Samter’s triad also known as aspirin exacerbated respiratory disease, or AERD is a rare, chronic condition. Diagnosing this condition is hard as well. Sometimes in people warning signs and symptoms don’t start to show up until their 30’s and 40’s. Samter’s triad can occur in children.
The second is nasal polyps that tend to recur. Nasal polyps are extra tissue growths in the nasal cavity. Nasal polyps can cause a runny nose, persistent stuffiness, post nasal drip, absence of smell, loss of sense of taste, facial pain, headache, and sinus pressure.
The third feature is sensitivities to NSAIDs, non-steroidal anti-inflammatory drugs, and aspirin. NSAIDs are medications that are anti-inflammatory, pain relieving, and fever reducing. Examples are aspirin, Alleve, Motrin, and Advil. NSAIDs can also be in cold medicines as well. NSAIDs sensitivity can cause trouble breathing, asthma flare up, wheezing, coughing, sneezing, runny nose, rash, and watery eyes.
Symptoms usually come on suddenly and can be severe quickly.
Other symptoms that Samter’s triad can cause are decreased sense of smell, eosinophils which are high levels of blood cells that cause inflammation and allergic response, asthma that presents itself later in life, and rhinosinusitis or inflammation of nasal passages.
Less than 1% of people who have Samter’s triad have a family member with it as well. There is no proof that it is caused by genetics or inheritance.
Samter’s triad is different from allergies or an allergic reaction.
Diagnosis
Diagnosing this condition is hard and can take some time and steps to get a diagnosis. Your doctor will want a full medical history, a physical exam done, and then may need to conclude some tests.
During the physical exam your doctor may check your nasal passages for polyps. This can be done with a tiny microscope they will insert up through your nose into your sinuses.
Telling your doctor if you have any symptoms showing signs of asthma is also important.
Your doctor may want to do a NSAID challenge test. This is done under close supervision in a doctor’s office. You will be given a dose of aspirin and then your doctor will wait to see how you respond. Symptoms or a reaction usually occurs within 30 minutes to 3 hours. Depending on how you react will help your doctor determine if you have a sensitivity to it or not.
Treatment
There is no cure for Samter’s triad. Usually with a blend of treatments your doctor will be able to manage your symptoms and side effects of this condition so you live a normal quality of life.
One of the main things is to avoid NSAIDs. This includes aspirin, Aleve, motrin, advil, and certain cold medicines. Learning to read a label is important to make sure you don’t take something that accidentally has NSAIDs in it. Telling your doctor you have NSAID sensitivity is also important so they don’t prescribe you with any medications that could cause a reaction.
In some cases your doctor may want to try desensitizing you to aspirin. This is done by gradually increasing the dose of aspirin prescribed to you. This is done slowly until you can take a full dose of aspirin with no side effects or reactions. This can help with decreasing your need for oral corticosteroid medications as well as reducing the frequency of sinus surgeries. People who have gone through aspirin desensitization have shown to have less nasal congestions, less polyp regrowth, improved sense of smell, and improved asthma symptoms.
Medications are not the only thing that you should be avoiding. Certain foods, and spices can cause unwanted symptoms or reactions in people with Samter’s triad. Keeping a food journal and writing down any foods that cause you to have a flare up of symptoms can be helpful in figuring out what foods you need to avoid.
Foods that have shown to cause trouble in people with Samter’s triad are alcohol, broccoli, peas, radish, dried tomato, avocado, cranberries, raisins, pineapple, cinnamon, paprika, rosemary, almonds, pine nuts, and pistachios.
Nasal polyps are a major feature of Samter’s triad. They can cause a number of symptoms that can be hard to deal with. You can treat nasal polyps with nasal corticosteroid spray. If that doesn’t stop growth or help with symptoms another option is nasal polyp removal surgery. This is when an ENT, ear nose and throat surgeon, will go into your nasal passages and scrape out your nasal polyps. It will be done in a hospital, but you will be released the same day to go home.
The problem with Samter’s triad is that your nasal polyps have a tendency to grow back. If you have to undergo surgery too many times there will be no healthy tissue left in your nasal passages to cut the polyps away from.
Asthma treatments such as oral corticosteroids, or rescue inhalers are also a treatment option that is sometimes needed when treating Samter’s triad. Having an asthma action plan, and a treatment plan can make living with Samter’s triad much more manageable.
Studies also indicate that spirulina may help treat allergic rhinitis, as it benefits the body by reducing the inflammation that causes people to experience sinus problems. Compared to placebo trials, spirulina is effective at reducing itching, nasal discharge, nasal congestion and sneezing.
A 2020 study demonstrated that spirulina was more effective than an antihistamine called cetirizine to deal with allergies, allergic rhinitis as well as decrease inflammation.
A sensitivity to aspirin or other NSAIDs can be an indication of Samter's Triad! #HealthSurgeon
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