Nasal polyps

What are nasal polyps

Nasal polyps are small, soft growths in the spaces (or lining) of the sinus cavities in the head / face. Nasal polyps consist of inflamed mucous or other tissue that grows in the sinus passages of the head and they can impede airflow and cause infection.

People who get nasal polyps usually develop many small ones together, which can block the nasal passages and prevent proper airflow. Nasal polyps can cause sinus infection (sinusitis) if they block the sinus passages by growing to a large enough size.

Mostly nasal polyps do not do much damage, but if they get large enough they can impede proper air flow into the nose and also breathing.

Sometimes nasal polyps can get so large they alter the shape of the face (especially around the nasal area where the sinuses are), but this is not very common and only happens rarely.

Facts about nasal polyps

• Nasal polyps are very common and occur in about 1 person out of every 200 people
• Nasal polyps are generally benign – they are very rarely cancerous
• Nasal polyps are very common in people with who suffer from chronic sinusitis or allergic rhinitis (hay fever)
• Surgery is recommended to remove the nasal polyps (especially if they impede airflow and cause recurrent infections) but they can grow back and invariably do in about 50% of all cases
• People with chronic upper respiratory conditions such as sinusitis or allergic rhinitis often develop more than one nasal polyp at a time
• People with chronic sinusitis or allergic rhinitis are recommended to use nasal decongestants every day, continuously
• People with chronic nasal polyps can sometimes have sleep apnoea, because of the polyps interfering with the ability to breath properly when lying down (if the nasal passages are blocked and the mouth is also closed, this can cause the person to stop breathing)

Symptoms of nasal polyps

The main symptom of nasal polyps is:

• Blocked nose – this causes a diminished ability to breath through the nose properly

Other symptoms of nasal polyps are:

• Changes to the face and nose – from very large polyps
• Headaches – from sinusitis
• Post nasal drip
• Runny nose
• Senses of smell and taste may be dull or diminished
• Sinusitis – from blockage of sinus passages, which enables more frequent infections to occur

Less common symptoms of nasal polyps are:

• Changes to the face and nose – from very large polyps, which cause severe swelling to the sides of the nose where they are growing
• Sleep apnoea – the nasal polyps cause blockages severe enough that they interfere with breathing at night when lying down
• Snoring – from larger polyps interfering with ability to breath properly when lying down

Causes of nasal polyps

Nasal polyps are caused by the long-term inflammation of the lining of the sinus passages (or even the nose).

This inflammation can then cause a build-up of inflammatory tissue in the sinus passages (or even the nose), which can be composed of not just mucous, but also dust, bacteria and other substances that were inhaled and not removed from the sinus passages, which can then form a nasal polyp and this can cause blockage of the sinus passages. People with chronic upper respiratory conditions such as sinusitis or allergic rhinitis often develop more than one nasal polyp at a time.

Some of the causes underlying the development of nasal polyps :

• Allergic rhinitis – this chronic upper respiratory system condition, also known as hay fever can cause chronic inflammation of the sinus passages, especially because people who suffer from allergic rhinitis do so over a long term, chronically
• Asthma – people with asthma tend to also suffer from allergies, which can give rise to inflammation of not just the lungs but also the nasal passages and long term, chronic inflammation of the nasal passages can cause a buildup of mucous and this enables the growth of the nasal polyps
• Chronic sinusitis – people who suffer from chronic sinus infections (sinusitis) can develop long term inflammation of the sinus passages, due to the continuous infections and build-up of mucous tissues and this is thought to create the nasal polyps
• Infection of the upper respiratory system – bacterial or viral infection may cause inflammatory build up in the sinus passages, but this is a lesser cause and will only occur in people who suffer from chronic infections of the upper respiratory system

Prevention of nasal polyps

Non-preventable risk factors

Nasal polyps may be unpreventable in certain circumstances:

