Nosebleed: Symptoms, Causes and Treatment

Overview

A nosebleed, also called epistaxis, is loss of blood from the tissue lining the nose. It is very common and often not serious. Most nosebleeds occur because of minor irritations or colds.

There are two types of nosebleeds based on where they originate: anterior nosebleed and posterior nosebleed. Anterior nosebleed occurs most often where the bleeding originates from a blood vessel on the nasal septum. It is usually easy to control. Posterior nosebleed is more complicated, and it often occurs only in elderly people. The bleeding usually originates from an artery in the back part of the nose.

Generally,
nosebleeds are common in adults and children between the ages of 3 and 10. They
also occur more often in the winter, when cold viruses are common and indoor
air tends to be drier.

It is estimated that about 60% of people have a nosebleed at some point in their life and about 10% of nosebleeds are serious.

Causes

There
are many causes of nosebleeds. The tiny and delicate blood vessels in the nose
can become damaged and bleed easily. The most common cause of nosebleeds is dry
air. The dryness causes crusting inside the nose, which may itch or become
irritated. If your nose is scratched or picked, it can bleed. Other common
causes include:

  • Foreign object stuck in the nose
  • Chemical irritants
  • Allergic reaction
  • Injury to the nose
  • Picking nose
  • Vigorous nose blowing
  • Repeated sneezing
  • Cold air
  • Upper respiratory infection
  • Large doses of aspirin
  • High blood pressure
  • Bleeding disorders
  • Deviated septum
  • Cancer
  • Nasal surgery

Symptoms

The
main symptom of nosebleed is bleeding in the nose. Usually, bleeding occurs
only from one nostril. If the condition is serious, it can cause simultaneous
bleeding from the other nostril as well. Blood can also drip into the back of
the throat or down into the stomach, causing a patient to spit up or vomit
blood.

Other
symptoms and signs of heavy blood loss include:

  • dizziness
  • weakness
  • confusion
  • fainting

Diagnosis

To
diagnose a nosebleed, the doctor will first conduct a personal medical history and
a physical examination to determine a cause. This includes looking up the nose
with a special lighted instrument called a rhinoscope. Making a diagnosis also
includes performing a variety of tests, which include:

  • Complete blood count (CBC)
  • Partial thromboplastin time (PTT), which is a test used to check the clotting time of blood. This can indicate the presence of blood clotting disorders.
  • Drug testing
  • Allergy skin testing
  • CT scan of the nose
  • X-ray of the face and nose

Treatment

Most
nosebleeds can be stopped without medical treatment, but in serious cases,
further treatment may be required.

If
you have an anterior nosebleed, you can try to stop an anterior nosebleed at
home by doing the following steps:

  • Sit up straight and firmly pinch the soft part of your nose for about 10-15 minutes.

  • Lean forward to avoid swallowing the blood and breathe through your mouth.

  • Place an ice pack covered by a towel on the bridge of your nose.

Stay
upright, rather than lying down, and wait at least 10 minutes before checking
if the bleeding has stopped.

If you have a posterior nosebleed, it can’t be treated at home. You should contact your doctor immediately. There are two main treatments that the doctor may use to stop your posterior nosebleed.

  • Cautery

A
medical technique called cautery can burn the blood vessels in your nose with a
heating device or silver nitrate. A local anesthetic will be sprayed into your
nose to numb it and the silver nitrate stick will be held against the bleeding
point for about 10 seconds.

  • Nasal packing

If cautery doesn’t work enough, the doctor may recommend packing your nose with gauze or special nasal sponges to stop the flow of blood by applying pressure to the part of the bleeding. A local anesthetic is also sprayed into your nose. The gauze or sponges often need to be left in the affected place for 24-48 hours before being removed. You need to be monitored during this time in hospital.

Keywords: nosebleed.

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