Genetics There is some evidence that genetics may influence the likelihood that a person will develop nasal polyps, says Kim. Asthma and allergies “In the United States, the greatest risk factor is having a condition such as asthma, allergies, or eczema; those people will tend to be at greater risk for developing nasal polyps,” says Kim.
Aspirin sensitivityAllergic fungal sinusitisCystic fibrosisChurg Strauss syndromeVitamin D deficiency
Nasal endoscopy In this procedure, a long, flexible tube with a light on the end is inserted into your nose. This allows the doctor to have a comprehensive view of your inner nose and your sinuses.CT scan In cases where the diagnosis isn’t clear after the endoscopy, a CT scan may be performed. For this diagnostic test, X-rays are used to create images of structures inside the body that can be analyzed by a radiologist with a computer.MRI If needed, an MRI scan can provide even more information to help a doctor make — or rule out — a diagnosis of nasal polyps. A magnetic resonance imaging (MRI) machine uses a magnetic field to make images of inner organs and other structures.Allergy testing Allergies can contribute to the likelihood of nasal polyps.
Prognosis of Nasal Polyps
“If your nasal polyps get to a phase in which you have a very large and significant polyp load, it’s very hard to get them to go away,” she says.
Medication Options
Treatment for nasal polyps generally starts with drug therapy. Nasal corticosteroids If the polyps are very small, they may be treated with nasal steroids, says Kim. Nasal steroids include:
Fluticasone nasal (Flonase Allergy Relief, Xhance)Budesonide nasal (Rhinocort)Mometasone nasal (Nasonex)Triamcinolone nasal (Nasacort Allergy 24HR)Beclomethasone nasal (Beconase AQ, Qnasl)Ciclesonide nasal (Omnaris, Zetonna)
Oral steroids If the polyps are big or you have a large disease load, oral corticosteroids such as prednisone may be prescribed, “although we try to avoid using these because they can have serious and potentially harmful side effects,” says Kim. Injectable corticosteroids Injectable steroids may be used if the polyp load is severe. Biologic drugs Monoclonal antibodies can be used to treat nasal polyps and can work well for some patients, says Kim. Three biologics have come onto the market since 2019: Nucala (mepolizumab), Dupixent (dupilumab), and Xolair (omalizumab). “Although these drugs can be expensive, they are a good option to try; they can potentially treat the polyps so that surgery is unnecessary,” Kim says. Antihistamines or antibiotics If allergies or chronic or recurrent infections appear to be causing swelling in your nasal passages or sinuses, your doctor may prescribe antihistamines or antibiotics to treat the underlying cause.
Surgical Options
In the most severe cases, both surgery and aggressive medical therapy, including biologics and delivery of steroids via nasal irrigation, may be necessary to treat the polyps, says Kim.
Alternative and Complementary Therapies
Although there isn’t a specific diet that has been proven to help prevent or manage nasal polyps, there are supplements that may help minimize inflammation that could in turn help with the symptoms of polyps. Bromelain There is some evidence that bromelain, an enzyme derived from pineapples, may help reduce inflammation and swelling and relieve symptoms of sinusitis. Bromelain may increase the risk of bleeding, so people who take blood thinners should not take bromelain without talking to their doctor first. Taking bromelain with ACE inhibitors may cause blood pressure to drop. Quercetin Quercetin is a flavonoid that has been shown to inhibit the production and release of histamine in lab studies. Histamine causes allergy symptoms such as a runny nose and watery eyes. But more studies are needed to confirm that it has the same effect in humans. Sinupret This herbal combination is produced in Europe and imported into the United States. Sinupret contains Sambucus nigra (European elder), Rumex acetosa (common sorrel), Primula veris (cowslip), Verbena officinalis (European vervain), Gentiana lutea (gentian). The herbs it contains may work by thinning mucus and helping the sinuses drain, which can help relieve some of the symptoms of sinusitis. Neti pot or nasal rinse A neti pot is a little teapot with a long spout that can be used to flush out nasal passages with saline solution to improve mucus flow and remove allergens and irritants. If you do use a neti pot, be sure to use distilled, sterile, or previously boiled water. Tap water isn’t safe to use because it contains low levels of bacteria and protozoa, including amoebas.
Obstructive sleep apnea People with chronic rhinosinusitis who also have nasal polyps often have sleep disruption and sleep apnea. In some cases, larger polyps can fill 75 to 90 percent of the nasal cavity, which can lead to mouth breathing and snoring and possibly result in sleep apnea.Asthma flare-ups If a person has really severe nasal polyp disease, it can impact their breathing and sometimes worsen asthma for a person who has asthma, says Kim.Sinus infections Sinus infections are a common complication of nasal polyps.Other infections In rare cases, nasal polyps can lead to more serious infections, including infection of the tissue around the brain and spinal cord (meningitis), infection around the tissue of the eye, or infection of the sinus bones.
This organization is dedicated to the advancement of the knowledge and practice of all things related to allergy, asthma, and immunology to ensure the best patient care. The website offers information about nasal polyps and an online tool to help you locate an allergist in your area. MedlinePlus This online resource is sponsored by the National Institutes of Health (NIH). The website provides information about nasal polyps and illustrations of the throat and nasal areas.
