• Reference Number: HEY-932/2020
• Departments: Neurology and Neurosurgery
• Last Updated: 31 December 2020

Introduction

This leaflet has been produced to give you general information. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What is nasal douching?

The term ‘douching’ means showering and this is undertaken in the nose for cleaning purposes. Nasal douching is also called nasal rinsing or nasal irrigation.

Why do I need to undertake nasal douching?

Some operations in the nose leave the surface inside raw, like a graze. Unlike a graze on the knee for example, you do not get a dry scab inside the nose with healing underneath. Instead the scab in the nose gets very soggy due to all the mucous which the nose produces. Over time the mucous may get dry and, if several layers of mucous get dry, a crust is formed. Under very thick crusts, bacteria may collect and this can cause infection, which will interfere with healing.

It is usual for patients who have undergone surgery in the nose to have frequent nose crusts. Therefore, in order to keep your sinuses clean and healthy after surgery, it would be helpful if you douche your nose. To start with, this should be undertaken at least three times a day for the first two weeks after discharge. This can then be reduced by gradually cutting down on the number of times you douche each day until your nose feels clear and you are not washing out mucous or many crusts at the time of douching.

Some of the change in the structure and airflow inside the nose is permanent resultant from the surgical approach, and therefore, most people are expected to have a degree of crust formation permanently. Therefore, nasal douching might need to continue indefinitely, depending on whether or not there is continued crust formation. Similarly, extrusion of crusts and yellowish nasal discharge is often mistaken as a sinus infection. Unless you develop facial pain or temperature antibiotics are not necessary. If in doubt, please contact your doctor.

What can I expect?

It is usual for your nose to feel blocked “for the first two or three weeks following surgery until the lining has settled down. Your nose may also run a lot for the first few days with blood-stained mucous. It is also normal to feel some pressure under your nose and forehead and you may need to take some pain relief for the first few days. However if you are getting clear fluid running down your nose, or if your headaches are getting worse.  then you should  contact the ward where you were discharged from.

How do I undertake a nasal douching?

Please read the information leaflet.  Share the information it contains with your partner and family (if you wish) so that they can be of help and support.  There may be information they need to know, especially if they are taking care of you following this examination.

To douche the nose first all make up the following mixture.

• 1 teaspoon of salt
• 1 teaspoon of bicarbonate soda
• Add to 1 pint (approx. 600 mls) of boiled water, allow the mixture to cool.

Pour some of the solution into a clean container and draw up the solution with a syringe (which will be provided by the ward prior to discharge). Gently dispense the solution into the nostril using the syringe whilst sniffing the solution through the nose into the throat and spit out. If you lean over the sink or a bowl, this will collect the solution that comes out of the nose.

Do not worry if you swallow some of the solution as it will not cause you any harm. It is best to continue until no more debris is washed out of the nose.  You should then repeat this process with the other nostril. Some people find the solution stings a little at first but this eventually settles after a few days.

As an alternative, there are nasal douching preparations that can be purchased from the pharmacy. Please ask one of the nurses or doctors caring for you if you would like to know more about these.

If you have been advised to take nose drops please take them after you have finished douching and have had a few moments to let your nose settle.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Neurosurgery Department (01482) 674369.