With the ever increasing incidence of respiratory illness, the practice of nasal irrigation or nasal cleansing (Neti kriya) serves as a panacea for helping improve the lives of many people. Although several methods of nasal irrigation exist, one of the most popular is the Neti pot or Jal neti technique.
In this article, you will get to know all about the Neti pot or Jal neti. We’ll explore Neti pots for colds, Neti post for sinus infections and Neti pots for tinnitis. Neti pots are a great and natural way to get relief from the symptoms of sinus infection, cold and associated tinnitus. Keep reading. Here’s what we’ll cover.
What Is Nasal Irrigation Or Neti Kriya? The Importance Of Saline Nasal Irrigation: Modern Perspective Sinus Infections, Common Colds + Tinnitis Why The Nostrils Are Important In The Management Of Sinus Infection, Common Cold And Tinnitus What’s A Neti Pot? How To Use A Neti Pot When To See The Doctor When To Use A Neti Pot Neti Pots For Colds + Neti Pots For Sinus Infections Evidence Related To Neti Pot Or Jal Neti Therapy
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What Is Nasal Irrigation Or Neti Kriya?
Nasal irrigation (Neti kriya) is considered one of the simplest yet powerful processes for nasal hygiene. It is traditionally used by yoga therapists in most respiratory related problems including sinus infection (sinusitis), cold, tinnitus, asthma, bronchitis, headache, sleep apnea and allergies. It is one of the six-purification procedures or Shatkarmas mentioned in the Hatha Yoga Pradeepika.
According to yoga experts Neti pots are advised in problems related to supraclavicular region, the area above the clavicle (urdhvajatrugata roga). In this process, nasal passage, nasopharynx and oropharynx are cleaned with simple saline water irrigation via a Neti pot (Jal Neti) or using a thread (Sutra neti).1 Since using a thread (Sutra neti) is inconvenient, contemporary naturopaths and yoga experts promote the Neti pot or Jala neti.
The Importance Of Saline Nasal Irrigation: Modern Perspective
Research concludes that saline nasal irrigation removes all the dirt and bacteria filled mucous from the nasal cavity. According to the research, this process improves the function of the nasal mucosa by direct nasal cleansing or irrigation. This improves mucociliary function in the nasal and sinus cavity, thereby effectively removing inflammatory mediators such as bacteria, allergens, and other irritants that cause sinus problems and other associated problems.2
Now let’s have a brief look at sinus infections, common colds and tinnitus along with their Ayurvedic perspective.
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Sinus Infections, Common Colds + Tinnitis
1. Sinus Infections (Sinusitis Or Kaphaja Shiroroga)
In Ayurveda, sinus infection or sinusitis can be compared to Kaphaja variety of diseases of the head (Kaphaja Shiroroga). Sinus infection or sinusitis is the inflammation of the paranasal sinuses which are air filled spaces within the bones of the skull and facial bone, located in the head region. It is caused by infection, allergies, air pollution or structural problems in the nose.
Common symptoms include thick nasal mucus, a plugged nose, and pain in the face. Other symptoms may include fever, headaches, sore throat and cough. Headache caused by the mucus build-up as a result of inflammation and pressure within the sinuses during a sinus infection is more of a dull type. Its management includes proper drainage and ventilation of sinuses through nasal passage.
Ayurveda considers the head as the main site of Kapha dosha. With an intake of Kapha aggravating factors like being in a continuous relaxing posture (Asyasukha), having heavy food (Guru) or unctuous food (Snigdha), there is vitiation of Kapha (Kapha dushti) which accumulates in the head. When this Kapha accumulation comes in contact with some immediate factors (Sannikrushta Nidana) like dust particles (raja) and cold air (Sheet Vayu), there is aggravation of all the three doshas (Tridosha Prakopa) causing vitiation of the blood (Rakta Dushti). This vitiated blood (Dushitarakta) in turn aggravates the vitiated Kapha (Dushita Kapha) in the head leading to Kaphaja variety of disease of the head (Kaphaja Shiroroga).3
The symptoms of Kaphaja Shiroroga4 as described by the ancient sage Sushruta are heaviness and fullness of the head (Guru Pratishtabdham), coldness in the head (Himam), swelling of the face especially around the eyes (Shunakshikootvadnam), dull headache (mandruk5 or Shiroabhitapa), and a feeling of having a coating of phlegm inside the head or throat (Shirogalam Kaphaaupdigdham).
The mode of treatment in Kaphaja Shiroroga is removal or purification of the aggravated dosha (Dosha Apkarshana) from the head and neck region (Urdhvajatru Pradesha).6
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2. Common Cold (Pratishyaya)
Common cold is a viral infectious disease of the upper respiratory tract that primarily affects the nose. The throat, sinuses, and larynx may also be affected. Signs and symptoms include coughing, sore throat, runny nose, sneezing, headache and fever. It is managed by getting plenty of rest, drinking fluids to maintain hydration and gargling with warm salt water .
