Nasal polyps

Overview

Nasal polyps are soft, painless, non-cancerous growths that develop on the lining of your nose or sinuses (the air-filled spaces around your nose). They look like small grapes or teardrops and are not dangerous, but they can block your nasal passages and cause breathing problems.

Nasal polyps are fairly common, affecting about 4 in every 100 people. They are more common in adults than in children.

Nasal polyps can affect anyone, but they are more common in people with asthma, allergies, chronic sinus infections, or cystic fibrosis. They tend to appear after age 40, but can occur at any age.

Symptoms

Common symptoms

• A stuffy or blocked nose that won't go away
• A runny nose or post-nasal drip (mucus dripping down the back of your throat)
• Decreased sense of smell or taste
• Facial pain or pressure, especially around your eyes or forehead
• Snoring or sleep apnea (stopping breathing during sleep)
• Frequent sinus infections

Symptoms in children

• Nasal polyps in children are rare but can cause a constant runny nose and difficulty breathing through the nose.
• Children may have trouble sleeping or snore loudly.
• If your child has nasal polyps, talk to their doctor about testing for cystic fibrosis.

Symptoms in older adults

• Older adults may notice a gradual loss of smell and taste, which can affect appetite and weight.
• They are more likely to have other health conditions like high blood pressure or diabetes, which can complicate treatment.
• Nasal polyps can make other breathing problems, such as COPD, harder to manage.

Causes

Main causes

• Chronic inflammation of the nose and sinuses – this is the key cause. It can be due to allergies, asthma, or long-term sinus infections.
• Irritation from exposure to dust, fumes, or cigarette smoke may also contribute.
• Some people have a family tendency to develop nasal polyps.

Risk factors

• Asthma – especially if it is severe or hard to control
• Allergic rhinitis (hay fever) or other allergies
• Chronic sinusitis (long-term sinus inflammation)
• Cystic fibrosis (a genetic condition that affects mucus production)
• Aspirin-exacerbated respiratory disease (AERD) – a reaction to aspirin or NSAIDs that causes breathing problems and nasal polyps
• Smoking or exposure to secondhand smoke

When to see a doctor

See a doctor urgently if:

• You have trouble breathing or your asthma gets worse
• You have severe face pain or a high fever
• You notice sudden vision changes or a bulging eye

Book a routine appointment if:

• You have a stuffy nose that lasts more than 2 weeks
• You lose your sense of smell or taste for a long time
• You keep getting sinus infections
• You have facial pressure or pain that doesn't go away

Diagnosis

Your doctor will ask about your symptoms and your medical history, then look inside your nose with a small camera called a nasal endoscope. This is done in the doctor's office and is usually painless.

Tests that may be done

• Nasal endoscopy – a thin, flexible tube with a light and camera is inserted into your nose to see the polyps
• CT scan of your sinuses – to see how many polyps there are and how much of the sinus cavities are blocked
• Allergy tests – if allergies are suspected to be the cause
• Sweat test or genetic testing – if cystic fibrosis is considered (more common in children and young adults)

What to expect at your appointment

The diagnosis is usually straightforward. Your doctor will explain the size and number of polyps and discuss treatment options. You may be referred to an ear, nose and throat (ENT) specialist. Most people can be treated without surgery.

Treatment

Treatment for nasal polyps aims to shrink the polyps and keep them from coming back. It often starts with medications and may include surgery if medications don't help. You will need to work with your doctor to find the best plan for you.

Self-care at home

• Use a saline (salt water) nasal rinse twice a day to keep your nose moist and clear out mucus
• Use a humidifier in your bedroom to add moisture to the air
• Avoid triggers like cigarette smoke, dust, and strong fumes
• Manage allergies with antihistamines (ask your doctor or pharmacist which one is right for you)

Medical treatments

Doctors often prescribe nasal spray medications that reduce inflammation in the nose and sinuses. These sprays are used daily and can shrink polyps over weeks to months. If sprays are not enough, you may be given short courses of oral anti-inflammatory medications (corticosteroids) to reduce swelling quickly. For people with allergies, additional allergy treatments may help. Antibiotics are used only if a sinus infection is present. Your doctor will explain the options and how to use them safely.

When is surgery considered?

If medications do not control your symptoms or the polyps are very large, your doctor may recommend surgery to remove them. This is called endoscopic sinus surgery. It is done through your nostrils, so there is no visible scar. Even after surgery, you will likely need to continue using nasal sprays to prevent polyps from growing back.

Living with this condition

Living with nasal polyps means managing your symptoms every day. Use your treatments as prescribed, and keep your nose clean with saline rinses. Avoid known triggers like smoke and strong odors. Keep track of your symptoms so you can tell your doctor if something changes.

Lifestyle tips

• Use a saline nasal rinse daily
• Stay away from cigarette smoke and other irritants
• Treat allergies and asthma as directed by your doctor
• Get regular exercise – it can help open your nasal passages
• Drink plenty of water to keep mucus thin

Diet and exercise

Eating a healthy diet with plenty of fruits and vegetables may help reduce inflammation in your body. Some people find that avoiding dairy or spicy foods helps, but this varies. Regular exercise can temporarily relieve nasal congestion and improve your overall health. If you have asthma, always warm up and use your inhaler if needed.

Mental health and emotional wellbeing

Chronic nasal congestion and loss of smell can be frustrating and affect your mood. You may feel tired from poor sleep or feel self-conscious about a runny nose. It's normal to feel this way. Talk to your doctor if you feel down or anxious – they can connect you with support.

Prevention

You cannot always prevent nasal polyps, but you can lower your risk by controlling allergies and asthma, avoiding cigarette smoke, and treating sinus infections early. If you have a tendency to get polyps, using a saline nasal rinse daily may help reduce inflammation.

Vaccines

Getting the flu vaccine and pneumonia vaccine may help prevent infections that can trigger sinus inflammation.

Screening programmes

There is no routine screening for nasal polyps. If you have symptoms, see your doctor.

Complications

If left untreated

• Chronic sinus infections that keep coming back
• Long-term loss of smell and taste that may become permanent
• Sleep problems from blocked breathing at night (sleep apnea)
• Rarely, a serious infection can spread to the eye or brain

Long-term outlook

With proper treatment, most people with nasal polyps can control their symptoms and breathe comfortably. Polyps often come back, but ongoing use of nasal sprays and good self-care can keep them small. Surgery can help when medications are not enough. While it can be a long-term condition, you can live a full and active life.

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