Sinus Irrigation for AERD (Samter's Triad)
Sinus irrigation is a daily ritual for most AERD (Samter's Triad) patients. At first, the experience can be somewhat unpleasant - but with practice it can actually be a refreshing experience. Because of the nasal blockage that we experience, there is a buildup of thick mucus in the sinuses. This can lead to repeated sinus infections. Sinus rinses are a great way to clear out some of the gunk.
How It's Done
There are several irrigation devices available, but the squeeze bottle (pictured above) is generally the easiest to use, and the most effective. It's very important that you add saline to your sinus rinse - it makes the pH of the water the same as your body and prevents the rinse from causing a burning sensation. You can purchase prepared saline packets at any pharmacy - or you can make your own:
½ tsp salt
½ tsp baking soda
8 oz warm water
We recommend using the prepared packets to ensure purity. It can be difficult to find salt without added iodine or preservatives (which can irritate the sinuses).
It is critically important that you use only sterile water. You can buy gallons of distilled water at any grocery store, or you can boil your tap water before making your rinse with it. This is vital to prevent pathogens from contaminated water from entering your sinuses, which can be extremely dangerous.
Using warm water makes the irrigation process more comfortable, but you can also use room temperature water. Sinus bottles can be microwaved for a few seconds to heat the water slightly. Never put very hot or very cold water into your sinuses.
After preparing your sinus bottle, lean over the sink and gently squeeze the water into one nostril until it runs out of the other nostril. Breathe through your mouth while you do this. Use half of the bottle in one nostril and then repeat the process in the other nostril.
Irrigation can be done several times a day if needed, but it is generally done in the morning.
Some people cannot tolerate the pressure that irrigation puts on their ears. If you have sensitive ears, this may be a problem for you. In the below video, Dr. Palmer describes the best method of using the rinse bottle and discusses how to reduce ear symptoms while rinsing.
If you continue to have ear symptoms despite using this method, sinus rinses can also be administered using an oral syringe. Make sure whatever irrigation supplies you use are kept sterile. You can sterilize sinus rinse bottles using a microwave. Read the instructions on how to do this here.
Medicated Sinus Rinses
ENTs will often combine sinus irrigation with medications. This is usually a steroid medication, but there are antibiotics and antifungal medications that can be added to sinus rinses as well. Many AERD patients use a sinus rinse with budesonide (Pulmicort) respules. Budesonide respules are capsules of steroid medication that be added to a sinus rinse bottle.
Visit our page on using budesonide respules for more information.
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