Nasal irrigation is very useful in this condition. This helps in reduction of the congestion and washing of the thick secretions.
According to Ayurveda, pratishyaya disorder is related primary to the nasal region but it affects all of the body’s systems. According to the ancient Ayurvedic sage Charaka, due to the suppression of natural urges (vegadharana), coming in contact of pollen grains, dust particles (raja) and drinking cold water (Sheetambu paan), all the doshas get accumulated in the head region and this results in aggravation of Vata dosha in the head, resulting in pratishyaya.7
Sushruta, another Ayurveda master, also opines that the immediate causes of this condition are excessive sexual activity (nari prasanga), exposure of the head to excessive heat like the summer sun (shirashabhitapam), smoke (dhum), dust, pollen, environmental pollutants (raja), exposure to excessive cold or heat (shitamatipratapa), suppression of the urge for urination and defecation (mutrapurishasandharanam). He further says that in this disease there is a vitiation of Vata and other doshas individually or collectively associated with or without blood (rakta) accumulating in the head, resulting in pratishyaya.8
Whereas the vitiation of Vata dosha in the nasal cavity leads to pratishyaya as mentioned by the Ayurvedic sage Vagbhatta9, its symptoms seem to correlate with that of the common cold which includes nasal discharge (Nasa Srava), sneezing (Kshavathu), nasal obstruction (Nasavarodha), headache (Shirahshoola), change of voice (Swarabheda), loss of smell (Ghrana Viplava), heaviness in the head (Shirogaurava), fever (Jwara), cough (Kasa) and halitosis (Mukha daurgandhya).10 Nasal instillation (Nasya) is prescribed in this condition.11
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3. Tinnitus (Karna Nada / Kranakshweda)
Tinnitus is a condition of hearing sound when no external sound is present. In this condition, there is a perception of noise like buzzing, hissing or ringing in the ears resulting from age-related hearing loss, ear injury or a circulatory system disorder. It is a symptom that can result from a number of underlying causes.
It may be caused by increased neural activity in the auditory brainstem where the brain processes sound, causing some auditory nerve cells to become over-excited. Its management is to treat the underlying cause.
Nasal congestion from a severe cold, flu, or sinus infection can create abnormal pressure in the middle ear, impacting normal hearing and causing tinnitus symptoms. If tinnitus is caused by cold or sinus infection or is a result of the clogged inner ear tube (eustachian tube), Neti pot or Jal neti is generally considered for its management in yoga text books.
According to Ayurveda, when the vitiated Vata Dosha enters into the auditory nerve and injures the ears, one feels sounds of different frequencies like ringing, whistling or buzzing (bheri, mrudang shabdanam). This condition is called Karna nada.12
The ancient Ayurvedic sage Sushruta suggests that due to excessive debility, exhaustion, intake of dry, astringent food, aggravation of Vata occurs which effects the auditory nerves (sabdavahanadi) in the ear. As a result, sounds of different frequencies, similar to a flute sound (shweda) are produced. This condition is called kranakshweda.13 Both these conditions resemble tinnitus. According to Ayurveda, it is treated by nasal instillation (Nasya).14
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Why The Nostrils Are Important In The Management Of Sinus Infection, Common Cold And Tinnitus
The nose is the portal (gateway) of the head. As the nose is internally linked with the brain, any instillation in the nose through the nostrils directly affects the brain and its pathology.15 According to an Ayurvedic classic Ashtanga Samgraha, the nose (Nasa) being the doorway to the head (Shira), any instillation administered through the nostrils, reaches the marma or vital point (Shringataka marma) which is predominantly formed by the union of blood vessels (Siras) and supplies to the nose, ear, eye and tongue by nasal channels (Nasasrota). After reaching there, it spreads into the brain (Murdha) taking route of the eye (Netra), ear (Shrotra), throat (Kantha) and the opening of the vessels (Siramukhas). It scrapes the morbid doshas present in the supraclavicular region and extracts them from the head (Uttamanga).16
As all these disorders (sinusitis, common cold, tinnitus) are related to the head and neck region and the treatment of these conditions can be achieved particularly through the nostrils according to the Ayurvedic classical texts, so the nostrils are considered the best route for the management of these pathologies.
Now let’s come back to the Neti pot or Jal neti therapy.
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What’s A Neti Pot?
A Neti pot is a small ceramic or stainless steel pot used for nasal irrigation, rinsing, washing or douching with lukewarm salty water. It resembles a small teapot with a long, tapered spout. This pot has a capacity of 200 ml. All the diseases occurring in the head, neck, eye, ear and nose can be generally dealt with Neti pot or Jal neti therapy.