• Allergic rhinitis – people who suffer from allergic rhinitis (hay fever) are particularly susceptible to developing nasal polyps, especially because this condition is chronic, occurs over the long term, creates inflammation in the nasal passage. Allergic rhinitis (or hay fever) often causes inflammation of the nasal passages, especially if the hay fever is unrelenting and difficult to manage and this is because allergic rhinitis causes severe irritation to the nasal passage, as well as runny or blocked nose symptoms from the build-up of mucous in the nasal passage. This inflammation in the nasal passages due to the allergic rhinitis (hay fever) can then precipitate the formation of nasal polyps
• Aspirin and NSAID sensitivity – people with a sensitivity (or intolerance) to the medication aspirin or other non-steroidal anti-inflammatory medications (NSAIDs) are also more likely to develop nasal polyps. Many people who have asthma also have an aspirin sensitivity too and are recommended not to use it as it can inflame symptoms and cause an asthma attack
• Asthma – People with asthma are also more likely to develop nasal polyps, especially if their asthma has an allergic component. Since recent studies have shown that a high percentage (over 50%) of all people with asthma are allergic to some substance, it means that many people with asthma will also develop inflammation in their sinus passages, which can increase their risk of developing nasal polyps
• Cystic fibrosis – children with cystic fibrosis are known to have a high risk factor for also developing nasal polyps. This is most likely due to the inability of the child with cystic fibrosis to eliminate the excessive mucous buildup in their body, which can manifest also in the sinus passages as nasal polyps
• Sinusitis – people who suffer from chronic sinusitis are particularly susceptible to developing nasal polyps. Chronic sinusitis causes inflammation in the nasal passage that continues to occur without much respite. The constant inflammation in the sinuses can then precipitate the formation of nasal polyps
• Upper respiratory infections – whenever there is a recurrent infection of the upper respiratory system, especially if symptoms including a runny or blocked nose, there is a risk for the development of nasal polyps. The reason for this, is because the constant viral infection does not allow the nasal passage to heal from the inflammation and nasal polyps can ensue

Preventable risk factors

There are ways to prevent nasal polyps from occurring:

• Avoid allergens – people who suffer from allergic rhinitis (hay fever) should try to avoid the allergens which cause the allergy symptoms as this will prevent inflammation of the nasal passages and may help to also prevent likelihood of nasal polyps growth too
• Avoid irritants – people who suffer from allergic rhinitis (hay fever) should try to avoid the irritants which cause the allergy symptoms as this will prevent inflammation of the nasal passages and this may help to also prevent likelihood of nasal polyps growth too
• Stay inside on windy days – people who suffer from allergic rhinitis (hay fever) or chronic sinusitis should avoid going outside on windy day as this can greatly exacerbate symptoms and create more inflammation in the nasal passages. If it is not possible to stay home, then have a shower immediately after coming home to remove all allergens, dust and other irritants and to help hydrate the nasal passages (from the steam of the shower), which can all help to prevent inflammation of the nasal passages and this may help to also prevent likelihood of nasal polyps growth too
• Use some type of nasal clearing – there are a number of conventional nasal sprays, alternative nasal sprays as well as other nasal clearing strategies (neti pot) to help clear out the nasal passages and reduce inflammation and help prevent at least worsening of symptoms, reduce inflammation in the sinus passages and also reduce nasal polyp growth

Complications of nasal polyps

There are a number of possible complications of nasal polyps:

Constant and chronic sinus infection

The most common complications of nasal polyps is sinus infection (sinusitis) which will be recurrent, difficult to manage and treat, due to the constant inflammation of the nasal passages.

While most sinusitis infection will not generally be very severe in most people, it can develop into a more serious bacterial infection if not treated promptly. This is the main reason why antibiotics are used for sinusitis infections – the prevention of a much more serious bacterial infection.

Malignancy

In a very small number of cases the nasal polyps are actually malignant and need appropriate care to remove them. Since both benign and malignant nasal polyps can occur together, the benign polyps may obscure the malignant ones and this can delay diagnosis until the disease is progressed to an advanced stage.

Sleep apnoea

Another very common complication of nasal polyps is sleep apnoea, which is a very serious sleep disorder that causes breathing to stop several times during sleep. People with very severe nasal polyps who have obstructed breathing in their sinus passages and who cannot breath through their nose at all (or very little), may stop breathing several times during the night while they are sleeping. This is because the nasals passages are blocked, the mouth is also closed or obstructed due to the nasal passages, sinusitis infection, allergy or combination of all and then breathing wont happen.

Regrowth

The most common complication of nasal polyps after surgery is their regrowth, sometimes years later. This requires further surgery, which has further possible complications and risks.

When to see a doctor about nasal polyps

Anyone who has any of the symptoms associated with nasal polyps should make an appointment to visit their doctor. A doctor can diagnose the symptoms to determine whether nasal polyps exist in the nasal passage and recommend appropriate treatment.

People with existing nasal polyps and who experience worsening of symptoms should visit their doctor to be re-evaluated.

