Our Summary

This research study looks at a condition called Aspirin-Exacerbated Respiratory Disease (AERD), which is a hard-to-treat disease that affects the respiratory system. The study aimed to understand the typical progression of the three main symptoms - asthma, nasal polyps, and reactions to certain painkillers (known as NSAIDs) - and identify any obstacles to diagnosing the condition quickly. It also aimed to describe when it would be appropriate to carry out an aspirin challenge (a test to see if a patient reacts to aspirin) to help diagnose the disease.

The researchers looked at 697 patients with AERD, all of whom had at least one operation to remove nasal polyps. They found that asthma was typically diagnosed first, followed by nasal polyps and then reactions to NSAIDs. However, the order and timing of these symptoms appearing varied significantly between patients.

The study concludes that it’s important to diagnose AERD as quickly as possible to ensure the best possible care and education for patients. It suggests that an aspirin challenge test should be considered in patients who have not previously reacted to NSAIDs but have other symptoms compatible with AERD. This is especially important for patients who take low-dose aspirin daily, use medications to modify leukotriene (a substance involved in inflammation), avoid NSAIDs, or have severe symptoms that make it hard to spot any worsening of their condition.

FAQs

  1. What is Aspirin-Exacerbated Respiratory Disease (AERD) and what are its main symptoms?
  2. Based on the research, when should an aspirin challenge test be considered for diagnosing AERD?
  3. How does the progression of asthma, nasal polyps, and reactions to NSAIDs vary among patients with AERD?

Doctor’s Tip

One helpful tip a doctor might tell a patient about nasal polyp removal is to follow post-operative care instructions carefully to ensure proper healing and prevent complications. This may include avoiding activities that could increase nasal pressure or cause nosebleeds, using saline nasal sprays or irrigation as directed, and attending follow-up appointments to monitor recovery progress. It’s also important to inform your healthcare provider of any new or worsening symptoms after the procedure.

Suitable For

Patients who are typically recommended nasal polyp removal are those with Aspirin-Exacerbated Respiratory Disease (AERD) who have symptoms such as asthma, nasal polyps, and reactions to NSAIDs. It is important to diagnose AERD quickly to ensure proper care and treatment for these patients. An aspirin challenge test may be considered for patients who have not previously reacted to NSAIDs but have other symptoms compatible with AERD. Patients who take low-dose aspirin daily, use medications to modify leukotriene, avoid NSAIDs, or have severe symptoms may also be recommended for nasal polyp removal.

Timeline

Before nasal polyp removal:

  • Patient may experience symptoms such as asthma, nasal congestion, loss of smell, and facial pain
  • Diagnosis of asthma may occur first, followed by diagnosis of nasal polyps and reactions to NSAIDs
  • Symptoms may vary in timing and order of appearance between patients
  • Aspirin challenge test may be considered to help diagnose AERD

After nasal polyp removal:

  • Patient may experience improved nasal breathing, smell, and reduced facial pain
  • Continued monitoring for asthma symptoms and reactions to NSAIDs may be necessary
  • Patient education and care should be tailored to their specific symptoms and needs
  • Regular follow-up appointments may be required to monitor for any recurrence of nasal polyps or worsening of symptoms.

What to Ask Your Doctor

  1. What are the benefits of removing nasal polyps in AERD patients?
  2. What are the risks or potential complications associated with nasal polyp removal surgery?
  3. How long is the recovery process after nasal polyp removal surgery?
  4. Will nasal polyp removal surgery improve my symptoms of AERD, such as asthma and reactions to NSAIDs?
  5. Are there any alternative treatment options to consider before undergoing nasal polyp removal surgery?
  6. How often do nasal polyps typically recur after removal surgery?
  7. Will I need to follow any specific post-operative care instructions to prevent nasal polyp recurrence?
  8. How will nasal polyp removal surgery impact my overall quality of life and ability to manage my AERD symptoms?
  9. Are there any specific lifestyle changes or medications I should consider after nasal polyp removal surgery to help manage my AERD symptoms?
  10. How frequently should I follow up with you after nasal polyp removal surgery to monitor my AERD symptoms and overall health?

Reference

Authors: Buchheit K, Bensko JC, Lewis E, Gakpo D, Laidlaw TM. Journal: World J Otorhinolaryngol Head Neck Surg. 2020 Sep 8;6(4):203-206. doi: 10.1016/j.wjorl.2020.07.003. eCollection 2020 Dec. PMID: 33336174