How To Use A Neti Pot17
A Neti pot is filled with lukewarm salt water. Traditionally Jal neti is performed by squatting on the toes in crow posture (Kagasana) but one can practice it standing with feet apart, body weight evenly distributed between two feet. Tilt the face to look upwards and sideward. The spout is inserted in one nostril and the head is bent to the other side. The mouth is open wide and breathing is done with the mouth during this procedure. The lukewarm salt water is poured slowly through the nasal cavity. It will come out the other nostril. If the saline water enters into the throat, it should be spit out. After this the nostril are blown gently to get rid of residual water. This process is repeated with the other nostril. At the end, the nose is dried properly by exhaling gently (Kapalbhati Pranayam). Rinse and dry the neti pot.
Precaution should to be taken not to inhale through the nose during this procedure. Boiled and cooled water should be preferred over ordinary tap water.
When To See The Doctor
Provided that the correct procedure is followed after taking all safety measures for Neti pot or Jal neti therapy, even then if at the end of the procedure, after repeated attempts of drying the nose still mucus blockage persists, seek the assistance of your doctor. An Ear, Nose and Throat (ENT) specialist may also help ascertain if there is some structural blockage in the nose or any other cause.
When To Use A Neti Pot
According to yoga practitioners, for therapeutic purposes, Neti pot or Jal neti can be done up to a maximum of four times a day but only after expert advice.
The following are the possible best times: upon waking before breakfast, mid-morning before lunch, evening before dinner and just before bed. In the case of a cold, 3 – 4 times a day generally gives relief, providing the nose is well dried each time and this frequency does not induce nose bleeds. But after the symptoms subside, once or twice daily practicing of Neti preferably in the morning or in the evening on an empty stomach for daily general cleansing is considered more than enough.
Moreover, research concluded that if a neti pot or Jal neti is done twice daily for a period of ten continuous days the symptoms of sinus congestion completely subside.18
Neti Pots For Colds + Neti Pots For Sinus Infections
In Ayurveda, nasal instillation (Nasya) is a generic term referring to all form of instillation through nose. Neti pot irrigation can be considered a variant of nasal instillation therapy.
One form of nasal instillation, the application of the watery extract of herbs squeezed into the nose (Avapeedan Nasya), has a close resemblance to Neti pot or Jal neti.
In addition to this, the Neti pot is a traditional form of nasal irrigation and is considered one of the best treatments for diseases pertaining to the supraclavicular region (Udhrawajatrugata roga). According to yoga practitioners, this therapy of purification has special significance because of certain specific features.
The use of lukewarm water for nasal irrigation.
The use of salt in isotonic concentration in water
The special technique of irrigation enabling the streaming of water through the whole nasal cavity.
The unique post irrigation procedure.
Neti pot or Jal neti gives desired effects of nasal irrigation as while performing it, the head is tilted to one side and the saline water flows down from above. The gravitational thrust aids the downward flowing of water, due to which lukewarm saline water reaches the deeper areas of the sinuses and assists in flushing out the debris and elimination of the dissociated mucus out of the nasal cavity. At the end of this procedure, gentle exhalation through one nostril while the other is closed and Kapalabhati Pranayama eliminates the remaining water and doshas out of the nasal cavity.
Lukewarm water in a Neti pot or Jalneti, is said to inhibit the replication of rhinovirus, irrigates nasal passages and creates a correct flow pressure shedding of virus. Besides this, lukewarm water used in Neti pot or Jal neti can be easily absorbed, pacifies Kapha dosha and helps in dissociation and dissolution of the disease-causing substances from the channels (srotasas).
Moreover, when salt is added to this lukewarm water the efficacy of the Neti pot solution is furthermore increased. Salt also has the property of dissociation (Chedana), it breaks down the Kapha and helps in its excretion (kaphnissaraka) and thereby clears all the channels (marga vishodhyati).19
These properties help in drainage of the doshas (mainly Kapha), easy detachment of sticky mucus from the nasal mucosa and sinuses, clears the passages and restores a healthy mucous membrane of the nasal cavity which renders effective relief in most of the upper respiratory tract related problems.
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Evidence Related To Neti Pot Or Jal Neti Therapy
Research shows that children with seasonal allergies who performed saline nasal irrigation and took antihistamine medication were more likely to experience a reduction in their symptoms rather than children who were only on medication.20
A questionnaire-based study on family physicians also suggested that 87% of family physicians prescribed saline nasal irrigation to patients suffering from a variety of upper respiratory conditions.21
Research also proved that nasal irrigation is effective in improving a wide range of allergic symptoms along with the health status of patients with sinonasal disease. Research clearly concluded that patients who did nasal irrigation experienced statistically significant improvements in 23 of the 30 nasal symptoms.22
Nasal passages are one of our body’s first lines of defense against several diseases. Regular cleansing the sinuses and nasal cavities, with the help of a Neti pot is an ancient practice performed by yoga therapists. It is believed to be beneficial in reducing the swelling of mucous membranes and subsiding the symptoms related to sinus infection, common cold, tinnitus, nasal dryness and other upper respiratory disorders.
