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Advantages of nasal cleaning with saline in people with allergic rhinitis

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eMediNexus    08 December 2020

Allergic rhinitis is a widely prevalent condition in adults as well as children.1,2 Affected individuals commonly experience symptoms of nasal obstruction, rhinorrhea, sneezing, and nasal itching. It not only deteriorates the quality of life but also has a high medical cost due to repeated healthcare visits and chronic therapy. Common allergic triggers include house dust mites, pollens (from trees, grasses, shrubs, and weeds), animal dander, and fungi. Besides, it can also be caused by triggers at work (occupational exposure) such as vegetable proteins, enzymes, and chemicals. Treatment options include allergen avoidance, pharmacological therapy (antihistamines, intranasal corticosteroids, and anti‐leukotrienes), and immunotherapy.1

Furthermore, nasal saline has garnered significant attention as a natural remedy for centuries for this patient population.1 Growing literature has added value to the traditionally accepted facts about this agent.1,2 Saline solutions, especially in the form of sprays or drops are easily available over the counter and can reach the nasal cavity adequately. The prime mechanism of action of saline has been proposed to be mechanical. It involves the clearance of mucus and removal of airborne allergens and inflammatory mediators such as histamine. Moreover, it may also improve the ciliary beat function and mucociliary function. Data extracted from some studies indicate that saline may be an effective approach for ameliorating symptoms of allergic rhinitis. Encouraging results have also been obtained from comparative studies that indicate the efficacy of saline compared to no saline in reducing patient‐reported disease severity in both adults and children, with no adverse effects.1 A prospective, unblinded, single-arm pilot study on patients with allergic rhinitis who were already on intranasal corticosteroid pharmacotherapy showed that the use of isotonic saline is an effective adjunctive option to improve the quality of life of patients who are already on intranasal corticosteroids.2 Thus, saline can be used either alone or as an adjunct to other pharmacological therapies in patients with allergic rhinitis.1

References

  1. Head K, Snidvongs K, Glew S, et al. Saline irrigation for allergic rhinitis. Cochrane Database Syst Rev. 2018;6(6):CD012597.
  2. Nguyen SA, Psaltis AJ, Schlosser RJ. Isotonic Saline Nasal Irrigation is an Effective Adjunctive Therapy to Intranasal Corticosteroid Spray in Allergic Rhinitis. Am J Rhinol Allergy. 2014;28:308-311.

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