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Causes and symptoms of nosebleed
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Causes and symptoms of nosebleed

Experts talk about different types, causes, symptoms, diagnosis and treatment of nosebleed
ENT, nose, nosebleed
Representational image | Shutterstock

Guwahati-based homemaker Malabika Kakati recalls how a lazy playful day turned into a horror story for her then seven-year-old son Prachurjya Agasti. One moment, Agasti was playing with his collection of trinkets and the next, he was shrieking in pain.

“I saw him bleeding through the nose and we immediately took him to the doctor,” Kakati recalls. “He examined him and found the toy lodged in his nose, causing the nosebleed.”

According to Dr Ravi Bhatia, director, ENT and Cochlear Implant, Sarvodaya Hospital, Faridabad, a nosebleed, also known as epistaxis (medical term for nosebleed) refers to the discharge of blood from the inner tissues of the nasal cavity, caused by a ruptured blood vessel. “It can occur in either one or both the nostrils and can range from a minor annoyance to a more serious issue,” he explains.

Types of nosebleed

There are two main types of nosebleeds according to Dr Bhatia:

  1. Anterior nosebleeds originate from the blood vessels in the front part of the nose and are more common.
  2. Posterior nosebleeds occur deeper in the nasal cavity and can be more severe and harder to control.

What causes a nosebleed?

“Causes of bleeding of nose can include dry air, nose picking, trauma, allergies, sinus infections, and underlying medical conditions like hypertension or blood clotting disorders,” says Dr Bhatia.

According to Dr H K Susheen Dutt, ENT specialist, Fortis Hospital, Bengaluru, climate can also play a role in nosebleeds. Dry and arid environments can cause the nasal passages to become dry and irritated, making the blood vessels more prone to bleeding.

Factors amplifying nosebleed risk

nose bleeding
Representational image | Shutterstock

According to Dr Bhatia, epistaxis can happen to individuals of all ages, but they are more common in children and older adults. Children are prone to epistaxis because the blood vessels in the nose are closer to the surface and can easily be irritated. Older adults may experience nosebleeds due to the fragility of their nasal blood vessels.

In addition to that, according to Dr Dutt, people with nasal septal deviation often experience increased susceptibility to epistaxis, especially when accompanied by sharp spurs (nasal passage). [Nasal septal deviation is a condition where the nasal septum – which is the cartilage and bone that divide the nose into two nostrils – is not centered or straight].

Additionally, those with severe allergies are more prone to nosebleeds. Smoking and anticoagulant therapy (therapy for individuals with prosthetic heart valve) can also heighten the likelihood of nosebleeds. In children, simple anterior nosebleeds are more frequent compared to older individuals.

Nose picking and blowing too hard could also cause nosebleeds. Furthermore, high blood pressure can lead to posterior severe nosebleeds, which need immediate medical attention.

Nosebleed diagnosis

A nosebleed is diagnosed through a physical examination of the nose and medical history. In some cases, an expert may recommend further tests to determine the underlying cause which can include nasal endoscopy and blood tests.

Treatment for nosebleeds

According to Dr Bhatia the treatment options for epistaxiss include:

  1. Pinch the nostrils together and lean forward slightly to stop the bleeding.
  2. Apply a cold compress to the nose.
  3. Use nasal saline sprays or humidifiers to keep the nasal passages moist.
  4. Nasal pack with gauze or special balloons in more severe cases.
  5. A cauterisation or surgery may be required in some cases.

Treatment options can vary depending on the type and severity of the epistaxis. Anterior nosebleeds can often be managed with simple pressure and home remedies, while posterior nosebleeds may require medical intervention like nasal packing or cauterisation.

Kakati says that it is important that parents keep small objects away from the curious hands of their little ones, as it might lead to accidents that cause severe nosebleeds. “The doctor prescribed a nasal spray after the consultation and asked us to use it for five days,” she says. Her son’s nosebleed healed well after that.

What is cauterisation?

Cauterisation is a medical procedure where an expert uses heat, chemicals, or electricity to seal off the bleeding blood vessels in the nose. It can be an effective way to stop recurrent nosebleeds by preventing further bleeding from those vessels. Cauterisation serves various purposes: it stops bleeding during surgery and removes abnormal or unwanted tissue.

Preventive measures 

A nosebleed can be prevented if necessary measures are taken. A few tips recommended by both Dr Dutt and Dr Bhatia are:

  1. Use a humidifier to add moisture to the air, especially in dry climates.
  2. Avoid picking your nose or inserting objects into it.
  3. Use a saline nasal spray to keep the nasal passages moist.
  4. Apply a thin layer of petroleum jelly inside the nostrils to prevent them from drying.
  5. Be gentle when blowing your nose and avoid forceful nose blowing.
  6. Manage underlying conditions like allergies or hypertension that can contribute to nosebleeds.

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