People with any of the risk factors for nasal polyps (allergic rhinitis or sinusitis especially) and who notice their nasal symptoms are getting worse (really severely blocked nose) should visit their doctor to diagnose their symptoms and provide appropriate treatment.

People who experience a lot of snoring or sleep apnoea symptoms and who also suffer from recurrent sinusitis infection or have chronic allergic rhinitis or asthma, should visit their doctor for further diagnosis.

Diagnosis of nasal polyps

Nasal polyps are initially diagnosed by a doctor through the following methods:

• Medical history of symptoms – the doctor will ask a series of questions about the severity and duration of symptoms, when they started and how often they occur
• Physical examination – to check for any symptoms of the condition (and severity). This includes listening to the lungs with a stethoscope, examining the throat, ears and looking inside the nose for any obvious signs of the polyps

Diagnostic tests

A doctor or ENT (ear, nose and throat) specialist will arrange for the following test if the symptoms continue or are serious enough to warrant it:

• CAT scan – this scan gives an excellent view of the tissues, bone of the sinuses and the head, as well as any polyps in the are. The CAT scan will show where the polyps are located and how large they are, which is useful if surgery to remove them is required

Conventional treatment of nasal polyps

Conventional treatment of nasal polyps is based on the severity of symptoms, the underlying cause and whether or not they are obstructing breathing and therefore must be removed.

Allergy desensitisation

This is the first line of treatment that is recommend for people with allergic rhinitis (hay fever). Allergy desensitisation therapy may help some people to reduce their allergic response to their triggers, reduce inflammation and this will help to reduce severity of symptoms. This means, allergy desensitisation may then help to decrease the size of the nasal polyps that exist and prevent further ones from growing if the inflammation in the nose is greatly reduced.

Corticosteroid nasal spray

The steroids in these medications reduce inflammation, slow the growth of the polyps and reduce their size to enable better airflow (and breathing) through the nasal passage and are often recommended to be taken long term to prevent the sinus infection and recurrence of nasal polyp growths. These medications have some side effects, but are not as severe as the corticosteroid tablets as they are not absorbed into the body in the same way as the corticosteroid tablets are, so are better tolerated by most people. Examples are: Aldecin, Rhinocort, Nasonex

Corticosteroid medication

Cortisone medications are used to reduce the inflammation in the nasal passages which helps to shrink the nasal polyps, but they cannot be taken long-term as they cause many side-effects. Examples are: Prednisolone, Prednisone.

Nasal decongestants

These type of medications are recommended instead of the corticosteroid nasal sprays in people with mild symptoms or those people who cannot tolerate the corticosteroid medication in those nasal sprays. These nasal sprays inhibit the release of histamine so to prevent an allergic reaction which ultimately reduces inflammation and this can inhibit growth of nasal polyps. The only side effect this type of nasal spray has, is slight irritation to the nasal passages after it has been sprayed. Examples are: Nasalcrom, Opticrom, Tilade

Surgery

Surgery is recommended only as a last resort and only if the nasal polyps are greatly restricting breathing.

The nasal polyps can be removed by surgery, but they tend to grow back in about 50% of patients, so surgery is used as a very last resort, because the its success rate is not great. Surgery does not have a high success rate because the condition that caused the nasal polyps to grow in the first place is chronic in those people and the symptoms will continue to occur, so the polyps will unfortunately grow again.

Alternative / complementary treatment of nasal polyps

There are a number of alternative / complementary treatment options for reducing nasal polyps and prevent them from recurring, as well as treating the underlying condition which caused the polyps to develop and strengthen the immune system.

Herbs

There are a number of excellent herbs which may help to provide relief for symptoms:

• Echinacea – studies show the potent herb echinacea has excellent anti-viral properties which stimulate the immune system to function more effectively and help to reduce severity and duration of viral respiratory infections, including sinusitis
• Fenugreek – the seeds of the fenugreek spice are traditionally used to clear nasal congestion (especially from allergic rhinitis or sinusitis) and this helps to prevent infection and inflammation, which may reduce likelihood of nasal polyps developing in the nasal passages
• Garlic – many studies show that the potent herb garlic has anti-viral, anti-bacterial and anti-fungal properties and it helps to clear up nasal congestion and inflammation, so it may prevent sinus infection. Garlic is also recommended for people with allergic rhinitis, as it helps to reduce inflammation in the nasal passages
• Horseradish – the herb horseradish has been traditionally used to clear nasal congestion and prevent infection. Horseradish has similar properties to garlic, where it increase circulation in the nasal area, reduces inflammation and helps to clear up nasal congestion, which may help to reduce likelihood of nasal polyps
• Olive leaf – studies show the potent anti-viral herb olive leaf reduces inflammation and clears up congestion in the upper respiratory system, which may greatly reduce likelihood of nasal polyps

