Small nasal polyps usually cause no symptoms, but larger ones can result in the feeling of nasal congestion, impaired sense of smell and taste, decreased airflow and recurring sinus infections. — Photos: TNS
The nose is the subject of many sayings.
A measurement could be “on the nose” or an object be “right under your nose”.
You may be reminded to “keep your nose clean” and “keep your nose out of” another’s affairs.
While often the focus of these idioms, your nose can also be affected by physical conditions, such as nasal polyps.
These are soft, painless, non-cancerous growths on your nasal passages or sinus linings, which hang down like teardrops or grapes.
Nasal polyps may form anywhere in your sinuses or nasal passages.
But they most often appear in the area where the sinuses near your eyes, nose and cheekbones drain through winding passages into your nose.
Here’s what you need to know about these small growths.
The cause
Nasal polyps often result from chronic inflammation of the nasal passages.
That’s why people who have chronic sinusitis have an increased risk of developing nasal polyps.
Chronic sinusitis is when the sinuses become swollen and inflamed for more than 12 weeks.
This causes the lining in the nose to make more mucus, while the swollen lining interferes with drainage.
People with asthma, allergies, drug sensitivities or certain immune disorders also have an increased risk for nasal polyps.
Scientists don’t yet fully understand why certain conditions and inflammation trigger polyps to form in some people and not in others.
Nasal polyps can develop at any age, but are most common in young and middle-aged adults.
The symptoms
This is what a nasal polyp looks like (with the help of chemical colouring) under a microscope.
A person can have nasal polyps and not know it, especially small ones.
Larger or multiple polyps can cause a sensation of nasal congestion, impaired sense of smell and taste, decreased airflow and recurring sinus infections.
Some people with nasal polyps develop an intolerance to over-the-counter pain-relieving medications like ibuprofen and naproxen.
Nasal polyps can cause complications because they block airflow and fluid drainage.
The long-term inflammation underlying their development also causes complications.
In some people, they cause worsening asthma or structural changes in the sinuses.
Many people with nasal polyps have recurring sinus infections.
This increases antibiotic exposure and could lead to a potentially severe gastrointestinal infection caused by the bacteria Clostridium difficile (also called C-diff).
Your healthcare team can usually make a diagnosis based on your answers to questions about your symptoms, a general physical exam and an examination of your nose.
Polyps may be visible with the aid of a simple lighted instrument called a nasal endoscope.
They may also suggest skin tests to determine if allergies are causing chronic inflammation.
With a skin prick test, tiny drops of allergens are pricked into the skin of your forearm or upper back.
Your healthcare team observes your skin for signs of allergic reactions.
If a skin test can’t be performed, a blood test can screen for specific antibodies to various allergens.
The treatment
The treatment goal for nasal polyps is to reduce their size or eliminate them.
Medication is usually the first approach.
Surgery may sometimes be needed, but it may not provide a permanent solution because polyps tend to recur.
Nasal steroids and budesonide rinses may reduce swelling and irritation.
These treatments may shrink polyps or eliminate them completely.
If you have nasal polyps and chronic sinusitis, your healthcare team may give you an injection of a medication called dupilumab to treat your condition.
This biologic medication may reduce the size of the nasal polyps and lessen congestion.
It’s often prescribed by an allergist (an immunologist who specialises in allergies) and can be administered at home.
Nasal polyps in children are typically treated with topical medications and dupilumab.
You may be able to reduce your chances of developing nasal polyps or having polyps come back after treatment by reducing inflammation in your nose and sinuses.
Start by following these tips:
Follow treatment recommendations from your healthcare team.
If your symptoms aren’t well-controlled, ask about changing your treatment plan.
As much as possible, avoid breathing airborne substances that are likely to contribute to swelling or irritation in your nose and sinuses, such as allergens (allergy-causing agents), tobacco smoke, chemical fumes, dust and fine debris.
Wash your hands regularly and thoroughly.
This is one of the best ways to protect against bacterial and viral infections that can cause inflammation of the nasal passages and sinuses.
Using a humidifier may help moisten your breathing passages, improve the flow of mucus from your sinuses, and help prevent blockages and inflammation.
Clean the humidifier daily to eliminate bacterial growth.
Use a saline spray or nasal wash to rinse your nasal passages.
This may improve mucus flow, and remove allergens and other irritants.
Do talk with your healthcare team if you have recurring sinus infections, infections that last longer than 12 weeks, impaired smell or taste, or are having trouble breathing through your nose. – By Dr John Wheeler Jr/Mayo Clinic News Network/Tribune News Service
Dr John Wheeler Jr is an allergist in Wisconsin, United States.
