a mechanical device that produces a low pressure, and the correct frequency of pulsation - pulsatile irrigation of the nose and sinuses.

Pulsatile irrigation is the method that is easiest and has been shown to have advantages over other types of treatment. A saline solution is prepared and the device is tested so that the pressure is set correctly at a safe level. As the pulsating solution passes in one nostril and out the other, and unwanted stale mucus is removed. The pulsation is at a rate calculated to get slow cilia moving. As the solution flows past the sinus openings there is a Bernoulli or vacuum effect that pulls stale material out of the sinus to be replaced by the solution. This effect is enhanced by the pulsing action as well.

When persons take an antibiotic for sinus infection, usually the antibiotic successfully kills the bacteria. But then an infection can re-occur in a few weeks if the nasal cilia have not returned to full speed.

Serious or chronic sinus problems are often treated with surgery. Despite the arrival of better diagnostic tools (such as better CT scans just for sinuses), better training for sinus surgeons, and improved techniques such as balloon sinuplasty, there are still poor outcomes for many sinus surgery. It is still best to avoid surgery whenever possible. Ask your doctor about trying pulsatile irrigation first, as an alternative to surgery. While surgery is sometimes necessary, often the root cause of the problem is simply slow cilia - which can be improved with pulsatile irrigation.

For the 37 million persons with sinus disease, use of these pulsatile irrigation to improve cilia function can be a major benefit. If you have tried the tea and chicken soup and the "oooommmm", ask your doctor about adding pulsatile irrigation to your therapeutic regime.

©2010 Hydro Med Inc.

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Last Update 2010 May 22
Murray Grossan M.D.