Nose bleeding – a banal ailment? Not necessarily

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Blood from the nose (nosebleed) is a common condition that can have various causes, ranging from fatigue, infections and injuries of the nose, to blood clotting disorders. If bleeding occurs frequently, a visit to the doctor is absolutely necessary.

Bleeding from the nose

Epistaxis is a common condition, and sometimes it even indicates a symptom of some disease. Bleeding from the nose most often occurs in children and the elderly, it is when blood flows out of the vascular system.

The nose is made of a muscular, cartilage and skin part, moreover, it is divided into two nasal cavities with a mucosa that has its own functions. The air entering the nose can reach a temperature of 32-34 degrees, and this is because the nose is very vascularized. The blood that circulates through the dilated blood vessels in the nose is a kind of radiator. The air entering the nasal cavity is also cleaned, all impurities that settle at the entrance to the nose are moved successively towards the throat, thanks to the cilia and saliva.

Nose bleeding – causes

The causes of a nosebleed can be of any number of ways:

1. arterial hypertension (doctors measure blood pressure during the examination, it is one of the basic activities). To monitor your health, it is worth taking your blood pressure regularly.
2. infectious diseases with fever,
3. congenital haemorrhagic diathesis (haemophilia and related, thrombocytopenia) or acquired (liver damage, acquired thrombocytopenia),
4. curvature of the nasal septum, trauma to the nose area,
5. excessive sunlight or overheating of the body,
6. physical effort,
7. atherosclerosis (especially in adult patients),
8. many other diseases (cancer, inflammation of the mucosa, foreign bodies, etc.),
9. nasal vascularization, which begins in the internal and external carotid arteries.

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Breakdown of the causes of nosebleeds

External causes of nosebleeds: nosebleeds may be caused by external injuries to the nose or head, especially in young children or the handicapped, which may lead to injury under the influence of intoxicating drugs. Also flying or diving, which are associated with a change in atmospheric pressure, affect nose bleeding.

Local causes of nosebleeds: among the local causes of nosebleeds, we can mention:

1. dry runny nose caused by chemical or thermal damage;
2. excessive use of preparations that constrict the mucosa during infection;
3. dry air;
4. cancer that develops in the area of ​​the nose and paranasal sinuses;
5. rhinitis, of a bacterial and viral nature;
6. polypy nose;
7. juvenile mucosal fibrosis;
8. nasal septum granulomas.

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General causes of nasal blood: among the causes of general nosebleeds, we should look for the following diseases and more:

1. vascular and cardiovascular diseases: atherosclerosis, arterial hypertension, occurring mainly in elderly people;
2. infectious diseases, including influenza and measles, during which the mucosa is severely hyperemic;
3. diseases of the kidneys and liver are caused by an increase in blood pressure and changes in the vascular wall;
4. pregnancy;
5. taking certain medications to thin the blood. e.g. aspirin;
6. diabetes;
7. blood coagulation disorders (lack of vitamin K);
8. C-avitaminosis, which disrupts the structure of small vessels;
9. hemorrhagic diathesis;
10. substitute bleeding occurring in women. It is caused by repeated nosebleeds during menstruation.

Symptoms of epistaxis

The blood from the nose may appear as slight spotting, but also severe haemorrhage. The peculiarity of blood from the nose is that it comes from one nostril. The intensity of the blood flowing from our nose depends on what caused it. Minor bleeding occurs in the case of dry nasal mucosa, minor trauma or allergies, in these cases haemorrhage usually disappears by itself. Haemorrhages caused by trauma to the head or nose, or blood diseases, as they cause coagulation disorders, are a threat to health and life. Some types of nasal cavity cancers also cause heavy nosebleeds.

Do your symptoms require medical consultation? Check it out for yourself in a short medical interview.

Blood from the nose (epistaxis) – diagnosis

To determine the causes of a nosebleed, you need to identify its source. If blood from the nose is very common, you should go to an ENT specialist. The doctor will start the visit by conducting a medical interview, during which he will obtain information on:

1. epistaxis frequency;
2. the age of the patient;
3. general condition of the patient;
4. situations where there is blood from the nose;
5. struggles of patients with chronic diseases;
6. medications the patient is taking.

After obtaining the above information, the doctor proceeds to an ENT examination, which will help to assess what the nose looks like (important, for example, after a nose injury), followed by a speculum examination of the inside of the nose. A specialist examines the nasal cavity with the help of a Hartmann speculum, while a longer speculum is used to reach its deeper regions.