Vitamins

There are a number of vitamins which may help to provide relief for symptoms:

• Betacarotene – this is the precursor to vitamin A, so has the same properties
• Bioflavonoids – the antioxidant bioflavonoids, together with vitamin C, support and boost the function of the immune system. In addition to this, the bioflavonoids have excellent anti-histamine properties, which are beneficial in people with allergic rhinitis, to reduce symptoms and prevent nasal polyps from developing in the first place
• Vitamin A – the antioxidant vitamin A is required to keep the mucous membranes soft, moist and healthy, provide a boost to the immune system and help reduce severity of any infections. Nasal polyps may be prevented from developing in the first place as long as there is adequate Vitamin A in the diet (or with supplementation)
• Vitamin B complex – the B vitamins support the immune system to function properly and this means they may assist with prevention of nasal polyps
• Vitamin C – the antioxidant vitamin C, together with the bioflavonoids, support and boost the function of the immune system. In addition to this, the vitamin C has excellent anti-histamine properties, which are beneficial in people with allergic rhinitis, to reduce symptoms and prevent nasal polyps from developing in the first place
• Vitamin D – the important vitamin D may be an effective nutrient to help reduce the growth of nasal polyps, by reducing the inflammation in the nasal passages, as suggested by a recent study
• Vitamin E – studies show the antioxidant vitamin E helps to reduce symptom of nasal congestion and inflammation by boosting the function of the immune system. Vitamin E is also recommended in people with any type of upper respiratory infection

Minerals

There are a number of minerals which may help to provide relief for symptoms:

• Magnesium – the mineral magnesium relaxes body tissues (especially smooth muscle in the body) and may help to reduce inflammation, as well as any anxiety associated with the underlying chronic conditions (sinusitis, allergic rhinitis)
• Selenium – many studies show the powerful antioxidant mineral selenium may reduce the length and severity of symptoms, as it helps to boost the immune system to fight off infection (in sinusitis and other upper respiratory infection) as well as reducing the allergic response to allergen (in allergic rhinitis)
• Zinc – many studies show the antioxidant mineral zinc may reduce the length and severity of symptoms, as it helps to boost the immune system to fight off infection (in sinusitis and other upper respiratory infection) as well as reducing the allergic response to allergen (in allergic rhinitis)

Other nutrients

There are a number of other nutrients which may help to provide relief for symptoms:

• Alpha-lipoic acid – the antioxidant alpha-lipoic acid provides a huge boost to the immune system to help reduce symptoms from the nasal inflammation
• Omega 3 essential fatty acids – many studies show that omega-3 fatty acids reduce inflammation in the body, increase circulation and so may reduce the severity and duration of symptoms, especially in chronic allergic rhinitis (hay fever) and sinusitis, which may prevent the nasal polyps from developing in the first place

Dietary modifications

There are a number of dietary modification strategies which may help to provide relief for symptoms:

• Avoid mucous-causing foods – certain foods such as dairy, processed foods (high sugar and high fat foods) tend to cause more mucous to form which can make symptoms worse in people who have an upper respiratory infection
• Avoid salicylates – some studies show that nasal polyps could be due to a sensitivity to salicylates, which are both naturally occurring in some foods (tomatoes, eggplant) and are added as an artificial additive to processed junk foods (chips, crackers, biscuits). Try to avoid these foods for a few weeks, then re-introduce them back into the diet, one food at a time, to determine if there is a problem (or sensitivity) with the food
• Drink more fluids – adequate water, diluted fruit juice or herbal tea (such as chamomile, elderberry, peppermint or rose hip) intake helps to hydrate the body and moisten the mucous membranes to keep the allergens out and prevent them from causing symptoms
• Eat more garlic and onions – intake of garlic and onions should be added to the diet, as much as can be tolerated either fresh, cooked or as garlic supplements. Garlic and onions both have anti-inflammatory properties which can help reduce nasal symptoms
• Eat more oily fish – oily fish such as mackerel, salmon, sardines, trout and tuna, as they all contain high levels of the anti-inflammatory omega 3 fatty acids which may help to reduce inflammation inside the nasal passage and reduce severity and duration of symptoms, so that nasal polyps do not form in the first place
• Eat more fruit and vegetables – adequate intake of fruit and vegetables, especially dark green leafy vegetables and brightly coloured fruit are natural foods that have a high content of vitamins, minerals and antioxidants which may reduce severity and length of symptoms. Fruit and vegetables are also high in water, which is beneficial for hydrating the nasal passages and also helping to reduce symptoms
• Eat more nuts – adequate intake of nuts, especially walnuts or pecan nuts, contains omega 3 fatty acids which may help to reduce inflammation inside the nasal passage and reduce severity and duration of symptoms, so that nasal polyps do not form in the first place
• Eliminate food allergens – people with allergies and sinusitis may be more likely to have some type of food allergy that causes the chronic symptoms. The most common food allergens are: as cow’s milk products, gluten, artificial additives and preservatives

