Nose bleeds — all you need to know

Got a nosebleed? Check out what triggered it and how you to treat as well as prevent it.

By: Shraddha Rupavate | | Published: January 14, 2014 3:57 pm

The sight of nosebleed can totally freak you out but there’s nothing to worry about. Nose bleed (medically termed as Epistaxis) is quite common during winters because of sudden fluctuations in temperature. It can rarely be serious or life-threatening. In fact, most nosebleeds can be treated at home with first-aid measures. But before knowing what can be done to stop nose bleeding, let’s understand why it is caused, what triggers it and how serious it could get.

What causes the nose to bleed?

Nose is highly vascular in nature –Its interior is covered with a delicate mucosal lining and several blood vessels which supply blood to the nasal tissue. Because of the delicate nature of these blood vessels, even a tiny scratch is enough to cause profuse nose bleeding that sometimes may appear to be severe. Moreover, the location of the nose makes these blood vessels accessible to external agents that can easily cause an injury.

Nosebleeds could occur either in the front part of the nose due to an injury to the part separating the nostrils or any part of the nostrils itself. Rarely, they could also occur in the posterior part of the nose as a result of an injury to larger blood vessels present deep inside the nasal cavity. In this case, the blood may drain directly into the throat.

What triggers a nosebleed?

Most likely, nosebleeds occur due to environmental changes and nose picking. But, there are several other factors that increase the chances of nose bleeds.

Dry weather: Just as the skin gets cracked during cold weather, the interior nasal tissues can also crack and bleed due to frequent seasonal changes. The cold wind, dry weather and sudden changes from pricking cold outside to indoor warm temperatures affect the tiny blood vessels of the nose making them susceptible to bleeding.
Infections: Common respiratory infections cause irritation and inflammation of the blood vessels in the nose, increasing the chances of bleeding. Nasal blockage, congestion and nose blowing are common during cold. All these factors further increase the chances of injury to the blood vessels. (Read: Eucalyptus oil: Instant home remedy for a blocked nose)
Exposure to external irritants: Dust allergies and primarily passive smoking (exposure to second-hand smoke) can cause nose bleeding. (Read: Allergic Rhinitis: All you need to know).
Health conditions: Several medical conditions such as high blood pressure, kidney problems, bleeding disorders, thrombocytopenia (low platelet count) increase the chances of profuse nose bleeding.
Alcohol consumption: Alcohol intervenes with normal platelet activity.It increases the time of blood clotting and also enlarges blood vessels,exposing them to injury.
Medications: There are several medicines that interfere with the blood clotting process. These include blood-thinners and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. (Read: Ibuprofen — why you shouldn’t pop these pills indiscriminately)
Deviated nasal septum: Rarely, the nasal wall may be slightly shifted to one side. This alters the air flow through the nasal passage while breathing. Because of the uneven pattern, the wider part of the nasal passage easily becomes dry and cracked, increasing the risk of nose bleeding.

Self care tips to treat nosebleeds:

Here are a few things you can try if your nose starts bleeding:

Slightly blow your nose to remove blood clots that may be formed inside your nostrils. This may increase bleeding a bit but don’t panic. It’s just temporary.
Sit or stand and then bend forward slightly at your waist. Don’t tilt your head backwards as it may drain some blood in the throat and cause discomfort. Keep breathing through your mouth.
Grip the soft, front part of your nose (just below the hard bone) with your index finger and thumb. Hold it for a few seconds, while breathing through the mouth, and then release. Repeat 4-5 times.
If bleeding doesn’t stop with the above measures, you can apply some ice externally on the nose bridge to reduce the blood flow.
If your nose is still bleeding, seek medical help.

If your nose is bleeding due to a more serious problem, your doctor may give you some nasal drops to stop the bleeding. If a larger vessel is injured resulting in profuse bleeding, then the doctor may seal the injured blood vessel using gauze packing, certain chemicals, plug or an electric device. Sometimes, laser therapy can be recommended to seal the bleeding blood vessel. Recurrent nose bleeds due to a deviated nasal septum can be treated with surgery to correct the position of the septum. (Read: Diagnosis and treatment of sinusitis)

You can also prevent nosebleeds with the following tips:

Always blow your nose gently.
Keep the indoors warms during winters, especially people who are too sensitive to cold.
You could use an over-the-counter saline nasal spray or a nasal gel to prevent the nasal tissue from drying. Consult with a pharmacist or a doctor before using.
Be careful while driving or playing sports, such as football, to prevent facial injury.
If you are allergic to chemicals or dust, cover your nose with a mask.
Stop smoking or inhaling second-hand smoke.

When should I seek medical help?

Nose bleeds usually stop within a few minutes. However, if it doesn’t stop with first-aid and is recurring, you should see a doctor immediately. Other signs like constant nasal congestion, foul nasal discharge or pain while bleeding could also be dangerous.

The doctor will check your health history and review what medicines you are taking. A physical examination of the nose will be done to check the site of bleeding. If it is posterior bleeding, then an instrument called endoscope will be used to analyse the site of bleeding. The doctor may also suggest blood tests to check for platelet count and bleeding irregularities.

References:

Corry J. Kucik and Timothy Clenney. Management of Epistaxis

Viehweg TL, Roberson JB, Hudson JW. Epistaxis: Diagnosis and Treatment

McGarry G. Nosebleeds in children.

Nosebleed (Epistaxis, Nose Bleed, Bloody Nose) (http://www.medicinenet.com)

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Published : January 14, 2014 3:57 pm

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