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Table of Contents
CASE REPORT
Year : 2021  |  Volume : 7  |  Issue : 1  |  Page : 63-65

Neti Kriya as a therapeutic intervention for chronic allergic rhinitis


Department of Scientific Research, Kaivalyadham SMYM Samiti (Kaivalyadham Yoga Institute), Pune, Maharashtra, India

Date of Submission07-Aug-2020
Date of Decision16-Sep-2020
Date of Acceptance03-Apr-2021
Date of Web Publication29-Jun-2021

Correspondence Address:
Mrs. Pratibha Hemant Rajbhoj
Department of Scientific Research, Kaivalyadham SMYM Samiti (Kaivalyadham Yoga Institute), Swami Kuvalayananda Marg, Lonavla, Pune - 410 401, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJCFM.IJCFM_93_20

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  Abstract 

Allergic Rhinitis is a recurrently occurring respiratory disorder, therefore the technique of Neti Kriya might be helpful to cure it. This case report describes the effect of Neti Kriya on a single patient of Acute Rhinitis, with the help of RQLQ, CQQ, and AEC. The patient reported to be asymptomatic post-intervention, with improved domains of RQLQ and CQQ. The raised AEC at the baseline showed normal range post-intervention. This case report showed that the regular practice of Neti Kriya could be effective in treating chronic AR.

Keywords: Allergic disorders, chronic allergic rhinitis, desensitization, eosinophilia, Neti


How to cite this article:
Rajbhoj PH, Bhogal RS, Bhalekar SD. Neti Kriya as a therapeutic intervention for chronic allergic rhinitis. Indian J Community Fam Med 2021;7:63-5

How to cite this URL:
Rajbhoj PH, Bhogal RS, Bhalekar SD. Neti Kriya as a therapeutic intervention for chronic allergic rhinitis. Indian J Community Fam Med [serial online] 2021 [cited 2021 Jul 25];7:63-5. Available from: https://www.ijcfm.org/text.asp?2021/7/1/63/319965


  Introduction Top


As per the allergy statistics of the American Academy of Allergy, Asthma, and Immunology, it has been observed that allergic rhinitis (AR) affects 10% to 30% of the population worldwide, and it also indicated that patients with AR have a high risk of developing asthma.[1] The pathogenesis of AR reflects in the elevated number of eosinophil granulocytes in the circulating blood. Eosinophils can modulate immune responses and allergic inflammation by releasing growth factors, cytokines, and chemoattractants.[2]

Some of the Yogic Shuddhi Kriyas are considered helpful to deal with allergic disorders.[3],[4] Among which, Neti Kriya helps to decrease the symptomatology and thereby can be used as a preventive as well as therapeutic approach for AR. Gheranda Samhita mentions the technique of Neti Kriya, for the removal of disorders of phlegm (G.S.I: 49,50), and Hathapradipika indicated its role in curing the diseases above the shoulder region (Hathapradipika: II.31). It has a key role in rhinitis as it is helpful to rectify the vasomotor disturbances related to nasal pathway.[5] Neti decreases the eosinophil count in asthma,[6] and thus, it has a plausible role in decreasing the eosinophil count in AR. On these grounds, this case report aims to understand the effect of Neti Kriya on AR.


  Case Report Top


This is a single case study of Ms. BT, a 30-year-old working woman with a history of chronic AR, since childhood. As advised by her family physician, she had been on tablet cetirizine intermittently, since many years. The medication could provide temporary relief, but the allergy would relapse with persistent recurrence, limiting her day-to-day activities. Therefore, she opted for yoga therapy. During her medical checkup, the Residential Medical Officer diagnosed her as a case of moderate intermittent AR.[7] She was advised to practice Neti Kriya for at least 2 to 3 months to get relief from her medical conditions. Written informed consent was obtained from the patient for the study and publication of this case.

Therapeutic focus

Neti Kriya was performed, followed by forceful exhalation, to expel the water that may get accumulated in the sinuses during the practice of Jalaneti Kriya. Participant followed the module [Table 1] for the period of 2½ months. All sessions were conducted under the supervision of Yoga Therapist.
Table 1: Yogic Shuddhi Kriya protocol

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Assessment

According to the symptoms of the study participant, following standard test was conducted at two time points – T0 (baseline) and T1 (post) intervention.

  1. Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ): internal consistency, reliability as measured by Cronbach's α, was 0.92 for RQLQ and also displayed strong construct validity reference[8]
  2. A Custom-made Qualitative Questionnaire: it was a custom-made questionnaire, where the participant has to express comprehensively, her symptoms, experiences, feelings, and about her overall life before and after the treatment process
  3. Absolute Eosinophil Count (AEC): the blood sample was collected by Phlebotomist and the technician processed the blood for the AEC measure.