Lifestyle modifications

There are a number of lifestyle modifications which may help to provide relief for symptoms:

• Avoid allergens – people with allergic rhinitis need to avoid the particular allergen(s) that cause their symptoms. If allergic to dust mites, use a vacuum cleaner with an air filter, if allergic to certain foods, avoid them, if allergic to other substances, avoid them as much as possible
• Remove carpeting – people who have chronic sinusitis or allergic rhinitis may benefit greatly by having hardwood (or tiled floors) instead of carpet. The hard flooring prevents a build-up of dust mites, dirt and other substances, which may reduce symptoms and prevent build-up of inflammation in the sinuses
• Rest – it is highly recommended to have an adequate amount of sleep and rest, to give the body the best chance of a quicker recovery from an infection
• Shower after being outside – people with chronic sinusitis or allergic rhinitis need to have a warm shower after coming home, especially if it has been a windy day. The warm water from the shower will remove any dust, pollens and other substances from the skin, the steam will help to open up the nasal passages and clear them, preventing severe symptoms
• Steam inhalation – the simplest remedy to help open up the sinus passage, break up the mucous and get rid of nasal polyps is regular steam inhalation. The steam breaks up the mucous in the nasal passages and lungs, lessens nasal congestion and wheezing and also assists with better sleep. Steam inhalation can be done with just plain water, or by adding a few drops of peppermint or eucalyptus oil to the water

Alternative treatments

• Immunotherapy – this treatment gradually provides increasing doses of the allergen(s) to which the person is allergic to over a period of time. Immunotherapy starts with a very minute dose of the allergen and as long as there is not severe reaction, the dosage of the allergen is increased over a period of time to help the immune system stop reacting aversely to the substance. Immunotherapy has the effect of making the immune system less sensitive to the allergen(s) and reduces nasal inflammation symptoms so that the nasal polyps do not develop in the first place or help to reduce them if they already exist simply by clearing up the nasal passages
• Natural nasal spray – there are a number of natural nasal sprays available, either with just saline (salt and water) or with other nutrients such as zinc and eucalyptus. Natural nasal sprays provide relief of symptoms of inflammation and may even help to reduce the size of the polyps and prevent further ones from developing

Always ensure that you notify your medical practitioner of any supplements that you want to take – it may interfere with other medication or conditions you have. Confirm with your doctor it is safe to take before you try it.

Living with nasal polyps

Self care strategies

There are a number of strategies which are recommended to help deal with nasal polyps:

