Nasal Polyps: Symptoms, Treatment & When to See an Online Doctor in the UK

Nasal polyps are soft, fleshy growths that develop in the lining of the nasal passages or the sinuses. Unlike some other types of polyps found in the body, they are typically non-cancerous (benign) and painless. They often hang down like teardrops or grapes. While small polyps might not cause any symptoms at all, larger growths or clusters of polyps can block the nasal passages, leading to breathing difficulties, a lost sense of smell, and frequent infections.

In the UK, it is estimated that around 1% of the population will experience symptomatic nasal polyps at some point. They are more common in adults over the age of 40 and are often associated with chronic inflammation of the airways, such as asthma, recurring infections, or allergies like hay fever. Following NHS and NICE guidance, the primary goal of treatment is to reduce inflammation and shrink the polyps to restore normal nasal airflow.

Because nasal polyps are soft and lack sensation, you might not realise you have them initially. However, as they grow, they begin to mimic the symptoms of a cold or sinusitis that simply does not go away. Key signs to look out for include:

• Persistent nasal congestion: A feeling that your nose is permanently blocked, often on both sides.
• Decreased sense of smell or taste: This is a hallmark symptom caused by polyps blocking the olfactory receptors.
• Post-nasal drip: The sensation of mucus constantly dripping down the back of your throat.
• Facial pain or pressure: Often felt around the forehead and cheeks, similar to chronic sinusitis.
• Snoring: New or worsening snoring due to restricted airflow through the nose.
• Runny nose: Clear or coloured discharge that persists for weeks.

If you find that your 'cold' has lasted for more than two or three weeks despite using over-the-counter paracetamol or decongestants, it may be time to speak to a GP to investigate the possibility of polyps.

While the exact reason why some people develop polyps while others do not isn't fully understood, medical evidence suggests that long-term inflammation is the primary driver. This inflammation causes the lining of the nose to become swollen (oedematous) and eventually fluid-filled growths (polyps) form.

Common UK-relevant risk factors include:

1. Asthma

Many patients with nasal polyps also suffer from asthma. The two conditions are often linked through a systemic inflammatory response in the respiratory tract.

2. Allergic Rhinitis (Hay Fever)

Allergies to pollen, dust mites, or pet dander can keep the nasal lining in a state of constant irritation, providing an environment where polyps thrive.

3. Aspirin Sensitivity

There is a specific condition known as Samter's Triad, where patients experience asthma, nasal polyps, and a sensitivity to aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.

4. Chronic Sinusitis

Long-term infections of the sinuses can cause changes in the tissue that lead to polyp formation.

The treatment of nasal polyps in the UK usually follows a tiered approach based on the severity of the symptoms. Most patients can be managed in a primary care setting without needing immediate surgery.

• Nasal Corticosteroid Sprays: These are the first-line treatment. Sprays containing mometasone or fluticasone help to reduce inflammation and can shrink small polyps over time. It is important to note that these must be used correctly and consistently; it may take several weeks to see the full benefit.
• Nasal Drops: If sprays are ineffective, a GP may prescribe stronger steroid drops (such as betamethasone). These often require you to get into a specific position (head upside down) to reach the higher areas of the nasal cavity.
• Oral Steroids: For larger polyps or severe symptoms, a short course of oral steroid tablets (prednisolone) may be prescribed to rapidly reduce swelling.
• Surgery: If medication fails, an ENT specialist may recommend an endoscopic sinus surgery or a polypectomy. This involves a surgeon removing the polyps using small instruments. However, even with surgery, polyps can sometimes return, making long-term use of steroid sprays necessary.

It is very common for patients to confuse these two conditions, largely because they often occur together. Chronic sinusitis is an inflammation of the sinuses that lasts more than 12 weeks, often caused by an infection. Nasal polyps are actual physical growths that can result from that inflammation. While you can have sinusitis without polyps, having polyps almost always leads to sinus issues because they block the natural drainage of the sinuses, leading to a build-up of mucus and subsequent infection.

If your symptoms include high fever and thick, green mucus, you may have an active infection requiring antibiotics. If your main issue is a total loss of smell and a physical feeling of blockage with no fever, polyps are more likely.

When you are struggling with a persistent blocked nose, waiting weeks for a traditional GP appointment can be frustrating. An online doctor in the UK can provide a convenient alternative to get a professional assessment and start treatment quickly. By booking a video consultation, you can discuss your symptoms, medical history, and previous treatments with an experienced GP.

An online GP can:

• Review your symptoms to differentiate between common allergies, sinusitis, and potential nasal polyps.
• Prescribe effective medicated nasal sprays or drops that are stronger than over-the-counter options.
• Advise on the best technique for using nasal medications to ensure they reach the affected area.
• Provide a private referral for further investigations if symptoms suggest you need an ENT specialist.
• Offer a sick note if your symptoms are significantly affecting your ability to work.