Please note that Neti pot or Jal neti therapy is safe and can help in most of problems related to the supraclavicular region but only when it is practice in a correct way. It is best to seek the advice of an expert Yoga therapist for learning this technique.
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References 1. G.S. Sahay, Swami Swatmarama (15th century CE) Hatha yoga Pradeepika, Chapter 2 verse 30 Yogic Heritage India. 2. Am Fam Physician. Saline Nasal Irrigation for Upper Respiratory Conditions 2 009 Nov 15; 80(10): 1117–1119.PMCID: PMC2778074NIHMSID: NIHMS113481. 3. Kashinath Pandey, Charaka Samhita, Sutrasthana chapter 17 verse 8-11 , 24 Chowkhambha Bharti Academy, 2005. 4. Ambikadutta Shastri, Sushruta Samhita, Uttar tantra, chapter 25 verse 7. Chowkhambha Bharti Academy, 2006. 5. Kashinath Pandey, Charaka Samhita, Sutrasthana chapter 17, verse 25, Chowkhambha Bharti Academy, 2005. 6. Mansi Varma, A Conceptual Study on Kaphaja Shiroroga with Special Reference to Sinusitis Volume 6 Issue 2 – 2017, International Journal of Complementary and Alternative Medicine. 7. AcharyaY.T,Agnivesha, CharakaSamhita with Ayurveda Dipika Commentary, Chikitsa Sthana, Chapter 26 verse 104: p. 604 31. Chaukhambha Surbharati Prakashan, Varanasi, 2009 (Reprint). 8. Vd. Y.T Acharya, Sushruta Samhita with NibandhaSamgraha and Nyayachandrika commentaries Uttara Tantra chapter 24 verse 3-4: p651 32., Chaukhambha Orientalia, Varanasi, 2009 (Reprint). 9. Acharya H.P, Vagbhatta, Ashtanga Hrudaya with Sarvanga Sundara Commentary, Uttara Tantra. chapter 19 verse 2: p841 Chaukhambha Orientalia, Varanasi, 2005 (Reprint). 10. Dr. Arjun Kumar Singh, PRATISHYAYA – THE LIFE STYLE DISORDER , wjpmr, 2017,3(9), 395-400 11. Kashinath ,Charaka Samhita, Chikitsa Sthan chapter 26 verse 139, Chowkhambha Bharti Academy, 2005. 12. Ambikadutta Shastri, Sushruta Samhita, Uttar tanra, chapter 20 verse 7. Chowkhambha Bharti Academy, 2006. 13. Ambikadutta Shastri, Sushruta Samhita, Uttar tanra, chapter 20 verse 9. Chowkhambha Bharti Academy, 2006. 14. Kashinath, Charaka Samhita, Chikitsa Sthan chapter 26 verse 139, Chowkhambha Bharti Academy, 2005. 15. Tripathi B (Ed.) Charaka Samhita (Chaukhambha Surbharti Prakashana, Varanasi) 1983, Si Sth 9/88. 16. Vagbhata, Ashtanga Samgraha with Hindi commentary by Kaviraj Atridev Gupta, Sutra sthana chapter 29 verse 2, Chowkhamba Krishnadas Academy, Edition: Reprint 2005, Pg. no. 216. 17. G.S. Sahay, Swami Swatmarama (15th century CE) Hatha yoga pradeepika, Chapter 2 verse 30, Yogic Heritage India. 18. Sanjeev Rastogi, Jalaneti application in acute rhino sinusitis, Indian Journal of Traditional Knowledge IJTK-Vol 6(2)-April 2007-pp 324-327. 19. Kashinath Pandey, Charaka Samhita, Sutrasthana chapter 26 verse 42, Chowkhambha Bharti Academy, 2005. 20. Garavello W, Hypersaline nasal irrigation in children with symptomatic seasonal allergic rhinitis: a randomized study. Pediatr Allergy Immunol. 2003 Apr;14(2):140-3. 21. Rabago D, The prescribing patterns of Wisconsin family physicians surrounding saline nasal irrigation for upper respiratory conditions. WMJ. 2009 May;108(3):145-50. 22. Tomooka LT,Clinical study and literature review of nasal irrigation Laryngoscope. 2000 Jul;110(7):1189-93.