Question: I used a sinus rinse last night and this morning to alleviate some pressure that has been causing me frontal headaches and snoring. Is using NYC tap water for nasal irrigation safe? I live in New York City and used its – famously clean – tap water for the rinse, though have since learned that this could be very dangerous due to the risk of bacteria and amoeba (and that boiled or filtered water is recommended). While I certainly wouldn’t see any adverse symptoms by this point, I have felt a little more sluggish and groggy today than usual. Are these common issues after using a sinus rinse and should I be concerned about the risk of infection after having used tap water?
Thanks for your question. We do believe that nasal rinsing with hypertonic (saltier than normal saline) water is effective in helping the nose and sinuses become better filters. We usually recommend using either distilled, boiled (and cooled) or bottled water to make the solution. There have been no good studies on whether tap water is safe, however, for nasal rinsing. There is that case report of the infection after nasal rinsing, as you mention. However, I believe that if you would feel safe drinking the water, then probably (and I emphasize probably) tap water for nasal irrigation will be OK for an otherwise healthy individual. An immune compromised person should probably only use sterile water to rinse, if at all.
I doubt your symptoms are from infection from your sinus rinse- although people can have adverse effects, like getting water into the ear or getting water stuck in the sinuses If that happens, either rinse less forcefully, or stop doing so.
In the past, we had marketed a nasal rinse, Saltaire, which is premixed and still might be available on line.
Robert Pincus MD
NY Sinus Center