From the Guidelines
Xylitol may have a positive effect on nasal symptoms when added to nasal saline irrigation, as suggested by the European position paper on rhinosinusitis and nasal polyps 2020 1. The use of xylitol in nasal irrigation is recommended by the steering group, potentially in combination with isotonic saline or Ringer’s lactate, due to its possible benefits in reducing nasal symptoms. Some key points to consider when using xylitol for nasal symptoms include:
- The addition of xylitol to nasal saline irrigation may have a positive effect on nasal symptoms, although the quality of the studies is not always very good 1.
- Nasal irrigation with isotonic saline or Ringer’s lactate has efficacy in CRS patients, and the addition of xylitol may enhance this effect 1.
- The steering group advises against the use of baby shampoo and hypertonic saline solutions due to side effects, but recommends the use of xylitol, sodium hyaluronate, and xyloglucan in nasal saline irrigation 1. It is essential to note that the evidence is not very strong, and more research is needed to confirm the effectiveness of xylitol for nasal symptoms. However, based on the available data, the use of xylitol in nasal saline irrigation may be a useful adjunctive treatment for nasal symptoms, particularly for patients with chronic rhinosinusitis.
From the Research
Effectiveness of Xylitol for Nasal Symptoms
- Xylitol has been studied for its potential in preventing otitis media, rhinosinusitis, and dental caries, with evidence suggesting it enhances the body's innate immunity and has anti-adhesive effects on micro-organisms 2.
- A pilot study found that intranasal xylitol was equally effective as saline in decreasing the time of symptom resolution and preventing hospitalizations in COVID-19 patients, and may play a role in preventing persistent olfactory abnormalities 3.
- A prospective, randomized study compared the efficacy of xylitol solution, xylometazoline, and physiological saline in patients with nasal congestion, finding that xylitol yielded better results than saline, although differences were not statistically significant 4.
- A pilot study on xylitol nasal irrigation in the management of chronic rhinosinusitis found that xylitol irrigation resulted in greater improvement of symptoms compared to saline irrigation, with xylitol being well-tolerated by patients 5.
- While xylitol shows promise, it is essential to consider it as part of a broader range of topical treatment options for sinonasal disease, including steroidal, saline, decongestant, antihistamine, and anticholinergic preparations, with a focus on evidence-based guidelines 6.