Nosebleeds

Description

Everyone experiences a nosebleed from time to time. The cause may be an impact to the nose, but many times the nose bleeds because of nasal congestion due to a nasal allergy, strep throat, a sinus infection, or a cold that irritates and weakens the delicate nasal lining.

In some adults, especially those taking aspirin or anticoagulants, the bleeding may start spontaneously. However, the main cause of nosebleeds is people picking or irritating the small blood vessels just inside the nose. If you pick, rub, or irritate these veins, they can break open and bleed.

Nosebleeds can develop in the rear part of the nose. Blood will typically flow backward and down the throat instead of out the nose. Applying pressure to the nostrils will not stop the flow of blood, and blood loss could be substantial. It is necessary to see a doctor or go to the emergency room in order to be treated.

Causes and Risk Factors

In middle-aged people, spontaneous bleeding is often related to high blood pressure that is not well controlled, or not yet diagnosed. A nosebleed stemming from the back of the nose can also result from hemophilia (a bleeding disorder), leukemia, and other bleeding disorders related to low platelet levels or blood clotting.

If you cannot stop your nose from bleeding, if its starts bleeding after a head injury but no accompanying injury to the nose, or if you have frequent nosebleeds and suspect that it is due to something other than a nasal irritation, contact your physician or go to the emergency room.

Treatment

To stop a common nosebleed, apply pressure to the dividing wall between the nostrils. First, sit or stand upright with the head tilted forward to lower blood pressure to the head, and prevent the escaping blood from flowing down the throat.

Take your thumb and forefinger and forcefully grab the front of your nose. Press hard enough so that the nostrils are pressed tightly against the septum. You know you have applied enough pressure if you look in mirror and see the skin blanch. Breathe through your mouth and continue to apply this pressure for one minute by the clock.

Most of the time, this pressure is sufficient to cause the blood to clot and stop the nosebleed. If the nose continues to bleed, apply pressure for another minute. If the bleeding still continues unabated after 15 minutes of steady pressure, contact your doctor.

Once the bleeding has stopped, do not blow your nose for several hours or you may cause it to bleed again. Apply an antibiotic ointment to a cotton-tipped applicator and gently rub it on the inside of your nose. The antibiotic will help destroy any germs, while the ointment will help keep the nasal lining moist. Reapply the ointment several times a day for several days, especially before going to bed at night. Many people tend to rub their noses unconsciously in their sleep, especially children. If the nasal lining is dry and unprotected, it can easily begin to bleed again.

Nosebleeds tend to recur because, although the tissue quickly heals, it takes more than a week for the area to heal completely. In the meantime, if you rub the nose hard, sneeze, blow your nose, or stick your finger in your nose to scratch or remove dried crusts of mucus inside the nose, you effectively remove the healing tissue and the bleeding can start all over again.

If professional help is needed, the doctor will probably pack the nose with gauze at the point where the back of the nose meets the back of the throat. This will put pressure on the damaged artery and stop the bleeding. For persistent bleeding, the nostril may first be anesthetized and a catheter then inserted. As the catheter fills with blood, pressure is applied to the artery and bleeding stops.

In the case of head injury, x-rays will be taken to see if there is a possible skull fracture.

Questions to Ask Your Doctor

What is causing the nosebleed?

Is it related to another medical problem or condition?

What can be done to minimize the risk of bleeding?

If bleeding starts, how can it be stopped?

What can be done to prevent future attacks?

Under what circumstances should an emergency room visit be appropriate?