Patients are more aware now of the possible side effects and interactions of drugs.  Patients often ask me if the medicines I am prescribing will be compatible with the ones they are currently taking.

Salicylic acid is found in the extract of the white willow tree and was used for thousands of years for the relief of pain and fever.  A chemist, Felix Hoffman, created acetylsalicylic acid (aspirin) for the Friedrich Bayer and Company in 1897. The rest is history.  However, in 1922 a respiratory disease worsened by aspirin was first described.  The initial triad of disease included nasal polyps, asthma and sensitivity to aspirin.  Today, this aspirin-induced disease is known as aspirin exacerbated respiratory disease or AERD.

AERD is characterized by swelling of the sinus and nasal membranes, formation of polyps, and asthma in response to exposure to aspirin. Patients are not usually born with AERD, but may develop it from late childhood to adulthood with average of onset in their 30’s.  There are many other aspects to the AERD syndrome including some that involve the GI tract and the skin.

In addition to aspirin, it has been found that patients with asthma may also react to other anti-inflammatory therapies available over the counter. The only know effective treatment for AERD is desensitization. This desensitization is usually performed by a specialist in allergy and immunology. If you have asthma, which worsens when you take aspirin or other anti-inflammatory drugs, especially with a history of nasal polyps, you may have aspirin sensitivity.