Nasal polyps: symptoms, causes, treatment and surgery

The NHS lists the symptoms as a blocked nose, a runny nose, a feeling that mucus is slowly dripping down the back of your throat (postnasal drip), a reduced sense of smell or taste, and snoring. ENT UK adds sneezing, which it says is seen in about half of patients, and catarrh.

Nasal polyps can sometimes feel like a cold, but the NHS says colds tend to clear up within a few days, whereas nasal polyps will not get better unless they are treated. If your polyps block your sinuses (the air pockets around your nose) you may also have symptoms of sinusitis.

ENT UK says a poor sense of smell and taste may not always return after treating the polyps.

ENT UK describes a polyp as a swelling of the lining of the nose, usually due to inflammation of that lining. They look like small grapes and can appear singly or in clusters in the nasal cavity, and often originate from the ethmoid sinuses, which drain into the side wall of the nose.

ENT UK says the chance of developing nasal polyps is between 1 and 20 for every 1,000 people, that they are more common in men, and that after the age of 60 the chance of developing polyps declines. Polyps on only one side of the nose are rare, are associated with a range of conditions and need further investigation.

The NHS says it is not clear what causes nasal polyps. It says certain things can increase your risk, such as asthma and an intolerance or sensitivity to aspirin. ENT UK similarly says the exact reason why some people get them and not others is not known, although they can be associated with allergy and infection.

ENT UK says nasal polyps commonly occur alongside more general conditions, such as late-onset asthma in an adult, aspirin intolerance or cystic fibrosis, and that 20% to 40% of people with polyps have coexisting asthma. It says more than two thirds of patients show no evidence of allergic disease.

The NHS says a GP should be able to tell if you have nasal polyps by looking inside your nose. If you do, you will usually be given steroid nose drops or a spray to shrink the polyps, and sometimes steroid tablets, usually for up to 2 weeks, to help relieve symptoms. Follow the GP's advice on how to use the medicine and for how long.

ENT UK says polyps respond and shrink with drops or sprays in up to 80% of people. Newer nasal steroid sprays can control symptoms for many years because very little is absorbed into the body, but many take up to six weeks before their full effect is felt. Stronger steroid drops are limited to short courses because some is absorbed, and steroid tablets give good relief that is short-lived and are used sparingly because of concerns about side effects.

After seeing a GP, the NHS says a pharmacist can recommend steroid nasal sprays that do not need a prescription and salt water washes (a saline rinse) to help unblock your nose. The NHS says the salt water wash it describes is not suitable for children.

The NHS says that if there is no sign of improvement after about 12 weeks, the GP may suggest surgery to remove your polyps. Most people who have surgery see an improvement, but it is common for polyps to grow back, usually within a few years.

ENT UK says that in three out of four patients the polyps come back after an average of four years, and that if they return repeatedly the sinuses can be cleaned out and opened up, which is thought to give a longer period before they come back. The NHS and ENT UK both say you may still need steroid sprays or drops after surgery to stop polyps returning quickly. ENT UK notes that people who have asthma, aspirin sensitivity and nasal polyps together tend to have polyps that recur more.

The NHS says to see a GP if you think you may have nasal polyps, you have difficulty breathing, your symptoms are getting worse, or you notice changes to your sense of smell.

A one-sided blockage should be assessed rather than assumed to be a polyp, because ENT UK says one-sided polyps are rare and associated with a range of conditions that need further investigation.

The NHS says nasal polyps are rare in children. ENT UK says they are rare between the ages of two and 10 years, and that if found in children cystic fibrosis should be excluded.

A child with a persistently blocked nose or noisy breathing should be seen by a GP. Salt water washes of the kind described by the NHS for adults are not suitable for children.

Nasal polyps, a cold and sinusitis share a blocked nose, so it is helpful to know the differences. The NHS describes sinusitis as swelling of the sinuses, usually caused by an infection, that is common and usually clears up on its own within 4 weeks.

On the NHS, nasal polyps are usually diagnosed by a GP, who prescribes steroid drops or spray and refers to an ear, nose and throat (ENT) service if there is no improvement or if surgery is being considered. ENT assessment may include a look inside the nose with a thin camera (nasal endoscopy).

Private ENT clinics can also examine the nose and arrange surgery, often with shorter waits. Whichever route you choose, ask about how long steroid treatment should be tried, the chance of polyps returning and what ongoing treatment will be needed after any operation.