Bleeding from the nose, or epistaxis, is a common and often mild occurrence. However, in some cases, having a bleeding nose can be a sign of a more serious health problem. An emergency consultation is particularly recommended in case of persistent or repetitive nosebleeds.

Bleeding nose: what is epistaxis?

Epistaxis is the medical term for a nosebleed. It is characterized by a flow of blood from the nasal cavities.

In which cases should you be concerned?

In the majority of cases, having a bleeding nose is a benign and temporary phenomenon. However, in some cases, epistaxis can be a sign of a more serious health problem. Some signs can alert, such as persistent or repeated nosebleeds.

Essential epistaxis, the most common case of nosebleeds

In 60% of cases, the epistaxis is said to be essential. Benign and transient, the nosebleed is due to the rupture of blood capillaries at the level of the vascular spot, point of convergence of the arterial systems of the nasal fossa.

Essential epistaxis is often caused by vascular fragility which can be caused or accentuated by:

• sun exposure ;
• a physical effort ;
• untimely scratching.

These causes are particularly common in children with nosebleeds. They are also found in adolescents and young adults. A nosebleed can also occur in older people.

Bleeding nose: what are the other possible causes?

While essential epistaxis is the most common form of nosebleed, there are others with various causes. In this case, the bleeding is usually the result of an underlying abnormality or disease. The epistaxis can then have a localized or generalized cause.

A nosebleed can have a localized origin when it is due to:

• a trauma ;
• inflammation, such as rhinitis or sinusitis, which can be caused by an ENT infection;
• a tumor, benign or malignant, which can be localized in different places of the nasal cavities.

A nosebleed can also have a generalized origin when it is the consequence of an underlying disorder such as:

• thehypertension ;
• a hemorrhagic disease caused by thrombocytopenia or thrombopathy, taking certain medications, haemophilia, or even certain forms of purpura;
• a vascular disease such as Rendu-Osler disease or ruptured intracavernous carotid aneurysm.

A nosebleed can manifest itself in different ways. He can be :

• more or less abundant, ranging from simple drip to prolonged flow;
• unilateral or bilateral, occurring at a single nostril or both nostrils simultaneously;
• occasional or frequent ;
• transient or persistent.

Although a nosebleed is usually mild, there are certain signs that should alert you to limit the risk of a complication. Medical advice is particularly recommended if the nose bleeds profusely, persistently or frequently. The same is true if the nosebleed is accompanied by other symptoms such as pallor, weakness or tachycardia.

Bleeding nose: what to do if you have a nosebleed?

In the event of a nosebleed, it is advisable to:

• Sit, whenever possible, in a quiet environment;
• do not tilt your head back to prevent blood from flowing to the throat;
• blow your nose to get rid of the blood clot (s) may have formed in the nasal cavities;
• limit the flow of blood through the nose using a handkerchief or cotton, for example;
• compress the wing of the nose for at least 10 minutes to stop the bleeding.

In addition to these measures, certain products, such as hemostatic pads, can also be used to help stop the bleeding.

Bleeding nose: when to consult?

If, despite all measures to stop the bleeding, the discharge persists, medical advice is necessary. An emergency consultation is also recommended if the bleeding is very profuse, repeats or is accompanied by other symptoms.

After the bleeding has stopped, several medical examinations may be done to understand the origin of the epistaxis. In first intention, a exam ORL is performed to identify a localized cause. Depending on the results obtained, a general medical examination may be necessary.

Treatment for glomerulonephritis depends on its origin and course.

As a first-line treatment, drug treatment is usually put in place to reduce symptoms and limit the risk of complications. A healthcare professional usually prescribes:

• antihypertensives to control blood pressure and limit high blood pressure, a common symptom of glomerulonephritis;
• diuretics to increase urine output and frequency of urination.

Other drugs may then be prescribed to treat the cause of glomerulonephritis. Depending on the diagnosis, the healthcare professional can, for example, prescribe:

• antibiotics, especially in cases of post-streptococcal glomerulonephritis, to stop an infection in the kidneys;
• corticosteroids and immunosuppressants, especially in cases of lupus glomerulonephritis, to decrease the immune response.

In addition to drug treatment, a specific diet can be implemented in case of glomerulonephritis. This diet is generally depleted in protein and sodium, and is accompanied by control of the volume of water ingested.

When the risk of kidney failure is high, dialysis may be used to ensure the filtration function of the kidneys. In the most severe forms, a kidney transplant may be considered.