Nosebleeds, also called epistaxis, can occur easily because of the location of the nose and the close-to-the-surface location of blood vessels in the lining of your nose.
Nose is a very vascular structure in our body.In simple words, a nosebleed is the loss of blood from the tissue that lines the inside of your nose.
Frequent or heavy nosebleeds may indicate more serious health problems, such as high blood pressure or a blood clotting disorder, and should be checked. Excessive bleeding over a prolonged period of time can also lead to further problems, such as anemia.
Depending on the source, there are two different types of nasal bleeding. The first one is an anterior nasal bleed, where the origin is at the front part of the nose. They are easily controlled and less severe. The second starts at the back end of nasal septum and is less accessible. These nosebleeds usually involve large blood vessels and result in heavy bleeding, which can be dangerous.
In adults aged between 45 and 65, blood may take longer to clot in mid-life and older adults. They are also more likely to be taking blood thinning medicines, have high blood pressure, atherosclerosis (hardening of the walls of arteries), or a bleeding disorder. Also, people who have blood clotting disorders such as hemophilia or von Willebrand disease can experience nose bleeds.
In pregnant women, the blood vessels in the nose expand which puts more pressure on the delicate blood vessels in the lining of the nose leading to nose bleeds
What are the causes of nose bleeds in adults?
Nosebleeds are generally caused by dry air or picking your nose, but here are some other causes:
▪ Bleeding disorders
▪ Nasal and sinus infection
▪ Allergies
▪ Foreign body in the nose
▪ Trauma to the nose and face.
▪ Common cold
▪ Blood-thinning drugs (aspirin, non-steroidal anti-inflammatory drugs, warfarin, and others).
▪ Chemical irritants (chemicals in cleaning supplies, chemical fumes at the workplace, other strong odors).
▪ Chronic sinusitis
▪ Nasal sprays
▪ Cocaine and other drugs inhaled through the nose.
▪ Non-allergic rhinitis
▪ Deviated septum
▪ Blowing your nose with force.
▪ Inserting an object into your nose
▪ High altitudes. The air is thinner (lack of oxygen) and drier as the altitude increases.
▪ Frequent use of nasal sprays and medications to treat itchy, runny or stuffy nose. These medications – antihistamines and decongestants – can dry out the nasal membranes.
A few other, less common causes of nosebleeds are:
▪ Alcohol use.
▪ High blood pressure
▪ Nasal tumors.
▪ Nasal polyps
▪ Atherosclerosis.
▪ Immune thrombocytopenia.
▪ Leukemia.
▪ Pregnancy.
What are the treatment options? :
Most nosebleeds can be handled at home, but certain symptoms should be checked by your ENT doctor. Also, this could be an early sign of other medical problems that need to be investigated.
The most appropriate way to stop a nosebleed is by bending our heads forward, pinching the nose with a tissue, and breathing through the mouth for two minutes. You can also try using a cold compress on the bridge of your nose and lightly blowing to remove any blood clots.
An anterior bleed from nose stops with compression or nasal packing for 24 hrs. After the bleeding stops, an ENT doctor assesses the inside of the nose with an endoscope to look for bleeding points. If identified, they are cauterized either chemically or electrically.
In cases of refractory nasal bleeds, endoscopic ligation of the artery is also performed rarely.
Home remedies to avoid nasal bleeds
When do I see my doctor, and what are the red flags?
You should seek medical attention right away if you experience any of these symptoms or signs because you could be bleeding excessively or have lost too much blood. Additionally, keep in mind that blood coming from the nose always appears to be a lot
If you experience bleeding from the mouth, cough out blood, or vomit blood, seek medical attention immediately. The blood loss can be severe and you may look pale / sweaty or not responsive
You should seek medical care in case of nasal bleeds after accidents/trauma, feeling light- headed after nasal bleeds, breathing difficulty or continues to feel blood taste in the mouth
If your nose has been bleeding for longer than 20 minutes, consider it a red flag.
- Dr. Prashanth R Reddy
“E.N.T. health – ENTry for better senses”.
