Overview
AERD links chronic sinus inflammation and nasal polyps with asthma and respiratory reactions to aspirin or other COX-1 inhibitors. Treatment tends to be more effective when sinus, asthma, medication-reaction, and recurrence goals are considered together rather than managed as separate problems.
What this evaluation should clarify
A focused evaluation should help you understand a few key decisions:
- What objective evidence distinguishes aspirin-exacerbated respiratory disease from look-alike conditions
- Which anatomic, inflammatory, dental, neurologic, infectious, or tumor-related contributors must be considered
- Which medical, procedural, surgical, or multidisciplinary path fits the findings and your goals
Living with aspirin exacerbated respiratory disease? The next step is a quiet, unhurried conversation.
Evaluation and treatment pathway
- Clarify the symptom pattern, duration, triggers, prior treatment, operations, medications, and relevant medical history.
- Diagnosis is based on a compatible history and specialist assessment; a supervised aspirin challenge may be used in selected uncertain cases. You should not attempt a diagnostic aspirin exposure on your own.
- Identify important look-alikes, complications, and contributors before assigning a definitive diagnosis.
- Care may combine topical sinus therapy, asthma management, endoscopic sinus surgery, biologic therapy, and specialist-directed aspirin desensitization or maintenance when appropriate.
- Set a measurable follow-up plan: symptom goals, objective reassessment, medication response, and imaging or surveillance when appropriate.
Causes and risk factors
The exact cause is not fully understood, but AERD involves an imbalance in how the body produces inflammatory molecules called leukotrienes, leading to ongoing airway inflammation.
It typically begins in adulthood, often after a respiratory illness, and is not inherited in a predictable way. Reactions to aspirin and NSAIDs are a defining feature rather than the underlying cause.
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.
Coordinated and long-term care
AERD is a long-term condition rather than a one-time problem. Even after surgery, polyps and inflammation can return, so ongoing topical therapy and follow-up are usually needed.
Because AERD affects the whole airway, care tends to be more effective when sinus, allergy, and pulmonary teams coordinate the plan and monitor both nasal and asthma symptoms over time.
What to bring to your consultation
Bringing or securely transferring the records that can change this decision helps make the visit productive:
- Imaging files and reports
- Endoscopy or operative findings
- Pathology results
- Laboratory results
- Prior treatment notes
- A current medication list
- The specific question you want answered
When to seek urgent care
A medication-triggered reaction with breathing difficulty, wheezing, throat symptoms, faintness, or severe systemic symptoms requires emergency care. Do not self-test aspirin or NSAIDs.
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.
Specialists who treat aspirin exacerbated respiratory disease
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
Not sure who to see? Our patient coordination team can help match you with the right specialist.
(212) 444-8006Frequently Asked Questions
Aspirin-exacerbated respiratory disease is characterized by asthma, chronic rhinosinusitis with nasal polyps, and respiratory reactions to aspirin or other COX-1–inhibiting medications.
Diagnosis is based on a compatible history and specialist assessment; a supervised aspirin challenge may be used in selected uncertain cases. Patients should not attempt a diagnostic aspirin exposure on their own.
Care may combine topical sinus therapy, asthma management, endoscopic sinus surgery, biologic therapy, and specialist-directed aspirin desensitization or maintenance when appropriate.
A medication-triggered reaction with breathing difficulty, wheezing, throat symptoms, faintness, or severe systemic symptoms requires emergency care. Do not self-test aspirin or NSAIDs.
Clinical References
These independent resources from medical and professional organizations offer further reading. They are provided for general education and do not replace a consultation with a clinician.
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