Nosebleed
Also known as: epistaxis
What is it?
A nosebleed is a condition in which the
membranes inside the nose are irritated or injured
and begin to bleed.
Who gets it?
Anyone can get a nosebleed. It is common in
people who take drugs that affect the blood’s
clotting ability, and occurs more often in men
than in women. It is not uncommon for children to
have nosebleeds.
What causes it?
Nosebleeds are most often caused by irritation
of the mucous membranes in the nose. The cold, dry
winter air; repeated, violent sneezing or nose
blowing due to infection or allergies; or
repeatedly picking the nose are common sources of
irritation. Nosebleeds can also be caused by
trauma to the nose, head, or facial area; by
conditions such as leukemia, high blood pressure,
kidney or liver disease, a bleeding disorder, or
vitamin K deficiency; or by using drugs that are
inhaled through the nose, such as cocaine. In most
cases, the blood comes from the front, or
anterior, part of the nose, called the nasal
septum, which is rich in tiny blood vessels.
Nosebleeds from the back, or posterior, part of
the nose are less common and usually more serious.
What are the symptoms?
Bleeding from the nose can range from light to
heavy, and can be from just one or both nostrils.
Bleeding from the back of the nose can cause rapid
blood loss and is usually indicated by a slow ooze
of blood. Other symptoms can include dizziness,
nausea, fainting (syncope), anxiety, and
respiratory distress.
How is it diagnosed?
A nosebleed is diagnosed according to its
characteristics symptoms. You should see a doctor
if the nosebleed is extremely heavy, the bleeding
will not stop, nosebleeds occur frequently, or if
you have a medical condition or have experienced
some type of trauma to the head that is causing
the nosebleed. Your doctor will take your medical
history and perform a thorough physical
examination. He or she may order blood tests and
other diagnostic procedures to determine if there
is an underlying condition causing the nosebleeds.
What is the treatment?
The first line of treatment for a nosebleed is
to sit still and breathe through the mouth,
tilting the head slightly forward so the blood is
not flowing down the throat. Pinch the sides of
the nose together firmly for approximately 10
minutes. If the bleeding has not stopped when you
release the nose, pinch it for another 10 minutes.
Seek medical attention if this treatment does not
stop the bleeding after around 20 minutes. Your
doctor may pack your nose with sterile material
soaked in a drug that constricts the blood vessels
to stop the flow of blood and promotes clotting.
In some cases, you may need to keep the nose
packed for a few days to stop the bleeding. If
your nosebleeds are severe or occur frequently,
your doctor may need to cauterize the blood
vessels that have ruptured. He or she will numb
the area, then use a chemical or an instrument
called an electrocautery to seal the blood vessels
so they cannot bleed anymore. People with bleeding
from the back of the nose (posterior nosebleeds)
or who need certain types of packing may need to
be hospitalized during treatment to monitor
breathing and comfort. Your doctor may prescribe
antibiotics to prevent or treat infection.
Self-care tips
If you experience nosebleeds more often in the
winter, you may find that running a humidifier in
your home will reduce the dryness of the air and
help moisten the mucous membranes. You can also
moisturize the nasal septum with a small amount of
petroleum jelly or a saline nasal spray, or use an
antibiotic cream to soothe and heal irritated
membranes. Never use your finger or any other
object to pick at the inside of your nose and do
not use inhaled drugs, such as cocaine. If you
have a nosebleed, avoid vigorous exercise, nose
blowing, hot, spicy foods, hot beverages, and any
type of straining for a few days to prevent
additional bleeding. If you must blow your nose,
blow it gently.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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