If you have chronic sinusitis, nasal polyps, and asthma you may have a hypersensitivity to aspirin or non-steroidal anti-inflammatory medications, like ibuprofen. This condition, traditionally known as Aspirin Sensitive Asthma or Samter’s triad, has been difficult to diagnose and treat. However, recent advances in diagnostic and therapeutic technologies have improved our ability to help these patients.
Aspirin-exacerbated respiratory disease is a clinical diagnosis that consists of nasal polyps, chronic eosinophilic sinusitis, asthma, and hypersensitivity to non-steroidal anti-inflammatory medications (Aspirin, Ibuprofen, etc.). Patients with AERD typically require multiple sinus surgeries and courses of high dose steroids to control symptoms and improve upper and lower airway function. The diagnosis of AERD is typically made by history, physical examination, sinus imaging, and oral aspirin challenge or a urine test.
Treatment must begin with a very thorough sinus surgery to remove polyps and debris, and create wide access to the paranasal sinuses for instillation of topical steroid irrigation. The surgery is then followed several weeks later by a process called Aspirin De-sensitization. During Aspirin De-sensitization the patient is given small and increasing doses of Aspirin to build a tolerance to the drug.
Following Aspirin desensitization, patients remain on a regimen of daily oral Aspirin therapy to curtail symptoms of asthma and sinusitis. The goal of therapy is to suppress sino-nasal and pulmonary inflammation to greatly reduce and possibly eliminate the need for future surgery and high dose oral steroids. With proper therapy these patients can experience significant improvement in their quality of life.
At Sinus and Nasal Specialists of Louisiana we have the knowledge and skill to both diagnose and treat Aspirin-Exacerbated Respiratory Disease. Our Fellowship trained Rhinologists, Dr. Henry P. Barham and Dr. Christian A. Hall, can help these patients by beginning the process with the necessary and appropriate sinus surgery, followed by an Aspirin Desensitization in clinic with our experienced allergy nurse, Brittany Zito RN.
If you or someone you know has Aspirin Exacerbated Respiratory Disease and has been told that oral steroids are the only treatment option, please make an appointment with Sinus and Nasal Specialists of Louisiana. We can greatly improve your quality of life. We would love to help you.