Can a gluten-free diet help reduce nasal polyp inflammation?

Question

Hello doctor,

I am 27 years old and have been diagnosed with nasal polyps for three years. I had functional endoscopic sinus surgery about 18 months ago but the polyps have grown back. My ENT has said a second surgery may be necessary but I am hesitant to have another surgery so soon.

I've read somewhere in my research that removing gluten from your diet can reduce inflammation in your nose and even shrink the polyps over time.

My recent CT scan showed bilateral polyps with marked opacification of ethmoid sinuses. I take Mometasone furoate nasal spray every day but still have nasal blockage and postnasal drip, which affect my sleep and concentration.

I would like to know if there is clinical evidence that taking gluten out may actually reduce nasal polyp inflammation or if this is mostly anecdotal.

I have not been diagnosed with celiac disease, but I wonder if I could have non-celiac gluten sensitivity that is affecting me.

Should an elimination diet be attempted in addition to medical treatment? How long should it normally take to see some improvement in symptoms or polyp size?

Please help.

Answer 1

Hello,

Welcome to icliniq.com

I have read your query and understand your concern.

The polyps keep coming back because of chronic inflammation. They don’t have a cause. Underlying drivers typically involve allergies, chronic sinus inflammation and eosinophilic (type 2) inflammatory pathways.

At present, there is no substantial clinical evidence to support the elimination of gluten as a standard treatment for nasal polyps in patients without celiac disease through a gluten-free diet. Most reports of improvement are anecdotal and may only apply to people with underlying gluten sensitivity or related conditions.

In medical literature, non-celiac gluten sensitivity as a direct cause of nasal polyps is not well established. Gluten withdrawal is therefore unlikely to have a major or consistent effect in most patients with nasal polyps.

If you want to, you can cautiously try a short-term elimination diet, provided your overall nutrition does not suffer. If you try it, it is reasonable to continue it for about six to eight weeks, watching your symptoms for any noticeable change.

Most importantly, testing for underlying allergic triggers such as serum IgE (immunoglobulin E) or allergy panels can help pinpoint specific causes. In chronic inflammation, newer therapies targeting inflammatory pathways such as biologic agents may be more effective in reducing polyp size and preventing recurrence.

As your symptoms are affecting your quality of life and you have had recurrent polyps after surgery, it would be helpful to discuss advanced medical therapies with your ENT specialist before considering another surgery.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.