According to past research, up to 4 percent of the population is affected by nasal polyps, teardrop-shaped growths that typically appear in groups on both sides of the nose. Small polyps don’t usually cause any symptoms, but you may notice issues as they grow. “Nasal polyps often manifest with changes in sense of smell, nasal obstruction, congestion, and mucus either being blown out of the nose or being felt as post-nasal drip,” says Alexander Schneider, MD, a board-certified otolaryngologist at Northwestern Medicine Central DuPage Hospital in Winfield, Illinois. (Postnasal drip is the sensation of constantly feeling like you have to clear your throat.) Nasal polyps often develop in people with chronic rhinosinusitis (sinus infection), a medical condition that’s reported to affect almost 12 percent of the adult population, according to the American Academy of Allergy, Asthma, and Immunology (AAAAI). People with asthma, allergies, and repeat infections are also more likely to get polyps, per Cleveland Clinic. There’s still a lot we don’t know about what causes nasal polyps, and why inflammation triggers them in some people and not others, but it may be that people who develop polyps have different immune system responses and chemical markers in their mucous membranes, Mayo Clinic notes.
How Do You Treat Nasal Polyps?
Several treatments can shrink nasal polyps or eliminate them altogether. However, the condition may never go away completely, and nasal polyps often come back if you don’t take preventive steps. Treatment options include nasal corticosteroid (“steroid”) sprays and intermittent oral corticosteroids to reduce swelling and irritation, and biologic medications that target pro-inflammatory chemicals that contribute to the development of nasal polyps, Dr. Schneider says. Many patients also undergo functional endoscopic sinus surgery (FESS), a minimally invasive procedure in which the doctor removes polyps without cutting the skin, per Johns Hopkins Medicine.
Signs and Symptoms of Nasal Polyps
Because nasal polyps cause many of the same symptoms as other sinus conditions, it can be tough to know what you’re suffering from. Polyps can be confused with acute rhinosinusitis, CRS, allergic rhinitis, and nonallergic rhinitis. Sometimes, polyps can appear on only one side. When this happens, the growth may be a tumor or another one-sided condition, such as a deviated nasal septum or sinus mucocele, says Chester F. Griffiths, MD, a fellow of the American College of Surgeons and chief of endoscopic sinonasal and skullbase surgery at Pacific Neuroscience Institute in Santa Monica, California. To diagnose nasal polyps, your doctor will look inside your nose with a nasal endoscope, a small thin telescope with a camera, notes Johns Hopkins Medicine. They may also take a computerized tomography (CT) scan to take detailed pictures inside your sinuses and confirm the diagnosis. So, is it nasal polyps or something else? Read on to narrow it down. Note that symptoms and presentation vary by patient, so always check with your doctor to help you get a proper diagnosis.
Nasal Polyps: Congestion, Runny Nose, Loss of Smell or Taste, and Sinus Pressure
Small polyps may not cause any symptoms. However, larger polyps can lead to headaches, loss of smell or taste, nasal congestion and drainage, nosebleeds, postnasal drip, pain or pressure in the sinuses, and snoring, per the Cleveland Clinic. They may also cause frequent asthma attacks in people with asthma, repeat sinus infections, sleep apnea, and breathing problems. The only way to know for certain if you have nasal polyps is to get a physical exam.
Acute Rhinosinusitis: Congestion, Tenderness, Fatigue, and Fever
Acute rhinosinusitis involves sinus inflammation that’s caused by a viral infection. According to Mayo Clinic, acute rhinosinusitis is mainly caused by the common cold. Like nasal polyps, signs and symptoms often include congestion, sinus pain and tenderness, headache, and changes in smell. However, you may also experience fatigue and fever with acute rhinosinusitis. Plus, most cases of acute rhinosinusitis resolve on their own within a week to 10 days, the Mayo Clinic notes. But sometimes, you may develop a bacterial infection that leads to chronic rhinosinusitis.
Chronic Rhinosinusitis: Long-Term Congestion and Tenderness
Like the acute version, CRS is characterized by inflammation of the nose and sinus cavities. According to Mayo Clinic, the condition is considered chronic when the symptoms associated with acute rhinosinusitis — with the exception of fever — have gone on for more than 12 weeks, despite medical treatment. Chronic rhinosinusitis occurs when fluid gets trapped in the sinuses, which allows germs to grow and create an infection, notes Northwestern Medicine. People with allergic rhinitis (more on this next) and asthma are more likely to suffer from CRS, but it can also be caused by a deviated nasal septum or an immune system deficiency, per the AAAAI. And while CRS is often associated with nasal polyps, you can also have it without polyps. The only way to tell if you have CRS with or without polyps is to get a physical exam.
Allergic Rhinitis: Congestion, Itching, Sneezing, and Runny Nose
Also known as hay fever, allergic rhinitis is a group of symptoms affecting the nose that strikes up to 60 million Americans, according to the American College of Allergy, Asthma and Immunology (ACAAI). When someone inhales an allergen such as pollen or dust, their immune system reacts by releasing histamine and other immune system chemicals. This response causes symptoms such as congestion, runny nose, sneezing, itching, and more, explains the ACAAI. Symptoms are often seasonal and appear during specific times of the year, such as spring, summer, and early fall.
Nonallergic Rhinitis: Congestion, Runny Nose, and Cough That Comes and Goes
At least 1 out of 3 people who experience allergic rhinitis symptoms don’t actually have allergies, according to the ACAAI. This condition is known as nonallergic rhinitis, because the immune system isn’t involved in creating the symptoms. While the triggers vary, they may include certain odors or irritants in the air, viral infections, hormone changes, weather changes, certain foods (such as hot or spicy foods and alcoholic beverages), and some medications (aspirin, ibuprofen, and beta-blockers, for example), according to Mayo Clinic. Your doctor may diagnose nonallergic rhinitis after ruling out allergic causes with a skin prick or blood test, the Mayo Clinic adds. However, there may be other clues that you’re suffering from nonallergic rhinitis: Your symptoms typically come and go year-round and don’t include the itchy nose, eyes, or throat associated with allergies. Nonallergic rhinitis can also be linked to nasal polyps, but the only way to tell is to get a physical exam.
Deviated Nasal Septum: Single-Sided Congestion, Repeat Sinus Infections, and Nosebleeds
If sinus congestion and tenderness is limited to one side, you may have a deviated nasal septum. This occurs when the thin wall (nasal septum) between your nasal passages is off-center, making one nasal passage smaller, explains Mayo Clinic. As many as 80 percent of people have a nasal septum that’s slightly off-center, but if the deviation is pronounced, it can block airflow on one side of the nose and cause congestion, according to the American Academy of Otolaryngology — Head and Neck Surgery Foundation. The resulting inflammation may lead to repeat sinus infections, mouth-breathing during sleep, and nosebleeds, the Foundation notes.
Sinus Mucocele: Single-Sided Congestion, Facial Swelling, and Headaches
Another potential cause of single-sided congestion is sinus mucocele. According to research, mucoceles are lesions (benign cystic growths) that gradually expand within the sinuses. They can develop when the sinuses get blocked, leading the damaged tissue to build up. “It creates a cyst that continues to grow,” Dr. Griffiths says. If the cyst gets big enough, it can push into bone and even the eye socket, he notes. Symptoms often include headaches, swelling and protrusion of the eye, or swelling of the forehead.
