Overview
Aspirin-exacerbated respiratory disease (AERD), also called Samter's triad, links three problems: asthma, recurrent nasal polyps with chronic sinus inflammation, and respiratory reactions after taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs). It usually develops in adulthood and is not something a person is born with.
Many people with AERD have stubborn nasal congestion, a reduced or absent sense of smell, and polyps that return even after treatment or surgery. Taking aspirin or an NSAID can trigger nasal congestion, wheezing, or other respiratory symptoms within hours.
Because AERD involves both the sinuses and the lower airway, care tends to be most effective when rhinology and allergy or pulmonary clinicians coordinate. This page explains how the condition is recognized and the range of treatment paths that may be reasonable, so you can understand what to discuss before any consultation.
What AERD is
AERD is a long-term inflammatory condition that affects the whole airway. It is defined by the combination of asthma, chronic sinus disease with nasal polyps, and respiratory reactions to aspirin or other NSAIDs. It reflects an abnormal inflammatory response rather than a classic allergic antibody reaction, although the practical effect is that these medications can provoke symptoms.
Symptoms and medication-reaction history
Most patients have persistent congestion, a markedly reduced or absent sense of smell, and polyps that recur after treatment. Asthma symptoms such as cough, wheezing, and shortness of breath are common.
A telling clue is a history of nasal congestion, runny nose, wheezing, or chest tightness developing within about 30 minutes to a few hours after taking aspirin or an NSAID.
Living with aspirin-exacerbated respiratory disease (aerd)? The next step is a quiet, unhurried conversation.
How diagnosis is established
AERD is recognized from the pattern of asthma, recurrent polyps, and reactions to aspirin or NSAIDs. Nasal endoscopy and CT imaging help assess the extent of sinus disease and polyps.
When the diagnosis is uncertain, a supervised aspirin challenge in an appropriate medical setting can confirm sensitivity. This should not be self-tested at home, because reactions can affect breathing and need to be managed by clinicians.
Treatment options
Treatment focuses on controlling inflammation in both the sinuses and the lungs:
- Topical nasal steroid sprays and steroid rinses
- Saline irrigation
- Endoscopic sinus surgery to remove extensive polyps and improve access for topical medication
- Biologic medications for selected patients
- Aspirin desensitization followed by daily aspirin therapy in appropriate candidates
- Asthma management coordinated with allergy or pulmonary specialists
Avoiding aspirin and NSAIDs is important unless a patient has completed supervised desensitization.
Long-term recurrence and multidisciplinary care
AERD is a chronic condition rather than a one-time problem. Even after successful surgery, polyps and inflammation can return, so ongoing topical therapy and follow-up are usually needed. Care tends to work best when sinus, allergy, and pulmonary teams coordinate the plan and monitor both nasal and asthma symptoms over time.
Living with aspirin-exacerbated respiratory disease (aerd)? The next step is a quiet, unhurried conversation.
When to seek care
Seek urgent or emergency care for sudden severe shortness of breath, wheezing that does not respond to your usual rescue inhaler, chest tightness, swelling of the lips or throat, or any breathing reaction after taking aspirin or an NSAID. These can be signs of a serious respiratory reaction that needs immediate attention.
Medical review
This page is a patient-education resource reviewed by the responsible Norelle Health clinician before publication. It does not replace an in-person evaluation. If symptoms are severe or rapidly worsening, seek immediate medical care.
Common Symptoms
Living with aspirin-exacerbated respiratory disease (aerd)? The next step is a quiet, unhurried conversation.
Treatment Approach
Treatment for aspirin-exacerbated respiratory disease (aerd) is individualized based on the severity of symptoms, anatomical considerations, and patient goals. Our specialists may consider:
- 01Topical nasal steroid sprays and rinses
- 02Saline nasal irrigation
- 03Endoscopic sinus surgery for extensive polyps in selected patients
- 04Biologic therapy for selected patients
- 05Aspirin desensitization under specialist supervision in appropriate candidates
- 06Asthma management coordinated with allergy or pulmonary care
- 07Avoidance of aspirin and NSAIDs unless desensitized
Specialists who treat aspirin-exacerbated respiratory disease (aerd)
Dr. Adrian Ong
MD
Board-Certified Facial Plastic & Reconstructive and Head & Neck Surgeon
Dr. Adrian Ong is a board-certified surgeon who practices exclusively on the face, head, and neck, with expertise spanning rhinoplasty, sinus surgery, facial trauma, reconstruction, and sleep surgery.
- Functional and aesthetic rhinoplasty (including revision)
- Sinus surgery and complex revision sinus surgery
- Facial trauma and nasal fractures
- Head and neck cancer surgery and microvascular reconstruction
Also caring for this area
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Clinical References
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