  Results Top


Rhinoconjunctivitis Quality of Life Questionnaire

The original RQLQ measures the limitations and the impairments that are caused due to rhinoconjunctivitis. While comparing the scores, the limitations and impairments of the patient were reduced by 2.04 postintervention [Table 2].
Table 2: Values of allergic rhinitis symptoms at two time points

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The RQLQ data analysis, after calculating the mean of each domain, is as follows [Table 2]:

A custom-made qualitative questionnaire

It was seen that her symptoms, impairments, and emotional traits, are perfectly corresponding to that of the RQLQ. She stated that she is feeling better after the treatment.

Absolute eosinophil count

There was a reduction in the AEC count postintervention [Table 3].
Table 3: Values of absolute eosinophil count at two time points

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  Discussion Top


This case report in a single patient showed that Neti Kriya effectively cures the symptoms of AR [Table 2]. After the intervention, the nasal symptoms decreased, the medication stopped, and the patient could resume her normal day-to-day activities.

Earlier research studies have shown that Neti Kriya induces direct physical cleansing by flushing out debris, thick mucus, allergens, and air pollutants.[9] It reduces the symptoms of AR by removal of inflammatory substances. In addition, it soothes the nasal airway.[10] It has an osmotic action and facilitates the removal of the cellular source of inflammatory mediators such as histamine and leukotriene.[11] The use of lukewarm water in Jalaneti Kriya leads to vasodilation, promoting phagocytosis and decreasing inflammation.[12],[13] The lukewarm water also helps in nasal drainage, thereby facilitating decongestion. De Vicent[11] mentioned that Neti Kriya improves the function of the immune system.

In the present study, the raised AEC at T0 [Table 3] shows an allergy-associated inflammatory condition and an ongoing event in the innate immune system as a defense for fighting the allergens. After the intervention (T1), the AEC came within the normal range [Table 3], indicating an improvement in the allergy status.

The outcome of the present study suggests that a daily practice of Neti Kriya can be helpful in avoiding allergen sensitization by keeping the nose free from irritants. The repeated practice of Neti Kriya may help in desensitization and can perhaps be a substitute for immunotherapy treatment.


  Conclusion Top


The practice of Neti Kriya in the patient was found to be effective in curing the symptoms of chronic AR. This study shows the effect of Jalaneti and Sutraneti, as a combined treatment for chronic AR. However, more studies with large sample size are required to understand whether Neti Kriya can be used as an independent therapy or should be used in combination with other yogic practices and/or medications, as effective means for chronic AR.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Pawankar R, Canonica GW, Holgate ST, Lockey RF, Blaiss MS, editors. WAO White Book on Allergy. Milwaukee, WI: World Allergy Organization; 2011. p. 11-2.  Back to cited text no. 1
    
2.
Martin LB, Kita H, Leiferman KM, Gleich GJ. Eosinophils in allergy: Role in disease, degranulation, and cytokines. Int Arch Allergy Immunol 1996;109:207-15.  Back to cited text no. 2
    
3.
Pathak S. Diseases caused by environmental pollution and their remedies through Satkarma-S. ECJ 2019;20(SE):121-7.  Back to cited text no. 3
    
4.
Yashika V, Vasanthi G. Yogic practice at different seasons for better health and well being. Asian Journal of Multidimensional Research (AJMR) 2018;7:1136-41.  Back to cited text no. 4
    
5.
Bhole MV. Technique of Neti Kriya. Yoga Mimamsa 1971;14:15-26.  Back to cited text no. 5
    
6.
Deshpande RR, Bhole MV. Effect of yogic treatment on eosinophil count in asthma. Yoga Mimamsa 1982;20:9-16.  Back to cited text no. 6
    
7.
Varshney J, Varshney H. Allergic rhinitis: An overview. Indian J Otolaryngol Head Neck Surg 2015;67:143-9.  Back to cited text no. 7
    
8.
Juniper EF, Thompson AK, Ferrie PJ, Roberts JN. Validation of the standardized version of the rhinoconjunctivitis quality of life questionnaire. J Allergy Clin Immunol 1999;104:364-9.  Back to cited text no. 8
    
9.
Pandey A, Tiwari M. Yogic management of chronic sinusitis WSR to Neti Kriya. World J Pharm Pharm Sci 2015;4:1534-42.  Back to cited text no. 9
    
10.
Meera S, Vandana Rani M, Sreedhar C, Robin DT. A review on the therapeutic effects of NetiKriya with special reference to JalaNeti. J Ayurveda Integr Med 2020;11:185-9.  Back to cited text no. 10
    
11.
Georgitis JW. Nasal hyperthermia and simple irrigation for perennial rhinitis. Changes in inflammatory mediators. Chest 1994;106:1487-92.  Back to cited text no. 11
    
12.
Pathania A, Thakur TC. Role of Jal Neti in the treatment of allergic rhinitis. World J Pharm Med Res 2018;4:95-7.  Back to cited text no. 12
    
13.
De Vicent P. Neti Kriya in management of bronchial asthma and spastic descending conditions of the respiratory tract. Yoga Mimamsa 1986;24:1-11.  Back to cited text no. 13
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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Abstract
Introduction
Case Report
Results
Discussion
Conclusion
References
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