Nasal Polyps

What are Nasal Polyps?

Nasal polyps are a type of eosinophil-driven disease (EDD) in the form of soft, non-cancerous growths that appear in the lining of the passages or sinuses in your nose. Nasal polyps can vary in size. If they’re small, they might not cause any symptoms and you may be unaware you have them. However, large polyps or multiple clusters of polyps can cause symptoms and even block your nasal passages.

When viewed by a doctor, developing polyps look like teardrop-shaped growths in your nose. As they mature, they start to resemble peeled grapes. They can cause uncomfortable symptoms, but they’re normally painless.

Unlike polyps that occur in other parts of the body, such as the bowel, nasal polyps are very rarely cancerous.

Other types of eosinophil-driven diseases include eosinophilic esophagitis (EoE), atopic dermatitis and chronic spontaneous urticaria.

What symptoms do nasal polyps cause?

They cause a range of symptoms and can sometimes feel like you’ve got a cold. But while a cold normally clears within a few days, they won’t get better without treatment.

Symptoms of nasal polyps include:

• A blocked or stuffy nose
• A runny nose
• Nasal congestion
• A reduced sense of smell or taste
• Postnasal drip – excess mucus drips down the back of your throat making you need to swallow a lot
• A feeling of pressure in your face, or forehead
• Snoring
• Nosebleeds

The exact symptoms you’ll have will partly depend on the size and location of the polyps in your nose and how much inflammation there is.

What causes polyps in the nose?

Nasal polyps are caused by inflammation and develop in inflamed tissue in the nose. Inside your nose is a wet layer called mucosa, which protects the inside of your nose and the sinuses. If you have a sinus infection or an allergic reaction, the mucosa can become swollen and red and may start to produce fluid that drips out. If you have a lot of irritation and inflammation, especially for a prolonged period, then a polyp may form.

A number of factors are believed to increase your risk of developing nasal polyps. These include:

• Experiencing chronic or recurring sinus infections
• Having asthma (including allergic and severe asthma)
• Experiencing reactions to taking aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs)
• Hay fever, otherwise known as allergic rhinitis
• Cystic fibrosis

It’s also likely that genetics and family history play a part, with certain genes making you more susceptible to experiencing inflamed nasal tissues.

Nasal polyps most commonly affect adults over 40 and are more common in men than women. Statistics suggest between 19-36% of people who have chronic sinusitis infections also have nasal polyps. Around 7% of people with asthma also have chronic sinusitis with nasal polyps.

How do you detect nasal polyps?

If you think you could have nasal polyps, you should see a medical professional, such as your family doctor. They’ll look at your nose and ask questions about the symptoms you’re experiencing.

Your nose may be examined using a special nasal endoscope. It will have a magnifying lens or camera on it that enables a doctor to see inside your nose and sinuses.

Sometimes other tests may be required, such as a CT scan of the sinuses, a biopsy, or allergy tests, to see if you have any allergies that could be causing the nasal inflammation. A CT scan will help specialists to get a clear view of the size and the location of your polyps. Polyps are rarely cancerous, but can sometimes hide other growths, so a scan can help to rule this out.

A blood test may also be done to check your vitamin D levels, as some studies have shown a link to vitamin D deficiency.

Do nasal polyps go away on their own?

If you have nasal polyps, they won’t go away on their own. If you have large nasal polyps or clusters of them, they can cause various symptoms and will need to be treated. A large nasal polyp could block the nose, causing ongoing problems.

Small nasal polyps might not cause any discomfort and you may be unaware you have them, so they can remain untreated without causing problems.

Don’t try to ignore nose polyps, hoping they’ll go away on their own as you sadly run the risk of developing ongoing sinus infections, asthma flare-ups, and even obstructive sleep apnea, in which the polyp affects your breathing. Sleep apnea is when you have bouts of stopping and starting breathing while you’re sleeping, which can be dangerous.

Treatment for nasal polyps

To get rid of nasal polyps, you’ll need medical treatment. Treatment options include:

• Corticosteroid nasal sprays – steroid nose drops or sprays may be prescribed to help shrink the polyps
• Steroid tablets – sometimes a course of steroid tablets may be prescribed, for one to two weeks
• Biologics (drugs derived from or containing biological sources) – mostly used for people who have severe chronic sinusitis, treatment with biologics, such as mepolizumab or can help to shrink the polyps and improve symptoms
• Surgery – surgical removal of polyps, particularly if they are blocking the airways or causing recurrent ongoing sinusitis.

Your family doctor will discuss treatment options with you and may refer you to a specialist.

Can nasal polyps be prevented?

There are practical steps you can take to reduce your risk of developing polyps in your nose. Plus, as polyps can re-occur, these steps are useful after you’ve had treatment too, to try and prevent further problems.

• If you have asthma, keep on top of your medications and treatment plan to keep your symptoms under control
• If you have a known allergy to aspirin or other NSAID drugs, including AERD or Samter’s Triad, avoid taking them – this could reduce the risk of polyps developing
• If you have allergies such as hay fever, try to reduce your exposure to irritants such as dust and pollen
• Avoid substances that could irritate the nasal passages, such as smoke, dust, or chemicals
• Use nasal rinses such as a saline spray or wash to remove irritants from your nasal passages and help the flow of mucus. Kits are available to purchase from pharmacies
• Try using a humidifier in your home to aid your breathing and help reduce the risk of nose blockages or nasal inflammation
• Practice good hygiene, such as regularly washing your hands to help reduce the risk of viral and bacterial infections which can cause nasal inflammation.

If you are worried you have nasal polyps or are having difficulty breathing, you should seek medical help.