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Nosebleed: Treatment, symptoms, advice and help

About nosebleed (epistaxis)

Nosebleed, termed in medical literature as ‘epistaxis’ occurs when the inner lining of walls of the nose is disrupted or irritated. Epistaxis can arise from the frontal compartment or the latter compartment of the nose. Epistaxis from posterior compartment of the nose is generally a serious problem.


Nosebleed (epistaxis): Incidence, age and sex

The occurrence of nosebleed is seen either in children before the age of 10 years or in the age group of 45 - 65 years. There seems to be no gender bias, especially in cases occurring after the age of 50 years. However, young boys seem to be slightly more afflicted with this condition as compared to young girls.

Statistical surveys suggest that although 60% of adults have experienced an episode of nosebleed, only about 10% required medical attention and very rarely, a surgical intervention.


Signs and symptoms of nosebleed (epistaxis): Diagnosis

Nosebleed is itself a clinical sign and symptom of underlying causes, which can be generalised or localised to nose. Nosebleed is accompanied by clinical features of the underlying cause. It is very rare for an affected individual, to faint from nosebleed.


Causes and prevention of nosebleed (epistaxis)

Most commonly, trauma to the face can result in nasal injury and subsequent bleeding from the nose. Nosebleeds may also occur in dry, cold weather when upper respiratory infections are more common. It may also occur in cases of high blood pressure, heart failure, use of blood thinning drugs, alcohol abuse, and occasionally in nose-related cancers or inherited bleeding disorders.

Individuals prone to nosebleed are advised to avoid certain activities like blowing nose, straining while passing bowels, lifting heavy weight, smoking and taking blood-thinning medications. It is often helpful to lubricate the nose from inside with an ointment of some type like petroleum jelly to prevent dryness.


Nosebleed (epistaxis): Complications

The complications of nosebleed include that of the underlying cause. Sometimes massive nosebleed may result in significant blood loss. Moreover, recurrent nosebleed may lead to longstanding blood loss, subsequently leading to iron deficiency anaemia.


Nosebleed (epistaxis): Treatment

Most nosebleeds are not a major problem and respond well to first aid management. First aid measures include:

  • Sit up and lean forwards so that blood does not flow back into the throat.
  • Pinch the nose firmly and hold it for some time to stop the bleeding.
  • Apply ice pack to nose and cheeks to impede bleeding.
  • Do not blow nose for a few hours after bleeding stops.

If the bleeding still persists, then the doctor may use a nasal swab to arrest bleeding or may apply a topical blood clotting medicine. Nasal packing may be done if all prior treatment methods fail and bleeding does not to stop. Nasal packing in cases of bleeding from latter compartment of the nose may potentially cause airway compromise.