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Understanding Nasal Polyps
Causes of Nasal Polyps
Polyps develop because the mucous membranes lining the nose or sinuses change. The membranes become inflamed for a long time or become inflamed over and over again. The inflammation features swelling, redness and fluid buildup.
Researchers believe that allergies and infections cause the inflammation. They think that because they’ve studied tissue taken from nasal polyps. Those samples contained extra eosinophils, white blood cells linked to infections and allergic reactions. The evidence points to inflammation causing small growths filled with fluid. Those growths then turn into polyps.
Symptoms of Nasal Polyps:
- Headaches.
- Loss of smell or taste.
- Nasal congestion (stuffy nose).
- Nasal drainage (runny nose).
- Nosebleeds
- Postnasal drip
- Not thinking clearly
- Pressure or pain in the sinuses
Risk factors
Infections, allergies or any condition that causes long-term inflammation in the nose or sinuses can increase the risk of having nasal polyps.
Conditions often linked to nasal polyps include:
- Asthma.
- Aspirin sensitivity.
- Cystic fibrosis.
- Dental infections.
- Lack of vitamin D.
Having a family history of nasal polyps also might increase the risk.
Prevention
The following might help lower the chances of getting nasal polyps or having nasal polyps come back after treatment:
- Manage allergies and asthma: Follow your treatment plan. Be sure symptoms are controlled. See your health care provider if they’re not.
- Avoid things that can irritate the nose: These include tobacco smoke, chemical fumes and dust. If you smoke, talk to your health care provider about ways to quit.
- Wash your hands often and well: This is one of the best ways to protect against infections that can cause irritation and swelling of the nose and sinuses.
- Use a machine that adds moisture to the air, known as a humidifier: This might help prevent the nose from getting stuffy and irritated. Clean the humidifier as directed to keep bacteria from growing.
- Use a nasal rinse: Rinsing the inside of the nose with a saltwater spray or nasal wash might help remove what irritates it.You can buy saltwater sprays and nasal wash kits without a prescription. Nasal wash kits come with a neti pot or squeeze bottle and directions for how to use them. Use water that’s distilled or sterile or has been boiled for one minute and cooled. The water can also be filtered using a filter with an absolute pore size of 1 micron or smaller. Rinse the pot or bottle after each use with the distilled, sterile, previously boiled or filtered water and leave it open to dry.
Treatments
Chronic sinusitis, with or without polyps, is hard to clear up. Treatment depends on the cause of the swelling and irritation. The goal is to lessen symptoms and improve life.
Medicines
Treatments might include:
- Nasal steroids: These nasal sprays include fluticasone (Flonase Allergy Relief, Xhance), budesonide (Rhinocort), mometasone (Nasonex 24hr Allergy), triamcinolone (Nasacort Allergy 24HR), beclomethasone (Beconase AQ, Qnasl) and ciclesonide (Omnaris, Zetonna).
- Steroids taken by mouth: Some nasal polyps can block nasal sprays. If so, taking steroids in pill form such as prednisone might help. Steroids taken by mouth also might be given to shrink polyps before surgery. The pills can be taken alone or with a nasal spray. Because oral steroids can cause serious side effects, health care providers generally prescribe them only for a short time.
Steroids given as shots may be used if nasal polyps are severe.
- Biologic medicines: Biologics work by aiming at certain cells or proteins to lessen irritation and swelling. These might be used for people whose nasal polyps keep coming back. In the United States, dupilumab (Dupixent), mepolizumab (Nucala) and omalizumab (Xolair) have been approved for treatment of chronic sinusitis with nasal polyps.
- Other medicines: Other prescription medicines can treat conditions that lead to long-term swelling and inflammation in the nose. These might include medicines to treat allergies, also known as antihistamines, and antibiotics to treat infection. A treatment known as aspirin desensitization might help people with nasal polyps and asthma who react badly to aspirin. An allergy specialist oversees the treatment. The treatment involves taking a little more aspirin bit by bit to help the body get used to taking aspirin.
Surgery to remove the polyps might come before aspirin desensitization. Desensitization might be followed by daily aspirin therapy.
Surgery
If medicine doesn’t shrink or get rid of nasal polyps, endoscopic surgery can remove polyps and correct problems with the sinuses that lead to polyps.
In endoscopic surgery, a surgeon puts a small tube with a lighted lens or tiny camera, also known as an endoscope, through the nostrils into the sinuses. A surgeon then uses tiny tools to remove polyps.
A surgeon can also make the openings to the sinuses larger. This can be done during endoscopic surgery. Or there’s a procedure called balloon ostial dilation. This procedure doesn’t involve removing tissue from inside the nose.
After surgery, a corticosteroid nasal spray might help keep nasal polyps from coming back. A saltwater rinse can promote healing after surgery.
Frequently Asked Question on Nasal Polyps
The exact cause is not always clear, but factors such as chronic inflammation, allergies, asthma, and recurrent sinus infections are associated with the development of nasal polyps.
Nasal polyps themselves are usually not painful. However, they can cause discomfort due to associated symptoms or if they block the nasal passages.
Yes, allergic reactions and chronic inflammation are associated with the development of nasal polyps.
Surgery may be recommended if medications do not adequately control symptoms or if the polyps are large. Surgical procedures include polypectomy or endoscopic sinus surgery.
While lifestyle changes cannot cure nasal polyps, managing underlying conditions such as allergies and avoiding irritants may help reduce symptoms.
Yes, nasal polyps can develop in one or both nostrils.