Nosebleeds – Causes, Treatment & Prevention

Nosebleeds are one of the most common healthcare problems. Medically, it is called Epistaxis. They are usually a result of the rupture of tiny blood vessels in the anterior or posterior part of the nose.

• Anterior nosebleed – starts in front of your nose on the lower part of the wall which separates two sides of the nose (known as the septum). The blood vessels in this region are closer to the surface. Therefore, they are more prone to injuries.
• Posterior nosebleed – happens deep inside the nose. This type of nosebleed is caused by bleeding in the larger blood vessels in the back part of your nose near the throat. 

The instances of elderly people suffering from posterior nose bleeding are usually higher than children or adults. Nosebleeds in the elderly can be because of something more severe like heart disease or hypertension.

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Causes of Nosebleed

Anterior bleeds are more common and less severe, and posterior bleeds, are rare but severe.

Here are a few common causes of nose bleeding:

1. Roughly blowing your nose
2. Picking your nose
3. A respiratory tract infection
4. Major sinus issue
5. Blunt trauma (like accidents)
6. Environmental irritants
7. Severe allergies (including food allergies)
8. Dryness in the nose
9. A blocked nose
10. High blood pressure
11. Deviated septum (abnormal shape of the wall that separates two sides of the nose)
12. Alcoholism
13. Blood-thinning drugs (aspirin, warfarin, non-steroidal anti-inflammatory drugs and others)
14. Chemical irritants (chemical fumes at workplace, chemicals in cleaning supplies, other strong odors)
15. High altitudes – air is drier and thinner (lack of oxygen) as the altitude increases
16. Allergic and Non-allergic rhinitis (inflammation of the nasal lining)
17. Cocaine and other drugs inhaled through nose
18. Frequent use of nasal sprays and drugs to treat stuffy, runny, or itchy nose. These drugs – antihistamines and decongestants – can dry out nasal membranes

Some of the major diseases that can cause nosebleeds are: 

1. Hypertension
2. Heart ailments (mainly in the elderly)
3. Thrombocytopenia (unusually low level of platelets in the blood)
4. Leukemia
5. Hemophilia
6. Fractures
7. HIV
8. Von Willebrand Disease (hereditary blood clotting disorder)
9. Severe liver ailments

Treatment

Nose bleeding can be treated at home. some people also use home remedies like applying ice on the forehead, on the bridge of the nose, etc. These remedies work in mild cases. But in severe bleeding, these techniques will not help and might worsen the situation.

• Anterior nosebleeds can be controlled by exerting gentle pressure, which helps in blood clotting. Patients are required to tilt their heads backward and lightly pinch their noses for five to twenty minutes. Avoid swallowing blood as it may cause vomiting and nausea. While pinching your nose, try to be as gentle as possible. Pinching will exert pressure on the bleeding point and stop the flow of blood. Breathe with your mouth. Try blowing your nose softly to remove any clotted blood and spray a nasal decongestant.

Also Read About: Blood Clot in The Brain

Sitting straight and leaning forward may help. By maintaining this posture, you will reduce the pressure exerted on veins. Sitting straight will prevent the backflow of blood and prevent it from getting into your stomach.

• Doctors might perform endoscopy if you have frequent episodes of nose bleeding.
• One of the common treatments is nasal packing. There are two different ways of nasal packing – anterior nasal packing and posterior nasal packing. Earlier, it was done by packing gauze in the nose and putting pressure on the nose to stop bleeding. Rapid Rhino and Merocel have replaced the traditional gauzes. This is done to reduce discomfort in patients.
• Another way to stop nasal bleeding is Tranexamic Acid. It is used on the site of bleeding, injected, or taken orally. 
• In cases of severe bleeding, the doctor may ask you to undergo surgery or cauterization. In cauterization, silver nitrate is applied to the nasal mucosa. It helps burn and thereby seal the blood. It is suggested for children. In this surgery, the bleeding point is healed, or the blood vessels leading to the nose are tied off.

Nosebleeds in Elderly

Nose bleeding is quite common in small children. However, in old age, it can be risky. Our skin becomes delicate and thin with age. It also loses its self-healing mechanism. The elderly are more vulnerable. Even nose blowing can rupture their veins and result in a bleeding nose.

Severe nosebleeds in the elderly could be because of head trauma, heart failure, or other diseases. They must see a doctor at the earliest. If you have any other symptoms along with a bleeding nose, like shortness of breath, increased palpitation, excessive sweating, pain in the heart, dizziness, you must seek medical help at the earliest. To avoid nosebleeds, use a humidifier, quit smoking and alcohol, trim your nails, stay away from allergens, and drink plenty of water.

When to Visit a Doctor

Nose bleeding in mild cases can be treated at home. Normally, it requires five to twenty minutes to stop bleeding. If your bleeding does not stop within this time, it is recommended to contact a doctor. You must also see a doctor if you have frequent bleeds , the situation persists or causes breathing difficulties. If you have met recently with an accident or injured yourself, you must seek a doctor’s consultation at the earliest.

You can either consult a general physician or an ENT (Ear Nose Throat) specialist.

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Prevention

To avoid re-bleeding, do not blow your nose harshly and avoid picking it. Don’t bend for several hours, and keep your head above your chest. After bleeding, do not touch or rub your nose and do not allow water to get inside. Avoid drinking alcohol as it can increase your nasal bleeding tendencies. Also, avoid consuming hot liquids for the next two days to prevent your blood vessels from dilating. 

If you take any medicines that can cause blood thinning, like Aspirin, adjust its dosage.

In a Nutshell

Nose bleeding is not considered a severe healthcare problem. There are many reasons behind it, but it is important to know the right reason to prevent future occurrences. Mild cases of nose bleeding can be cured at home by following the correct procedure. Doctors suggest surgery only in rare and critical conditions. Nosebleeds alone are rarely fatal, but they can be a sign of severe disease. Do not panic and take good care of your body, and stay hydrated.