In addition to the classic endoscopy, the rear throat endoscopy is also performed with flat mirrors. During this examination, the doctor looks at the opening of the nasal cavities. Another type of diagnostics is a manual examination, during which the doctor uses the index finger (inserted behind the soft palate into the nasopharyngeal cavity) to assess whether the patient has any lumps. If there is a suspicion that they may be present, the patient is referred for imaging tests for further diagnosis, usually computed tomography or magnetic resonance imaging.

After all examinations are carried out and the doctor determines that no pathological changes are present, the patient is referred for consultation with an internist in order to find the general causes of nosebleeds. You can arrange an online teleconsultation with an internist quickly and safely at haloDoctor.pl.

Treatment of epistaxis in individual cases

Stopping the haemorrhage:

1. tilt the patient’s head forward so that the blood flows out and is not swallowed, which may cause choking,
2. apply a cold compress to the area of ​​bleeding, i.e. the bridge of the nose or the top of the neck,
3. Press your nose lobes directly with your fingers against the septum.

To make a cold compress, you will certainly need a suitable compress, which you can find at Medonet Market. Try it out:

1. FLEX Mini compress for cold and warm compresses,
2. FLEX Standard compress for cold and warm compresses,
3. FLEX Medium compress for cold and warm compresses,
4. FLEX Max compress for cold and warm compresses.

Prolonged and intense epistaxis:

A doctor is required for patients who have a nosebleed for more than 20 minutes. Such a person should see an ENT doctor as soon as possible. During transport to the hospital, a Foley catheter is often inserted (especially when bleeding from the back of the nasal cavity). The inflated balloon at the end of the catheter is inserted into the nasopharynx to stop bleeding.

— an anterior or posterior tamponade is inserted (this depends on the site of bleeding). Before this happens, however, the ENT specialist prescribes the patient with anesthetic and vasoconstrictive drugs. Occasionally, doctors try to locally close the bleeding with electricity or nitrate. What is an anterior tamponade? It is a method of inserting oiled setons sticking out of the nose into the front of the nose. They are left for about 2 days. Tamponade is effective but unpleasant because we are forced to breathe with our mouths,

– insertion of the posterior tamponade: consists in applying coiled gauze balls matching the size of the nose to the back of the nasal cavity. This type of tamponade is tied in turn to the catheter that is passed through the nose into the throat and pulled out in a manner that allows gauze to be placed at the back of the nose. This method is called invasive, so it is common to use general anesthesia to administer gases. The posterior tamponade is applied for about two or four days. The negative effect of this procedure may be blockage of the paranasal sinuses,

– transfusion of blood / plasma or blood globulin,

– administration of vitamin K and C and hypertonic sodium chloride solution,

– surgery in the form of ligation or closure of the vessel is performed in the case of hemorrhage from one nostril, after skull fractures. However, these are rare cases

– detachment of the nasal mucosa and cartilage in case of frequent nasal septal haemorrhage.

Indications for hospitalization:

1. posterior tamponade;
2. frequent hemorrhages that caused anemia;
3. patients struggling with very heavy and frequent bleeding.

Foreign body in the nose

Children often put various balls, beads or toy parts into their nose, it also happens that it is peas or beans. Anything in the nose affects the length of the bleeding and should be removed from the outside in front of the nostrils. You should not remove the elements in the nose on your own, because we can only make the situation worse and introduce them deeper, which makes it difficult for a specialist to remove them.

The doctor pulls the foreign body out of the nose with a hook, but sometimes surgery is necessary, especially if we overlook the foreign body in the nose and the walls of the nasal cavities are damaged and recurrent hemorrhage occurs.

Juvenile fibroma

What is juvenile fibroma? It is a benign neoplasm with local malignancy in the nasopharyngeal area. Fibroma consists of a large number of blood vessels and fibrous tissue, the disease most often affects children aged 10-14 (boys). Blood from the nose in this disease can be life threatening. Treatment of cancer involves the incision of the tumor by a specialist or its irradiation.

How to prevent nosebleeds?

1. Moisturize the nasal mucosa (especially during fall and winter). Air humidifiers can be used for this purpose.

2. Avoid nose picking, which can lead to microtraumas and hence bleeding.

3. If you use decongestants, do it wisely. Remember that you should not use this type of medication for more than 5 days, as they can interfere with the proper flow and air cleansing in the nose and damage the mucosa. A safer solution is an isotonic sea water solution, which gently moisturizes the mucous membranes and can be used for a long time. Check the offer

4. Each case of nosebleeds (especially the intense ones) should be consulted with a doctor.

5. If you have problems with high blood pressure, record your measurements as the risk of blood from the nose is increased in people with hypertension.

1. Blood pressure monitors – compare prices

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