When chronic stuffiness isn’t a cold or allergy, it could be nasal polyps
The typical person has two to three colds a year. Winter is usually the peak cold season but from 1 to 4 percent of the population suffers from chronic congestion. This can come from completely different sources.
Hyperactive Immune Response
When regularly exposed to irritants like allergens, cigarette smoke, or construction dust, the lining of the nose can develop a hyperactive immune response. This can cause it to grow nasal polyps. Nasal polyps can form on one side of the nose or both sides. Their classic symptoms are nasal congestion accompanied by a decreased sense of smell and sometimes taste.
What is the Cause of Nasal Polyps?
Why nasal polyps form is a mystery. We don’t know the underlying cause, but what we do know is that it’s a hyperactive immune response. For this reason, removing the polyps alone doesn’t provide a cure. Once you remove the polyps, the lining still must be treated or else it may make polyps again.
Nasal polyps usually originate in the back of the nose. They aren’t usually visible to the naked eye or to a doctor’s nasal speculum until they have grown larger. Usually, it is necessary for your doctor to use an endoscope and camera to see these polyps. The polyps usually resemble a cluster of grapes, made up of tissue that is like the lining of the nose but usually is more fluid-filled and swollen.
Almost anyone can develop polyps, but about 50% of cases occur in patients who also have seasonal allergies. Doctors have identified conditions commonly associated with polyps called Samter’s triad. The three conditions are nasal polyps, asthma, and aspirin allergy. If you have any of these conditions, it’s worth talking to your doctor about having the others.” Those with cystic fibrosis have an increased risk of nasal polyps.
What’s the difference between regular nasal congestion and nasal polyps?
Polyps growing in the nose eventually block the olfactory cleft, or smell zone. If your nasal congestion is combined with a loss of smell, it should be checked by your primary care physician, allergist, or ENT.
The severity of nasal polyps depends on the size and location. This condition can be as debilitating as COPD or heart disease and is a leading cause of loss of quality of life.
Signs and Symptoms of Nasal Polyps
Sometimes it is hard to tell if a person has nasal polyps. The most common complaint is nasal congestion. When the polyps grow, they can cause a decrease or loss of smell, postnasal drip, facial pain, or headaches, sinus infection, and/or fever.
Polyps aren’t malignant, but it is still important to evaluate them. A small sample of the polyp is taken to make sure it’s not something more serious, like a tumor, especially when the polyps only occur on one side of the nose.
Treatment for Nasal Polyps
If nasal polyps are not treated, they can interfere with your quality of life. Doctors have effective treatment to provide relief. Usually, the first line of treatment is topical steroids with a nasal spray used once or twice a day. The steroids reduce the polyp size and nasal congestion.
If the polyps are large and prevent the nasal spray from working, we can use a short course of oral steroids to shrink the polyps down so that the spray works. Some patients who have no response to steroids will need to further be evaluated to make sure there isn’t something more serious happening.
Surgery is another treatment option. Endoscopic sinus surgery can be used to reduce the polyps to a level where medical treatment can keep them away. Medical therapy will still be needed to prevent the lining from forming new polyps.
The treatment and effectiveness vary from patient to patient, but most people respond very well. For most people, surgery combined with medical therapy has a 90% success rate, with real improvement in quality of life and breathing. But the outcome also depends on the patient following the medical regimen.
Research for Nasal Polyps
Researchers are still searching to find out why polyps develop in the first place. The biggest breakthrough is a dissolvable steroid implant. Previously steroids were delivered to the nose with nasal spray or irrigation. But there was no way of knowing how much of the steroids reached the polyp.
Questions for your Doctor about chronic congestion
If you are experiencing chronic congestion with decreased smell, ask your doctor if this could be polyps. If you’re receiving treatment for asthma and allergies and you’re not getting better, ask if it could be polyps. Polyps are not something you have to live with for the rest of your life. There have been a lot of treatment advances, so there are many things we can do to bring polyps under control.
Be Informed about Nasal Polyps
Learn more about Polyps at
Manage your allergies. – If you have known allergies, consider allergy shots.
Comply with medication. – Surgery is really an addition to medical treatment. It is essential for patients to take their medications as prescribed.
So, if your stuffy nose isn’t from allergies or asthma, it could be nasal polyps developed by an overactive immune response. Schedule an appointment today!