“N A S A L P O L Y P S”
Nasal polyps are benign growths (swellings) that occasionally develop in the nasal cavity and/or the sinuses. The presence of such growths implies that the patient had inflammatory reactions in the nose and sinuses for long periods. Aspirin “allergy” is an important predisposing condition that leads to nasal polyps; often this is a part of the so-called “aspirin triad”. Chronic asthma and sinusitis with polyps and hives constitute this ‘triad’. The polyps are painless and as they develop gradually, one does not suspect their presence until they physically block the nasal passages. Of course, smaller growths may be detected by ENT surgeons and allergists in the course of an examination. Once they are established, the polyps do not spontaneously resolve.
In aspirin sensitive individuals, avoiding it and the “nonsteroidal anti-inflammatory drugs” (NASAIDs) such as ibuprofen and natural salicylates in diet are recommended. Some also suggest avoiding tartrazine or the Yellow food coloring agent, FD&C #5. Prolonged use of steroid nasal sprays may help shrink some polyps. Many may require surgery to remove them; the so-called ‘polypectomy’ operations. However, in the vast majority of patients undergoing such operations, the polyps promptly return. In those who have allergy to numerous “aero-allergens” such as pollens and molds, a lengthy course of allergy injections ( immunotherapy or desensitization may both help reduce the polyps and prevent the formation of new ones.
A special form of treatment is called “rush desensitization”. In this process, aspirin is given by mouth, starting with extremely small amounts and doubling in dose every twenty or thirty minutes. This is continued until a therapeutic or normal dose is reached. Then, that amount is continued daily for indefinite periods and as long as this is continued, the polyps do not usually return.
This article has been submitted by P.K. Raghuprasad M.D. If the reader has any questions regarding this topic, please direct them to Dr. Raghu at his email address at firstname.lastname@example.org.
Disclaimer: The facts presented in this article and the views expressed are solely those of the author(s) and do not necessarily reflect the views of the Board of Directors or other members of West Texas Physicians Alliance.