Nasal polyps: Are they causing your nose block (nasal obstruction)?

Nasal polyps are jelly-like swellings within the nasal cavity and sinuses, which cause nasal congestion. 

Do you often find yourself struggling to breathe through your nose, feeling like it’s perpetually congested? If so, nasal polyps might be the underlying cause of your discomfort. These benign  jelly-like clusters of oedematous (swollen) nasal and sinus mucosa, can significantly obstruct airflow, resulting in persistent nasal congestion and a range of other symptoms.

In this article, we will discuss what nasal polyps are, the symptoms they cause, and how they lead to nasal obstruction. We will explore the various treatment options available to help you breathe easier and improve your overall well-being. 

Why and how do nasal polyps cause congestion? 

There are two ways in which nasal polyps can cause nasal congestion, these are:

1.Physical obstruction 

The first mechanism of how nasal polyps cause nasal congestion is attributed to the physical obstruction of your nasal passages. As nasal polyps increase in size and number, the space within your nasal passage becomes occupied and blocked by the polyps. In severe cases, patients may even observe their nose or nasal bridge widening and their eyes growing further apart, known as Woakes’ Syndrome [1]. At this stage, your body adapts to polyp growths and “physically deforms” to cater to these formations. 

2. Inflammatory response 

In most cases, the congestion you undergo related to nasal polyps results from an inflammatory response in your upper airway. The reason why polyps form is currently understood to arise from inappropriate inflammatory response by our immune system, which results in excessive inflow of inflammatory cells into the nasal tissue, such as eosinophils [2]. 

Subsequently, venous engorgement, increased mucus secretion, and tissue swelling (oedema) occur in your nasal passage and sinus cavity in response to the infiltration of eosinophils and other inflammatory mediators. The congestion may be due to the nasal polyps, as well as the inflammatory reactions within your nasal cavity and sinuses. 

If there is a surge in the inflammatory response, there will be growth of nasal polyps, causing changes in the extracellular matrix of the nasal passage and progressively blocking off the nasal passage. Thus, the sensation of congestion is felt. 

3. Acute sinus infection secondary to nasal polyps 

When the polyps obstruct the sinus outflow tract, this is believed to cause mucus stasis (blockage of mucus flow) and this results in secondary bacterial infection of the sinuses, leading to increased nasal blockage. There may also be increased pain around the face and forehead, as well as blockage of the ears, or even fever. 

Seek treatment for nasal polyps; make an appointment with us today!

What triggers congestion from nasal polyps?

Some patients with nasal polyps are asymptomatic with little to no disruption in their quality of life. In contrast, others report high levels of discomfort due to nasal congestion. Nasal congestion can result in chronic mouth breathing, sore throat, sleep quality disruption, and may result in higher occurrence or worsening of co-existent obstructive sleep apnoea [3]. So why are some patients more affected than others? The differences in the manifestation of symptoms boil down to exposure to triggers. In other words, the more one is exposed to their triggers, the more likely they are to feel they have nasal congestion.  

Nasal polyps can cause mouth breathing and, ultimately, a sore throat.

Therefore, to reduce congestion and symptoms associated with nasal polyps, it is first essential to manage the inflammatory response and remove triggers that cause the flaring up of nasal polyps. Some triggers include:

  • Allergens: While nasal allergies have a different aetiology (cause), they can co-exist and exposure to environmental allergens or consuming foods that contain allergens will increase the rate of inflammation and irritate your nasal polyps. Consequently, nasal congestion symptoms will manifest. 
  • Dry air: cold, dry air, such as in an air-conditioned place, can cause individuals with nasal polyps to have persistent or worsening nasal congestion. This is because dry air exacerbates inflammation in your sinus cavity and nasal passages. Your body will also attempt to self-regulate dryness by producing more mucus to compensate for the lack of moisture in the air, thus contributing to nasal congestion. 
  • Underlying health conditions: inflammatory health conditions such as eczema [4], Churg-Strauss syndrome [5], and asthma may also be associated with nasal polyps and subsequent irritation. For instance, it is common for a patient with eczema to have nasal congestion during flare-ups.

How do you reduce congestion caused by nasal polyps?

If you are uncertain about what exactly is triggering your nasal polyps, below are some prevention and management steps you can take to reduce the frequency of congestion: 

  • Food journal: take notes on what you are consuming daily. On days when you experience nasal congestion, review your diet. Then, consume the items separately to identify the specific cause of your flare up. If there is no clear pattern,food allergens may not be an aggravating factor. 
  • Consuming anti-inflammatory diets: to reduce inconveniences caused by nasal polyps, consume anti-inflammatory diets [6] to holistically build your resistance to flare-ups. 
  • Humidifiers: if you spend a lot of time in air-conditioned spaces, consider purchasing a humidifier and observe if your symptoms improve. This simple step is often sufficient to reduce nasal polyps irritation and congestion. You can also reduce the use of air-conditioners.
  • Fixing the root cause: if you are struggling with an inflammatory health condition, aim to improve your general health first. By managing the root cause of inflammatory reactions, the subsequent symptoms, such as nasal congestion, will improve over time. 
Humidifiers help moisten nasal passages to reduce the inflammatory response of the sinus.

How to determine if nasal polyps are causing your congestion? 

