Question for those with both asthma and nasal polyps

[Blueforest23]

Hello, I just wanted to ask those with CRSwPolyps (rhinitis and polyps) and asthma, which developed first ie asthma or rhinitis/polyps and by how many years.

Reason I ask - apparantly up to 70% of people with rhinitis and polyps develop asthma. I have had rhinitis with polyps and I am told that I am at high risk for developing asthma (due to family history too- my dad developed asthma in middle age and polyps). I sort of feel like I am doomed to develop it which makes me very wary as I already have a lot going on with my digestive system (plus a minor lung condition)

I try to tell myself that I have had the polyps/rhinitis since I was 23 (13 years ago) so so far so good (allergy tests were negative) but it is persistent and I have had a high blood eosinophil count all these years.

[Thomas45]

In my case the asthma came first, in 1974, at the age of 29. It was about five years later I had rhinitis and polyps. Then a gap of 20years and more polyps. I had those removed around the year 2000 . My asthma has been much better since having anti- COVID injections.

[Poobah]

Personally, it was asthma first and then polyps along with aspirin sensitivity for me. Around 8% to 20% of asthmatics develop this condition, which is AERD and usually occurs in adulthood and the asthma has already developed in childhood.

Stats vary, but they generally state that between 20% to 60% of those with CRSwNP may have asthma. High eosinophils is something that some asthmatics have, but not all. What I haven't been able to find are studies that look at patients over time in order to establish WHEN and IF they will develop asthma after they develop CRSwNP.

As usual, studies conclude that more research is required to better understand the links between upper & lower respiratory diseases.

It's frustrating to have the sword of Damocles hanging over you because of very generalised statistics. I did find one study that attempted to look at this area, and it states "However, the factors associated with comorbid asthma in patients with CRSwNP have not been fully investigated, and a simple and practical tool for screening asthma comorbidity in this patient group is presently not available."

bmcpulmmed.biomedcentral.co...

For you it will be important to have annual checks to establish as early as possible if you have developed asthma, as the sooner it's treated the more improved overall control of the condition can be achieved.

[briqua]

I was glad to read your information. I had never been told nasal polyps and asthma go together. I was diagnosed with nasal polyps three years ago but was told they weren't bad enough to have an operation. I was coughing all the time, hoarse voice, sore throat. I went back after a year and was told the polyps had not changed so I didn't need to go back. The coughing continued and I was sent to a lung specialist. He put me on Prednisone and I had to do the Spirometry test. He said my lung capacity was better than his. No mention of asthma was made but he put me on Spiriva and Symbicort and I was to take it daily, and if I felt like it was getting better I could quit the Spiriva for the summer months. My coughing stopped and started several times and twice when travelling overseas I had to rush to a doctor who said I was having an asthma attack. Nowhere on my paperwork from the specialist did it say I had asthma. I was eventually told I had developed asthma at 70. Never smoked, don't drink. Covid came along I continued coughing. Was told it wasn't Covid. Ended up in hospital overnight with pneumonia. So now over that. Feeling good. Started doing park runs. Always ends up with me not being able to breath and having presumably an asthma attack but could keep moving, but had to stop running. Ventolin helps a bit but its hard to take it when you have been running. But I still have a job breathing through my nose. That has never gone away I sleep with mouth open. I think now a visit back to the ear, nose and throat specialist is in order after reading your post. Thank you

[Poobah in reply to briqua]

It can be very hard on the lungs if you can't breath through your nose. Nasal breathing is important as it prepares each breath for the lungs in order to achieve good gas exchange in the lungs (oxygen in & carbon dioxide out ).

When we breath through the nose, several things happen; slows the air down, warms it up, filters out impurities and vitally, mixes in nitric oxide. When we mouth breath, we put too much strain on the lungs and miss out on the nitric oxide, leading to poor gas exchange.

Your nasal polyps can be treated with steroid sprays or drops, if an operation is not suitable. This excellent video explains how to get the best from your nasal spray; youtu.be/LOhmsn4gQMM(Not working as expected?)

Whatever you do, avoid over the counter decongestants as they are only designed for short term use and if used beyond 3 or 4 days can make symptoms worse or even damage the sinuses.

You may also benefit from nasal breathing exercises. I use Buteyko after it was recommended by my respiratory physiotherapist. There are good videos on YouTube that walk you through the exercises (I use those made by Patrick McKeown). But you may have a local Buteyko practitioner who can help, unfortunately not on the NHS.

[jdylm]

Blueforest23 -- Growing up, I had rhinitis from allergies. In my early 20s, just after having a baby, I developed asthma . Around age 50, acquired nasal polyps, one side. No surgery as doc said daily Fluticasone would keep them from swelling too much (and I'd need to be on Fluticasone anyway, even after surgery, to keep them from returning). I still use Fluticasone, but the asthma is improved enough to reduce my long-term inhaler to 1 puff a day (down from 4) -- it's only taken 40+ years!

[Blueforest23]

Hi thanks for the replies they are useful and some interesting stories/experiences there!