In October 2023, Kolkata-based Sitaram Gaud, 47, who has been working in the construction business for more than two decades started having difficulty breathing.
Despite enduring this issue for two to three months, he initially dismissed it as a minor problem, attributing it to nasal congestion caused by his exposure to dust at work and his history of asthma. Moreover, having smoked for 20 years, he consistently experienced mucus accumulation in his throat, particularly in the mornings.
However, when the problem persisted, he consulted a physician. “My doctor diagnosed polyps in my nose as the cause which was later surgically removed,” explains Gaud.
What are nasal polyps?
Dr Anish Gupta, lead ENT consultant, C K Birla Hospital, Gurugram says that nasal polyps are soft, benign growths on the tissue that lines the nose and sinuses. They hang like teardrops or grapes and can vary in size and colour.
Individuals with small nasal polyps may not experience any symptoms or even realise they have them. But they can block the nasal passage when they are enlarged or in groups. This leads to breathing difficulties, loss of smell, and frequent nasal infections.
Sometimes these large or multiple polyps block the sinuses causing sinusitis as well, says Dr Nikhat Parveen, an ENT consultant from Kolkata.
“Inverted papilloma [a benign tumour in the nasal cavity and sinuses] can mimic polyps [with a] 1-2 per cent chance of developing into squamous cell cancer [skin cells that make up the middle or outer layer],” says Dr Gupta.
Signs and symptoms
Dr Parveen says that nasal polyps that are small may lack any sensation. Those who have them may not experience any symptom and be unaware of their presence. However, a large group of polyps can block the nose. People may sometimes feel they have a clogged nose and experience symptoms associated with the common cold. However, it is advisable to consult a doctor if one or more symptoms persist for a long time.
Some typical symptoms of nasal polyps are:
- Blocked nose
- Difficulty in breathing
- Snoring
- Decreased or total loss of smell and taste
- Excessive mucus dripping from the back of the nose causing a constant urge to clear the throat
- Frequent nosebleeds
- Facial pain or headache
Causes
The exact cause of nasal polyps is not known, but it is thought to occur due to inflammation of the lining of the nose. Individuals who develop nasal polyps show a different immune response. There may be some triggers that induce polyps, which are mostly seen in adults around 30 to 40 years of age, but can occur at any age. According to the ENTUK and American Academy of Allergy, Asthma and Immunology the following are some of the factors that can trigger nasal polyps:
- Asthma (20 to 40 per cent more chances of polyps with pre-existing asthma)
- Allergic rhinitis where a person develops cold-like symptoms due to an allergic reaction
- Aspirin sensitivity
- Cystic fibrosis where the body produces thick sticky fluid mostly from the lungs, clogging the lungs and digestive system
“Allergy is the main cause of polyps. Other reasons include fungal sinusitis, eosinophilia [an increase in the number of a type of white blood cells, eosinophils) and non-allergic polyps,” says Dr Gupta.
Diagnosing nasal polyps
According to experts, the typical symptoms associated with nasal polyps can be used to diagnose the condition. However, imaging, and other diagnostic procedures can be used to establish a confident diagnosis.
Dr Gupta says that a simple nasal endoscopic examination is sufficient to diagnose polyps in which a camera fitted at the end of a tube is inserted through the nose to offer a clear view of the internal nasal structures. A radiological investigation is required to understand the extent of the disease, the presence of any fungal disease, involvement of the eye and brain, and to plan surgery if required.
“Usually, polyps do not lead to complications if treated on time. Long-standing polyposis or polyps associated with the fungus can breach the bony partition between the eye and brain and can lead to complications,” adds Dr Gupta
Experts say that a course of treatment for nasal polyps usually includes steroidal drops, saline wash, and medication to reduce inflammation. Antibiotics can be added as therapy if infection of the sinuses is suspected. If the polyps do not shrink with medication, the only option is surgical removal of the nasal polyps (polypectomy).