• Avoid any allergens – removing exposure to allergens will reduce allergic rhinitis symptoms, which can reduce the amount of inflammation in the nasal passages and reduce likelihood of nasal polyps developing in the first place
• Don’t smoke – cigarette smoke irritates the sinus passages, which may cause further inflammation. You also needs to reduce your exposure to your second-hand cigarette smoke too
• Drink more fluids – adequate water, diluted fruit juice or herbal tea (such as chamomile, elderberry, peppermint or rose hip) intake helps to hydrate the body and moisten the mucous membranes to keep the allergens out and prevent them from causing symptoms
• Eat more garlic – intake of garlic and onions should be added to the diet, as much as can be tolerated either fresh, cooked or as garlic supplements. Garlic and onions both have anti-inflammatory properties which can help reduce nasal symptoms
• Humidifier (or vaporiser) – a humidifier (or vaporiser) helps to provide more moisture in the air, which may help to reduce symptoms of inflammation in the nasal passages. The humidifier can be used with just plain water or with a few drops of eucalyptus oil to help further reduce symptoms
• Increase intake of fish, nuts and seeds – oily fish (such as salmon) as well as nuts and seeds have high levels of omega-3 fatty acids, which have excellent anti-inflammatory properties. The omege-3 fatty acids in the fish may help to reduce nasal symptoms which can reduce incidence of nasal polyps developing in the first place
• Natural nasal sprays – there are a number of natural nasal sprays available, either with just saline (salt and water) or with other nutrients such as zinc and eucalyptus. Natural nasal sprays provide relief of symptoms of inflammation by moistening the nasal passages and may even help to reduce the size of the polyps and prevent further ones from developing
• Rest – it is highly recommended to have an adequate amount of sleep and rest, to give the body the best chance of a quicker recovery from an infection. Even people with allergic rhinitis need to ensure they are resting properly as the constant allergic reaction is hard on the body and creates a lot of lethargy and tiredness (because of the body having to deal with the immune system constantly over-reacting)
• Shower after being outside on windy days – people with chronic sinusitis or allergic rhinitis need to have a warm shower after coming home, especially if it has been a windy day. The warm water from the shower will remove any dust, pollens and other substances from the skin, the steam will help to open up the nasal passages and clear them, preventing severe symptoms
• Steam inhalation – the simplest remedy to help open up the sinus passage, break up the mucous and get rid of nasal polyps is regular steam inhalation. The steam breaks up the mucous in the nasal passages and lungs, lessens nasal congestion and wheezing and also assists with better sleep. Steam inhalation can be done with just plain water, or by adding a few drops of peppermint or eucalyptus oil to the water

Caring for someone with nasal polyps

Partner

There are a number of strategies that are useful to help a partner with nasal polyps:

• Check on your partner’s breathing – while in bed, if you are awake and your partner is sleeping, try to check on their breathing to confirm whether or not they are breathing properly. If your partner is snoring a lot or has sleep apnoea (stops and starts breathing) while they are sleeping, they should visit a doctor to have further evaluation of their symptoms
• Don’t smoke – cigarette smoke irritates the sinus passages, which may cause further inflammation. If you need to smoke, do so away from your partner so that they are not exposed to your second-hand smoke
• Remove exposure to allergens– if your partner is allergic to specific substances, ensure you do not bring them into their environment, as that can make their symptoms worse

Friends

There are a number of strategies that are useful to help a friend with nasal polyps:

• Don’t smoke – cigarette smoke irritates the sinus passages, which may cause further inflammation. If you need to smoke, do so away from your friend so that they are not exposed to your second-hand smoke

Parents

There are a number of strategies that are useful to help a child with nasal polyps:

• Check on your child’s breathing – when your child is sleeping, try to check on their breathing to confirm whether or not they are breathing properly. If your child is snoring a lot or has sleep apnoea (stops and starts breathing) while they are sleeping, they should visit a doctor to have further evaluation of their symptoms
• Don’t smoke – cigarette smoke irritates the sinus passages, which may cause further inflammation. If you need to smoke, do so away from your child so that they are not exposed to your second-hand smoke
• Increase intake of fish, nuts and seeds – oily fish (such as salmon) as well as nuts and seeds have high levels of omega-3 fatty acids, which have excellent anti-inflammatory properties. The omege-3 fatty acids in the fish may help to reduce nasal symptoms which can reduce incidence of nasal polyps developing in the first place
• Recommend more vegetables – dark green leafy vegetables are a rich source of nutrients, are high in antioxidants and are rich in water, so they provide a great deal of nutrition for the body and help it
• Remove carpeting – if your child has been tested to have an allergy to dust and dust mites and they have chronic sinusitis or allergic rhinitis, it would be much more beneficial for their respiratory health to live in an environment which does not have any carpeting on the floors as that will exacerbate symptoms
• Remove exposure to allergens – if your child is allergic to specific substances, ensure you do not bring them into their environment, as that can make their symptoms worse

