title: Treatment of aspirin exacerbated respiratory disease with a low salicylate diet: a pilot crossover study.
abstract: OBJECTIVE
  Aspirin exacerbated respiratory disease (AERD) is comprised of aspirin/acetylsalicylic acid (ASA) sensitivity, bronchial asthma, and nasal polyposis. Treatment of this condition is challenging and may include topical/systemic steroids, endoscopic sinus surgery, and/or aspirin desensitization.
  
  
  METHODS
  A prospective crossover pilot study (n = 10) was conducted in which patients were randomized into either of 2 groups with 6 weeks of regular diet (R) or 6 weeks of a low salicylate diet (LS).
  
  
  METHODS
  The study was conducted in a tertiary otolaryngology clinic.
  
  
  METHODS
  Patients with AERD were enrolled in the study.
  
  
  METHODS
  Subjective (Sino-nasal Outcome Test-22 [SNOT-22], Nasal Sinus Symptom Scale [NSSS], and the Asthma Control Questionnaire-7 [ACQ-7]) and objective outcome instruments (Peri-Operative Sinus Evaluation [POSE] and Lund-Kennedy Endoscopic Score [LKES]) were used to evaluate patients at baseline, 6 weeks (at crossover), and 12 weeks.
  
  
  RESULTS
  Wilcoxon rank sum tests demonstrated that patients on the low salicylate diet had improved scores compared to their regular diet when evaluated by 4 of the 5 outcome measures (SNOT-22 pLS = 0.0059, NSSS pLS = 0.0195, LKES pLS = 0.0039, POSE pLS = 0.005).
  
  
  CONCLUSIONS
  Results of the pilot study indicate that implementation of a low salicylate diet improves the nasal symptoms and nasal endoscopy findings of individuals with AERD. Further research is required to support these findings.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Canada.
authors.forename: Doron D
authors.initials: DD
authors.lastname: Sommer
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Canada.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Hoffbauer
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Au
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Western University, London, Canada.
authors.forename: Leigh J
authors.initials: LJ
authors.lastname: Sowerby
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Canada.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Gupta
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Canada smriti.nayan@medportal.ca.
authors.forename: Smriti
authors.initials: S
authors.lastname: Nayan
mesh_terms: D000328:Adult; D000368:Aged; D001241:Aspirin / Q000009:adverse effects*; D001249:Asthma / Q000139:chemically induced / Q000150:complications; D018592:Cross-Over Studies; D003888:Desensitization, Immunologic; D004342:Drug Hypersensitivity / Q000178:diet therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000139:chemically induced / Q000150:complications; D010865:Pilot Projects; D011446:Prospective Studies; D012140:Respiratory Tract Diseases / Q000139:chemically induced* / Q000178:diet therapy*; D012220:Rhinitis / Q000139:chemically induced / Q000150:complications; D012459:Salicylates / Q000008:administration & dosage*; D016037:Single-Blind Method; D012852:Sinusitis / Q000139:chemically induced / Q000150:complications
chemical_list: D012459:Salicylates; D001241:Aspirin
keywords: aspirin exacerbated respiratory disease; asthma; low salicylate diet; nasal polyps; salicylates; sinusitis