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Nasal Polyps and Eosinophilic Asthma

Nasal Polyps and Eosinophilic Asthma

Learn about nasal polyps, abnormal growths associated with eosinophilic asthma, chronic sinusitis, and other conditions.

Nasal polyps are benign growths that form in the nasal cavity and sinuses. Shaped like teardrops, they vary in size and may form on their own or in clusters. Small polyps may not cause any symptoms. Larger polyps or clusters of polyps can make breathing difficult, blocking airways and contributing to congestion, sinus infections, loss of smell, and other symptoms.

Nasal polyps are also associated with a number of health conditions. These include chronic rhinosinusitis, aspirin-exacerbated respiratory disease (AERD), allergy or sensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs), allergic rhinitis, and asthma. Chronic rhinosinusitis with nasal polyps has a known association with eosinophilic asthma, a type of asthma related to high levels of white blood cells called eosinophils. People who have eosinophilic asthma typically experience their first asthma symptoms in adulthood, and symptoms are often severe.

Below are some answers to common questions about nasal polyps, including symptoms, diagnosis, and treatment options.

What causes nasal polyps?
While healthcare experts do not know the exact cause of nasal polyps—or why some people get nasal polyps and others do not—it is believed that nasal polyps are caused by chronic inflammation in the mucous membranes of the nasal cavity and sinuses.

What are the symptoms of nasal polyps?
Small nasal polyps may not present any symptoms and may go unnoticed or undiagnosed. Larger nasal polyps, or nasal polyps that cluster (sometimes described as having an appearance like a bunch of grapes) can cause a number of symptoms, including:

  • Sneezing, runny nose, and/or postnasal drip
  • Headaches and/or facial pain or pressure
  • Sinus infections (caused by the polyps blocking the mucus and preventing it from draining, which can lead to infection)
  • Difficulty breathing
  • Increased sensitivity to chemicals and fumes
  • Reduced sense of smell and taste
  • Snoring
  • Trouble sleeping
  • Frequent nosebleeds

Nasal polyps can occur on one side of the nose or both, though it is more common for people to have nasal polyps on both sides.

Are nasal polyps cancerous?
Nasal polyps are benign tumors, abnormal growths of tissue that are not cancerous—meaning they do not invade nearby tissues or spread to other areas of the body. However, not all abnormal growths in the nose are nasal polyps, which is why it is important to see a healthcare provider to have nasal polyps examined and diagnosed.

How are nasal polyps diagnosed?
People with persistent symptoms like those described above should be referred to an otolaryngologist, also known as an ear, nose, and throat (ENT) doctor. In addition to a physical exam and medical history, your healthcare provider may use a nasal endoscope—a small camera attached to a thin, flexible tube—to examine your nasal passages. In some cases, healthcare providers may also order a CT scan, a type of imaging test, to determine the exact location and size of the polyps. Your healthcare provider may also order allergy tests.

How are nasal polyps treated?
If you have nasal polyps, you will need to work with your healthcare provider to address any conditions that could contribute to the formation of nasal polyps. This includes taking medications as prescribed, attending follow-up appointments, and making any necessary lifestyle changes (for example, quitting smoking).

How the nasal polyps themselves are treated can depend on their location and size. The first step in treatment is typically a nasal corticosteroid that can hopefully shrink the polyps and also keep them from growing. Nasal corticosteroids can be administered as a nasal spray. In some cases, a short course of oral steroids may be used, as well as an antibiotic if you have a sinus infection. Some patients may need surgery to remove polyps.

Prevention is also important. You should take steps to avoid irritants or allergens that can make nasal symptoms worse, and wash your hands regularly to prevent bacterial or viral infections. Your healthcare provider may discuss making changes to your home, such as using a humidifier, which helps some people with respiratory conditions breathe easier. Your healthcare provider may also recommend using a saline rinse to help flush irritants out of your nasal cavity and sinuses. When using any type of nasal wash device, it is important that you always use sterile water and follow the device’s instructions for sterilizing before and after use—using non-sterile water can increase the risk of infection.

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