References

• Arnal JF, Flores P, Rami J, Murris-Espin M, Bremont F, Pasto I Aguilla M, Serrano E, Didier A. Nasal nitric oxide concentration in paranasal sinus inflammatory diseases. Eur Respir J. 1999 Feb;13(2):307-12
• Cekin E, Ipcioglu OM, Erkul BE, Kapucu B, Ozcan O, Cincik H, Gungor A. The association of oxidative stress and nasal polyposis. J Int Med Res. 2009 Mar-Apr;37(2):325-30
• Cheng YK, Hwang GY, Lin CD, Tsai MH, Tsai SW, Chang WC. Altered expression profile of superoxide dismutase isoforms in nasal polyps from nonallergic patients. Laryngoscope. 2006 Mar;116(3):417-22
• Dagli M, Eryilmaz A, Besler T, Akmansu H, Acar A, Korkmaz H. Role of free radicals and antioxidants in nasal polyps. Laryngoscope. 2004 Jul;114(7):1200-3
• Doğru H, Delibaş N, Döner F, Tüz M, Uygur K. Free radical damage in nasal polyp tissue. Otolaryngol Head Neck Surg. 2001 May;124(5):570-2
• Hiraki N, Suzuki H, Udaka T, Shiomori T. Snoring, daytime sleepiness, and nasal obstruction with or without allergic rhinitis. Arch Otolaryngol Head Neck Surg. 2008 Dec;134(12):1254-7
• Kalpaklioğlu AF, Kavut AB, Ekici M. Allergic and nonallergic rhinitis: the threat for obstructive sleep apnea. Ann Allergy Asthma Immunol. 2009 Jul;103(1):20-5
• Karlidağ T, Ilhan N, Kaygusuz I, Keles E, Yalçin S, Yildiz M. Roles of free radicals, nitric oxide, and scavenging enzymes in nasal polyp development. Ann Otol Rhinol Laryngol. 2005 Feb;114(2):122-6
• Kimura T, Majima Y, Guo Y, Yoshida T. The effect of growth factors on the proliferation and differentiation of human nasal gland cells. Arch Otolaryngol Head Neck Surg. 2002 May;128(5):578-82
• Meltzer EO, Blaiss MS, Derebery MJ, Mahr TA, Gordon BR, Sheth KK, Simmons AL, Wingertzahn MA, Boyle JM. Burden of allergic rhinitis: results from the Pediatric Allergies in America survey. J Allergy Clin Immunol. 2009 Sep;124(3 Suppl):S43-70. Epub 2009 Jul 9
• Mion Ode G, Campos RA, Antila M, Rapoport PB, Rosario N, de Mello Junior JF, et al. Futura study: evaluation of efficacy and safety of rupatadine fumarate in the treatment of persistent allergic rhinitis. Braz J Otorhinolaryngol. 2009 Sep-Oct;75(5):673-9
• Osiecki H. The Physicans Handbook of Clininical Nutrition, 6th Edition. Bioconcepts Publishing QLD, 2001
• Ragab S, Scadding GK, Lund VJ, Saleh H. Treatment of chronic rhinosinusitis and its effects on asthma. Eur Respir J. 2006 Jul;28(1):68-74. Epub 2006 Mar 1
• Rostkowska-Nadolska B, Fraczek M, Gawron W, Latocha M. Influence of vitamin D(3) analogues in combination with budesonid R on proliferation of nasal polyp fibroblasts. Acta Biochim Pol. 2009;56(2):235-42. Epub 2009 Jun 6
• Slavin RG. Nasal polyps and sinusitis. JAMA 1997; 278: 1849-54
• Taysi S, Uslu C, Yilmaz A, Aktan B, Altas E. Lipid peroxidation and some antioxidant enzymes in nasal polyp tissue. Cell Biochem Funct. 2006 Sep-Oct;24(5):461-5
• Thomas M, Yawn BP, Price D, Lund V, Mullol J, Fokkens W; European Position Paper on Rhinosinusitis and Nasal Polyps Group. EPOS Primary Care Guidelines: European Position Paper on the Primary Care Diagnosis and Management of Rhinosinusitis and Nasal Polyps 2007 – a summary. Prim Care Respir J. 2008 Jun;17(2):79-89
• Tratter R, Jones A. Better Health Through Natural Healing: How to Get Well Without Drugs or Surgery, 2nd Edition. McGraw Hill, 2001
• Walls RS, Heddle RJ, Tang MLK, Basger BJ, Solley GO, Yeo GT. Optimising the Mmanagement of Allergic Rhinitis: an Australian Perspective. MJA 2005; 182 (1): 28-33
• Yamamoto H, Okamoto Y, Horiguchi S, Kunii N, Yonekura S, Nakayama T. Detection of natural killer T cells in the sinus mucosa from asthmatics with chronic sinusitis. Allergy. 2007 Aug 17

Last reviewed and updated: 14 May 2024