Nasal polyps

What causes them?

These pale swellings inside the nose can occur due to a number of diseases. The most common association of nasal polyps is with adult onset asthma and sensitivity to aspirin (salicylate). This group of conditions is called Sampter’s triad and is also known as the pan respiratory eosinophilic syndrome due to its association with high eosinophil levels in the blood. They usually occur on both sides.

One sided polyps can be caused by infection or cancer (benign or rarely malignant) and it is always sensible to remove these for analysis.

Polyps in children can be due to birth defects or cystic fibrosis.

Contrary to popular opinion, polyps are not due to common allergies like hay fever.

What symptoms would I suffer?

As a polyp is a swelling in the nose it causes nasal obstruction. If the polyps occur on both sides then it is common to have a reduced sense of smell. Other symptoms that occur with polyps include watery dripping from the nose and an increased sense of catarrh. If the polyp is on one side only and associated with pain and a bleeding nose then you should seek urgent ENT attention.

Treatment of nasal polyps

Polyps only on one side need removal or at least biopsy urgently as this will need careful analysis.

Polyps on both sides can be treated in a number of ways and surgery is only one option. Treating the polyps with a steroid nasal spray or drops or even a short course of oral steroids will shrink them and often relieve the symptoms. This may have to be repeated at intervals as the underlying disease will tend to make the polyps recur.

If the polyps are large then medication rarely makes a big difference and surgery is usually advised to remove the obstruction to the airway and sense of smell. However, the underlying cause of the polyps often remains and they can recur so it is advisable to continue with a nasal steroid spray even after surgery to prevent recurrence.

If it is confirmed that you have a sensitivity to aspirin then desensitisation can be an option.

Aspirin (salicylate) is a chemical in most fruit and vegetables so one option is to reduce them in the diet. This is only advised with professional dietary help.

Some new medications are showing promise in the treatment of severe pan respiratory eosinophilic syndrome.

How long does the disease last?

There is no known cure for polyps on both sides so treatment may have to be continued for years.