Why do nasal polyps worsen after illness despite treatment?

Question

Hello doctor,

I am 49 years old and have had nasal polyps for several years. I use Fluticasone nasal spray and occasionally take Prednisone tablets, but every time I get a cold or the flu, my symptoms become much worse. I want to know the following:

Why do nasal polyps worsen after every illness, even with treatment?
Is this something that happens to everyone with nasal polyps, or is it specific to my condition?
Whenever I have a flare-up, my nose becomes completely blocked, and I lose my sense of smell. It feels like I never fully recover after each episode. Does this mean I need surgery or stronger medications?
Could you please guide me on what options are available to better control my symptoms?

I am tired of depending on nasal sprays all the time, and breathing through my mouth is affecting my sleep and daily life.

Please help.

Thank you in advance.

Answer 1

Hi,

Welcome to icliniq.com.

I understand how frustrating it must feel to deal with nasal blockage, loss of smell, and repeated flare-ups despite using treatments regularly. However, it is important to understand that nasal sprays and steroids do not simply mask symptoms; they are important treatments that help reduce the underlying inflammation, control swelling, and decrease the size of nasal polyps.

However, they may not completely eliminate the tendency for polyps to develop, especially when there is ongoing inflammation in the nose and sinuses.

Nasal polyps are non-cancerous (benign) soft tissue growths that develop inside the nose or sinuses due to long-term inflammation of the nasal lining. When a person with nasal polyps gets a cold, the flu, or another viral infection, the immune system responds by increasing inflammation. This can cause the nasal tissues to swell further, leading to worsening blockage, reduced sense of smell, and difficulty breathing through the nose.

The fact that your symptoms worsen after every illness does not mean you are the only one experiencing this. Many people with nasal polyps notice similar flare-ups, even while using regular treatment. However, frequent episodes, persistent blockage, loss of smell, and poor sleep indicate that your current treatment plan may need to be reviewed.

If symptoms continue despite appropriate medical treatment, an ENT (ear, nose, and throat) specialist may discuss additional options. These may include adjusting medications, evaluating for contributing conditions such as allergies or chronic sinus inflammation, or considering endoscopic sinus surgery with polyp removal (polypectomy).

Surgery can help clear blocked nasal passages, improve breathing and sense of smell, and allow medications to work more effectively afterward. However, it is important to understand that surgery does not always permanently prevent polyps from returning because the underlying inflammatory tendency can continue.

A long-term management plan, including regular nasal steroid sprays, saline rinses, trigger control, and follow-up care after surgery if needed, is usually important to reduce the chance of recurrence.

Please consider scheduling a consultation with an ENT specialist to assess the severity of your nasal polyps and discuss the best treatment approach based on your symptoms and examination findings.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.