User login

Enter your username and password here in order to log in on the website:
Login

Forgot your password?

Please note: While some information will still be current in a year, other information may already be out of date in three months time. If you are in any doubt, please feel free to ask.

Follow-up question on nasal irrigation

Question
Hello,
I understand the problem of tap water potentially being contaminated with bacteria. What do you think about the following alternatives to boiling water:

1) distilled water
2) non-carbonated bottled water

Can I use these two alternatives instead of tap water for nasal irrigation or are there any risks/concerns?

Many thanks.
Answer
Hello,

1) Distilled water is "desalted water." Trace elements and suspended solids (particles and also microorganisms such as bacteria) are removed through vaporization and subsequent condensation ions. Therefore, distilled water is typically less contaminated than tap water; however, it cannot be regarded as sterile or germ-free at all. For example, a secondary germ growth can occur after distillation. In our lab, we once tested distilled water on request that a CF patient used for inhalation and found Burkholderia spp. Furthermore, as distilled water may extract salts from the mucus membranes, it is not recommended.

2) In Germany, mineral water (with or without or with gas) is subject to a Drinking Water Ordinance which holds that a certain absolute germ count must not be exceeded in 250ml and that neither E.coli nor enterococci or P. aeruginosa, resp. must be contained (the latter is valid especially for "drinking water filled into sealable containers for dispensation," thus e.g. mineral water). Therefore, mineral water is less questionable biologically than tap water or distilled water, but not to be considered sterile or completely germ-free, either. Since it contains salts, (non-carbonated) mineral water is better suited for nasal irrigation than distilled water.

The risk of germ spread and colonization of the upper respiratory tracts with CF germs through nasal irrigation with mineral water (freshly opened and meeting the standards of the Drinking Water Ordinance) is extremely low, but cannot be ruled out entirely. This is only possible when using sterile (i.e. previously adequately boiled) water.

Kind regards,
Michael Hogardt
13.12.2012