The most common source of pain in just one nostril is one or more nasal polyps. A polyp is an abnormal growth that is the end result of a long period of inflammation. Nasal polyps are a complication of alcohol abuse, asthma, allergies, non-allergenic rhinitis ("hay fever without the hay"), fungal infections of the sinuses (or just one sinus), sinus allergies, unusual reactions to Aspirin, and even liver disease. While nasal polyps can be associated with allergies, they are much more common in people who don't have allergies.
A nasal polyp can be an overgrowth of the nasal and sinus membrane, or a swelling of the tissues beneath them. In cystic fibrosis, polyps are due to abnormal transport of chloride ions that cause accumulation of fluid in the linings of the nose and sinuses.
The older you are, the more likely you are to have nasal polyps. In children who don't have cystic fibrosis, about one in 1000 has nasal polyps. In adults who don't have cystic fibrosis, about one in 25 has nasal polyps. (Up to 50 percent of children and adults who have cystic fibrosis have nasal polyps.) Men are more likely to have nasal polyps than women, although the condition occurs in all racial groups and income levels.
Nasal polyps can cause intense pain. They also cause headaches, snoring, loss of sense of smell (anosmia), and drainage. Really large polyps can depress the bones of the face and cause facial deformities, or press against the eyes enough to cause double vision and roll the eyes outward. The largest nasal polyps occur in people who have cystic fibrosis and in people who have fungal infections of the sinuses.
Medical care for nasal polyps starts with treating and preventing staph and fungal infections. It's important to understand that one family member's staph infection in a polyp can cause another family member's staph infection of the skin and vice versa. Antibiotic treatment for staph doesn't help just the person taking the antibiotics. It's important to finish an entire prescription of antibiotics to avoid creating a resistant strain that can infect everyone in the household.
Antihistamines, decongestants, and neti pot treatments usually don't do a lot of good in treating nasal polyps. That's because the polyp is due to inflammation,not allergy, it's not just an accumulation of mucus, and it can't be washed away. It's an extremely bad idea to try to break up a polyp with hotter and hotter water. All you will accomplish is burning your sinuses and opening them up to even more inflammation and infection that will eventually cause even more polyps.
The treatment that eventually works for polyps is usually steroid medication, Prednisone or fluticasone. Steroids stop inflammation. However, they also interfere with the immune system's ability to fight bacterial infections, interrupt the formation of stress hormones, make it harder to stop nosebleeds, and interfere with growth in children and tissue repair iand bone maintenance in adults. When nasal polyps are small, it's usually possible to treat them with a steroid nose spray, which cuts down on potential side effects. For larger polyps, however, the usual treatment is oral steroid medication or IV steroids for the worst symptoms; steroid nose sprays simply can't reach the entire surface of the polyp.
Surgery offers more complete relief, but polyps tend to grow back so that the operation has to be repeated every few years. Still, this can be preferable to taking steroid medications.
What else can you do to reduce the pain of nasal polyps? Food allergies may be a contributing factor to sinus pain. Most people get some relief by eliminating wheat, potatoes, tomatoes, chocolate, or citrus fruit from the diet. You don't have to stop eating all of these foods all at once. Just try giving up one of them at a time and see whether your symptoms improve.
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