“Nasal polyps or something else?” is a common concern for many patients struggling with persistent nasal congestion. To help identify if nasal polyps might be the source of your discomfort, consider asking yourself the following questions:

  • Do you experience persistent headaches that feel like pressure building up from your nasal and sinus cavities to your temples?
  • Has your sense of taste and smell gradually diminished over time?
  • Do you find yourself frequently breathing through your mouth due to nasal obstruction?
  • Is your sleep quality progressively getting worse because of nasal congestion?
  • Do you feel a sensation of post-nasal drip at the back of your throat?
  • Have you noticed changes in your facial structure, such as swelling or asymmetry?

If you answered “yes” to most of these questions, nasal polyps might be the culprit behind your persistent congestion. However, it’s important to remember that other conditions can also cause similar symptoms. Allergic rhinitis, sinusitis, a deviated nasal septum, or turbinate hypertrophy are among the conditions that can lead to nasal congestion. Additionally, nasal polyps can coexist with these other issues, which can complicate the diagnosis.

Seeking professional help for nasal polyps and nasal congestion

The most reliable way to determine if nasal polyps are causing your nasal congestion is to visit an ENT specialist. They will conduct a thorough assessment, including a nasal endoscopic examination, to accurately diagnose your condition.

If your symptoms are worsening, it is crucial to seek professional help rather than attempting to self-manage. We frequently encounter patients with advanced disease who delayed seeking early intervention and instead tried to manage their symptoms on their own. One common issue is the overuse of over-the-counter medications such as nasal decongestant sprays.

Unfortunately, excessive use of these medications can actually worsen nasal congestion over time. This occurs due to the engorgement of the turbinates, which can cause a condition known as rhinitis medicamentosa [7], or “rebound rhinitis.” For effective and safe treatment of nasal polyps and associated congestion, consult an ENT specialist, Early intervention can significantly improve your quality of life and prevent complications associated with untreated nasal polyps.

Treatment Options by an ENT Specialist 

When it comes to treating nasal polyps, an ENT specialist can offer several effective options:

  • Medications and topical steroid therapy: these are often the first line of treatment. Medications, including nasal corticosteroid sprays, can help reduce inflammation and shrink polyps, which can provide relief from symptoms.
  • Surgery: endoscopic sinus surgery and other associated procedures may be considered  for more severe cases. Endoscopic sinus surgery involves removing the polyps and clearing the nasal passage to restore normal breathing. While this is a complex procedure with potential risks, the outcomes can be excellent when performed by an experienced ENT surgeon who specialises in sinus surgery. The risk of complications is minimal, and patients can experience significant improvement in their symptoms.
  • Anti-inflammatory medications and biologics: the latest advancements in treatment include biologics, which are anti-inflammatory medications administered through injections. These can be highly effective in restoring nasal and respiratory health when used appropriately. 

As with any health condition, preventionrelievingto effectively managing nasal polyps. Reduced quality of life due to nasal congestion and polyps is not something anyone should have to endure. It’s important to understand that nasal polyps do not have to be a permanent issue. With the right treatment and the expertise of an ENT specialist, you can look forward to improved health, easier breathing, and a restored sense of smell.

Schedule an appointment with an ENT specialist today to explore your treatment options and take the first step towards better nasal health and a higher quality of life.


  1. Fakiri, M.M.E., Lakhdar, Y. and Raji, A. (2019) Woakes’ syndrose Reports. Available at: https://casereports.bmj.com/content/12/3/e229021 (Accessed: 10 August 2023). 
  2. Mayo Clinic Staff (2021b) Eosinophilia, Mayo Clinic. Available at: https://www.mayoclinic.org/symptoms/eosinophilia/basics/definition/sym-20050752#:~:text=Eosinophils%20are%20a%20type%20of,or%20inflammation%20(tissue%20eosinophilia). (Accessed: 10 August 2023). 
  3. National Eczema Association (2022) What is eczema?, Overview . Available at: https://nationaleczema.org/eczema/#:~:text=What%20is%20Eczema%3F,most%20common%20symptom%20of%20eczema. (Accessed: 10 August 2023). 
  4. Mayo Clinic Staff (2021) Churg-strauss syndrome, Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/churg-strauss-syndrome/symptoms-causes/syc-20353760#:~:text=Churg%2DStrauss%20syndrome%20is%20a,granulomatosis%20with%20polyangiitis%20(EGPA). (Accessed: 10 August 2023). 
  5. Foods that fight inflammation (2021) Harvard Health. Available at: https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation (Accessed: 10 August 2023). 
  6. Wahid, N.W.B. and Shermetaro, C. (2022) Rhinitis Medicamentosa, National Library of Medicine . Available at: https://www.ncbi.nlm.nih.gov/books/NBK538318/#:~:text=Rhinitis%20medicamentosa%20(RM)%2C%20also%20known%20as%20’rebound%20congestion,subset%20of%20drug%2Dinduced%20rhinitis. (Accessed: 10 August 2023). 
  7. Wahid, Nur Wahidah B., and Carl Shermetaro. “Rhinitis Medicamentosa.” StatPearls, StatPearls Publishing, 2024. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK538318/

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    Head & Neck Surgery Singapore

    Dr Soma Subramaniam
    Consultant ENT Specialist and Surgeon
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