Nosebleed

From ArticleWorld


A nosebleed is a hemorrhage of the inside or mucosal lining of the nose. There are two types of nosebleeds or “epistaxis”. An anterior nose bleed occurs in the front of the nose and is more common. This kind of nosebleed is also less severe than posterior nosebleeds. While rarer, posterior nosebleeds are generally more severe.

Causes

Trauma can cause the nose to bleed fairly easily. A broken nose often bleeds as well. Those on anticoagulants (or blood-thinners) are more likely to sustain a nosebleed. Nasal malignancies may be asymptomatic until they begin to bleed. Older people with high blood pressure or the pressure changes from high altitude can result in epistaxis.

Rare genetic diseases or sarcoidosis can result in nosebleeds as can any disorder that reduces the ability of the blood to clot. Even dry air or excessive nose picking can cause epistaxis, particularly anterior nosebleeds. Those who consume high amounts of fish oil are more prone to nosebleeds.

Treatment

An acute attack of epistaxis can be treated at home by pushing on the bridge of the nose or by pinching the nostrils together. Allowing a clot to form inside the nose will stop the bleeding and allow for healing. There are pros and cons to the way one tilts the head. Tilting the head back effectively elevates the nose but allows more blood to be swallowed, resulting in an increase in nausea and vomiting. Tilting the head forward increases the arterial pressure in the nose slightly but avoids collection of blood in the stomach.

Acute epistaxis in the emergency room is often treated with nasal packing. This can involve a tampon-like device that expands and shuts off the bleeding. Petroleum-based packing that is stuffed into the nose in layers also provides direct pressure to the nasal mucosa. In some cases, the area of bleeding can be visualized and cauterized with silver nitrate or electric cautery.

Chronic epistaxis, if not caused by a malignancy, involves improving blood coagulation or using petroleum jelly or saline to keep the membranes from being dry. Keeping the blood pressure normalized helps as well.

Nosebleeds, while common, can be highly life-threatening, especially posterior nosebleeds. The area is difficult to visualize and pack. Without prompt attention, an individual with a severe nosebleed can die from the blood loss.