Aspirin-Exacerbated Respiratory Disease (AERD)

Often shortened to AERD and also known as Samter’s Triad, aspirin-exacerbated respiratory disease is considered a ‘chronic’ medical condition that affects the body in three different ways: asthma, sensitivity to aspirin, and sinus disease (with recurring nasal polyps). In addition to aspirin, the medical condition also includes non-steroidal anti-inflammatory drugs (NSAIDs) and others that inhibit cyclooxygenase-1 (enzyme). Common NSAIDs include Motrin and Advil.

Unfortunately, despite much research and much investment from various medical associations, the cause of the medical condition is largely unknown. Initially, it was thought to be a genetic condition but researchers disproved this theory recently. Typically, people become aware of having AERD after taking or even just inhaling a NSAID. However, this is as much as we know and scientists aren’t quite sure of why the reaction occurs.

Since the condition features a triad of issues, around 30% of all asthma and nasal polyps sufferers are likely to have all three. Meanwhile, for people with asthma alone, the likelihood reduces to just under 10%. Regarding age, people discover they have AERD in adulthood, and it happens quite suddenly compared to many other medical conditions. For most, this comes after the age of 20, and the majority of people find out before the age of 50. To this day, aside from NSAIDs, there is no known trigger for AERD.

Symptoms of AERD

As we saw previously, a certain amount of people with asthma have all three problems and the likelihood increases for those with asthma and nasal polyps. With these two health conditions, AERD patients tend to find that conventional treatments don’t help. Furthermore, many with chronic sinus infections experience some degree of loss to their sense of smell.

By definition, AERD patients experience some form of reaction after taking aspirin or any other NSAIDs. For the majority, AERD patients experience upper respiratory symptoms including sneezing, sinus pain, increased nasal congestion, and frontal headaches. In addition to these symptoms, lower respiratory symptoms are also possible, which include wheezing, coughing, and tightness in the chest.

As with many other health conditions, alcohol consumption is a significant factor. According to physicians, around three-quarters of all those with AERD experience respiratory reactions after consuming alcohol. Depending on the case in question, it could be just one type of alcohol, or it could be several. It can also occur after less than one glass or after quite some time. As you can see, there are still a lot of unknowns to this condition, and ongoing further research is being performed daily.

An array of pills (people with AERD should always talk to their doctor before taking any new drugs or medications together.)

Patients with AERD should always take precautions and ask their doctor before taking a new medication or any type of NSAIDs.

Diagnosis

With so many unknowns regarding the causes and triggers of AERD, diagnosis of the problem is clinical, meaning there isn’t one universal test that can be used to confirm its presence in a patient. Instead, physicians administer three individual tests for diagnosing asthma, sensitivity to aspirin and sinusitis. For situations where a reaction to NSAIDs isn’t apparent, doctors might carry out a formal aspirin challenge to test the idea.

Elsewhere, doctors do have a backup protocol, and it comes from the knowledge that AERD sufferers have an abundance of eosinophils within the nasal polyps as well as in their blood. Eosinophils are immune cells that are common wherever inflammation is likely to occur. However, the presence of these cells can only be used as a guiding tool as opposed to a part of the diagnosis.

Treatment

If you’re suffering from AERD and haven’t found a solution to the problem, you should look to avoid all NSAIDs to prevent any possible reactions. Sadly, the symptoms of nasal polyps and asthma will still exist until they are treated individually.

For the majority of patients, doctors prescribe daily medications that allow the symptoms to remain under control. For asthma, this could involve inhaled corticosteroids, while the nasal polyps can be controlled using intranasal steroid sprays. Even though medical therapy can be intensive with various medications and even injections, nasal polyps still commonly require surgical intervention.

In treating AERD, aspirin desensitization is a common solution. Ultimately, this will see aspirin carefully administered in increasing doses within a clinic or perhaps even the hospital. Eventually, the goal is to have the patient engage in long-term daily aspirin therapy, which prevents the need for corticosteroid medications while also reducing the likelihood of nasal polyps returning.

If you’re experiencing the symptoms we’ve described or think you may have AERD, please visit a qualified professional who will run the appropriate tests and start you on a treatment plan that’s right for you.

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