Nasal Polyps

Have you ever wondered why your nose feels constantly stuffy, even when you don't have a cold? Nasal polyps might be the culprit. These soft, painless growths inside the nasal passages or sinuses affect millions of people worldwide. While often harmless, nasal polyp disease can cause discomfort and interfere with normal breathing, making it crucial to understand their nature and available nasal polyp treatment options. This article delves into the reasons behind nasal polyps, their symptoms, and how doctors diagnose them. 

What are Nasal Polyps?

Nasal polyps are soft, painless, non-cancerous or non-malignant growths that develop on the lining of the nasal passages or sinuses. These grape-like swellings result from chronic inflammation and can vary in size from small to large. They often appear in clusters, resembling a bunch of grapes. The growths typically form in the area where the sinuses open into the nasal cavity. 

Symptoms of Nasal Polyps

These growths can cause a range of symptoms that vary in severity. Small polyps might not cause any noticeable issues, but as they grow, individuals may experience:

• Nasal congestion (stuffy nose)
• Rhinorrhea (runny nose)
• Headaches
• Loss of taste and smell
• Nosebleeds
• Postnasal drip
• Sinus pressure
• Snoring

When polyps grow large enough to block nasal passages and sinuses, they can lead to more severe complications:

• Frequent asthma attacks (in asthmatic patients)
• Recurrent sinus infections (sinusitis)
• Sleep disorders like sleep apnoea
• Difficulty breathing, even in people who don't have asthma

Causes of Nasal Polyps

The exact cause of nasal polyps remains a mystery to medical experts. 

Chronic inflammation in the nasal passages & sinuses plays an elementary role in the development of nasal polyps. This long-term inflammation can stem from various sources, including:

• Chronic sinusitis
• Allergies
• Asthma
• Infections

Diagnosis of Nasal Polyps

Diagnosing nasal polyps involves a combination of physical examination and medical tests. 

• Doctors start by reviewing the patient's medical history, focusing on allergies, asthma, and sinus infections. They also ask about symptoms and their duration.
• The physical examination typically includes a nasal endoscopy. This procedure uses a narrow tube with a lighted lens or tiny camera to examine the inside of the nose. 
• CT scans can reveal the size of polyps deep in the sinuses and help rule out other causes of nasal blockage. 
• Skin prick tests or blood investigations can identify allergens causing ongoing inflammation. 
• Doctors may suggest a sweat test for children with nasal polyps to confirm cystic fibrosis, a genetic condition affecting mucus production.
• Blood tests may also be conducted to look for conditions linked to nasal polyps, such as allergies or immune system problems. 

Treatment for Nasal Polyps

Doctors use various approaches depending on the cause of inflammation and swelling, including:

• Nasal steroids are often the first line of medical treatment for nasal polyps. These sprays help shrink polyps and alleviate symptoms. 
• Biologic medicines offer a targeted approach for recurring nasal polyps. These drugs work by reducing inflammation at the cellular level. 
• Other medications may be used to address underlying conditions. These include antihistamines for allergies and antibiotics for infections. In some cases, aspirin desensitisation therapy might help patients with both nasal polyps and asthma who are sensitive to aspirin.
• When medications don't provide sufficient relief, nasal polyps surgery becomes an option. Endoscopic surgery allows surgeons to remove polyps and correct sinus issues using small instruments inserted through the nostrils. Balloon sinuplasty is another minimally invasive option that can open blocked sinus passages.

Risk Factors for Nasal Polyps

Several factors increase the likelihood of developing nasal polyps, such as: 

• Asthma
• Allergic rhinitis
• Chronic sinus infections 
• Cystic fibrosis
• Individuals with hypersensitivity to certain nonsteroidal anti-inflammatory drugs (NSAIDs) 
• Having a family history of nasal polyps 
• Long-term inflammation in the nose or sinuses
• A lack of vitamin D has been identified as a potential risk factor

Complications of Nasal Polyps

Nasal polyps can lead to several complications, affecting respiratory health and overall well-being. These may include:

• One of the most common issues is the worsening of asthma symptoms. 

Chronic sinusitis, a condition closely linked to nasal polyps, can result in ongoing sinus infections. These persistent infections may lead to rare but serious complications:

• Bone infection (osteomyelitis) & bone loss
• Abscesses (pockets of infection) spreading to eye sockets and brain
• Meningitis (infection of layers around the brain and spinal cord)

When to See a Doctor

Certain symptoms require immediate medical attention. People should seek emergency care if they experience:

• Rapidly worsening symptoms
• Double vision or other vision changes
• Swelling of the forehead
• Pain or swelling around the eyes
• A severe headache that continues to intensify
• Stiffness in the neck

Prevention

While it's not always possible to prevent nasal polyps, individuals can take several steps to reduce their risk, such as: 

• Managing allergies and asthma effectively plays a crucial role. 
• Avoiding irritants that can inflame the nasal passages is equally essential. These include tobacco smoke, chemical fumes, and dust. 
• Maintaining good hygiene habits can significantly lower the chances of developing nasal polyps. 
• Using a humidifier at home can help prevent nasal stuffiness and irritation. 
• Nasal rinses can be beneficial in removing irritants from the nasal passages. 

Conclusion

Nasal polyps have a significant impact on many people's lives, causing discomfort and breathing difficulties. Understanding their causes, symptoms, and available treatments is crucial to managing this condition effectively. From medical interventions to lifestyle changes, there are various ways to tackle nasal polyps and improve overall nasal health.

FAQ's

1. Will nasal polyps go away on their own?

Nasal polyps may shrink naturally and disappear without treatment in some cases. For most patients, nasal polyps do not go away on their own and require medical intervention. 

2. How can I remove nasal polyps on my own?

While there are no safe or proven nasal polyps treatments at home, some natural remedies may help alleviate symptoms:

• Nasal irrigation with a neti pot
• Steam inhalation
• Using a humidifier
• Drinking plenty of water
• Keeping the head elevated during sleep

3. Is it OK to remove nasal polyps?

Removing nasal polyps should only be done by a doctor. Trying to eliminate or remove them at home can cause complications like injury and infection. 

4. Can nasal polyps be cured?

While nasal polyps can be treated effectively, there is no permanent cure. Even after successful treatment or surgery, polyps may recur. Long-term management often involves ongoing use of nasal corticosteroids and saline irrigations to prevent recurrence.

5. Can polyps be removed without surgery?

Medications can often shrink nasal polyps without requiring nasal polyp removal surgery. Corticosteroid nasal sprays are the most common treatment, reducing inflammation and polyp size. 

Dr. Vijay Bansod

CARE Medical Team