Ask a Doctor: AERD

Introducing: Ask a Doctor

At UTHSC ENT, we understand that patients need clear, helpful answers to their questions. We also know that a flood of new information can be overwhelming.

That’s why our department’s introducing Ask a Doctor: an ongoing series of posts that tackle Frequently Asked Questions about common issues. We hope these articles give you a better understanding of your situation and an easy path to treatment.

Today, we highlight an issue that most people haven’t heard of: AERD, or Aspirin-Exacerbated Respiratory Disease.

Prepared by: Michael Barats
Reviewed by: Dr. Sanjeet Rangarajan

What is Aspirin-Exacerbated Respiratory Disease (AERD)?

AERD is a respiratory reaction that may occur after taking aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or others.

Though not a household name, AERD is a relatively common disorder. Based on recent surveys, an estimated 1 million people living in the U.S. experience AERD.

What are its causes and symptoms?

The cause of this reaction is not completely understood, although studies have shown that approximately 9% of those with a history of asthma can also develop AERD. The onset of AERD can be abrupt and may develop sometime between the ages of 20 and 50.

The main symptoms are known as Samter’s Triad: asthma, recurring nasal polyps, and increased respiratory sensitivity after taking aspirin or other NSAIDs.

Other symptoms include but are not limited to:
-Runny nose
-Nasal congestion
-Coughing
-Wheezing
-Shortness of breath
-Chest tightness
-Watery eyes
-Runny nose.
-Nasal polyps might also occur.

Some symptoms have been reported to start between 30 minutes to 3 hours after taking the aspirin/NSAID. Occasionally, patients also experience similar respiratory symptoms after consumption of alcoholic beverages or other foods.

While the symptoms may resolve on their own after a few hours, please call your doctor or visit the emergency room if you develop trouble breathing.

How will my doctor diagnose AERP?

Often, a diagnosis of AERD can be made simply by talking with your otolaryngologist. While there’s specific blood test to diagnose AERD, your doctor may decide to do a diagnostic aspirin challenge.

In this scenario, your specialist administers small but increasing doses of aspirin, while monitoring the reaction within a controlled office setting. These “aspirin challenges” are performed by otolaryngology and allergy specialists and should only be done under physician supervision.

What are my treatment options?

A common treatment for AERD is known as aspirin desensitization. This is similar to the aspirin challenge which may have been used in your initial diagnosis.

Here, your doctor prescribes increasing doses of aspirin for you to continue taking at home as indicated. The goal of this therapy is to train your body’s immune system to tolerate taking aspirin or other NSAIDs.

Many patients who have undergone aspirin desensitization therapy report improvement in their respiratory symptoms, and some have noticed a reduced growth of nasal polyps.

Other forms of treatment include various biologic agents that have been shown to help patients that suffer from severe asthma and AERD. These are newer medications that promise to significantly reduce patient symptoms. However, please discuss this with your doctor to see if these are right for you.

Are there potential complications?

Side effects of desensitization therapy may include worsening gastrointestinal or respiratory symptoms. Please also discuss this form of treatment with your doctor if you are pregnant.

How can our Dream Team help?

UTHSC ENT’s Dream Team provides world class treatment in your hometown, and we’d love to hear from you!

If you’d like to talk to a specialist about your issues with aspirin, please give us a call.

Schedule your consultation today: (901) 866-8384