What are nasal polyps?
Nasal polyps are soft growths that develop in the nasal passages or sinuses. They hang down like teardrops or grapes in your nasal passages. They are not a sign of cancer and they are not painful. They develop because of inflammation, and they are common in people who have asthma. Polyps can occur in children and adults but they occur more commonly in adults. When you have nasal polyps in your nose, the condition is sometimes referred to as nasal polyposis. No one knows what causes nasal polyps, but they can develop in anyone.
People with respiratory diseases such as asthma, allergic rhinitis, and chronic sinusitis are more likely to develop nasal polyps.
Signs or symptoms of nasal polyps
Some of the symptoms of nasal polyps include:
- a stuffy or blocked nose and feeling congested
- trouble breathing with your nose (because the polyps block your airflow and do not allow mucus from your nose to drain)
- frequent sneezing
- a runny nose
- trouble with your sense of smell
- inability to taste your food
If the polyps in your nose are small, you may not have many symptoms. If you have larger nasal polyps, you will likely have more symptoms. If your polyps are not removed, they can lead to worsening asthma symptoms if you already have asthma.
How does a doctor diagnose nasal polyps?
Usually, your doctor will examine you to tell you if you have nasal polyps. Some of the things an ear, nose and throat doctor might do include performing a nasal swab. This would mean your doctor would use a narrow tube called a nasal endoscope, which is connected to a tiny camera, so your doctor can look inside of your nose and see if there are polyps there and if so, how big they are. If you see your family doctor, they would look in your nose with a nasal speculum which widens your nostrils. That way, your family doctor can get a better look inside your nose.
How does your doctor treat nasal polyps?
There are a number of ways that nasal polyps can be treated or managed. The decision a doctor makes in treating your nasal polyps depends on how severe the polyps are. One of the most common ways to treat nasal polyps is to use nasal spray that releases steroids into your nasal passages and sinuses to help shrink your polyps. Your doctor might also suggest a nasal saline rinse.
Another type of treatment to shrink your nasal polyps is to take steroids by mouth, but your doctor will try to avoid prescribing you oral steroids because there are many side effects with oral steroids especially if they are taken for a long period of time. If you have used a nasal spray and have used oral steroids, and you still have nasal polyps, your doctors might want to consider surgery to remove your polyps or a biologic agent to help shrink your polyps.
Your doctor may tell you to use a nasal spray for a long period of time or to use the spray when you are having bad symptoms, like having a hard time breathing. If you forget to take a dose of your nasal spray on one day, you can take a double dose on another day.
Your doctor may suggest you take oral steroids first to shrink your polyps, if they are large polyps and you are having very bad symptoms, and that you then take a nasal spray. Medical literature suggests that if you use oral steroids, they can reduce the size of your polyps and help you feel better.
If taking medication does not shrink or reduce your polyps, you can have surgery to remove the polyps in your nose. The surgery, called endoscopic surgery, removes the polyps and corrects your sinuses to help prevent more polyps from developing. A doctor may also suggest that you use a nasal spray which releases steroids into your nose to prevent more polyps from developing. There are also saltwater rinses that you can use to help heal after surgery.
Newer ways to treat polyps
One of the new ways to shrink or reduce polyps is to use a medication called a biologic. These medications are usually taken by injection and patients may need to take the injections all their lives to keep nasal polyps from developing in their nasal passages and sinuses.
A biologic is usually used for severe polyps. These are situations where the usual medications or surgery have not been successful, so a biologic is another way to try to shrink the polyps. A biologic therapy attacks specific cytokines that circulate in your body, and specific cytokines drive inflammation and the development of polyps. Using a biologic gets to the root of the problem by attacking the cytokines.
Biologics to treat nasal polyps
One biologic that doctors in Canada can prescribe to help shrink nasal polyps is called dupilumab. Dupilumab attacks cytokines called IL-4 and IL-13, which are involved in inflammation that lead to nasal polyposis. Other biologics that are being studied as possible treatments for nasal polyps are omalizumab and mepolizumab. Canadian doctors also use these biologics to treat asthma.
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