Nosebleeds: Causes, Symptoms & Treatment

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Nosebleeds are more common than you think. It happens to us suddenly when blood starts to stream from one nostril. Majority of us have had them at least once in our lifetime. Nosebleeds, medically called epistaxis, can be life-threatening in rare cases ^[1] .

What Are Nosebleeds?

Nosebleed is the active blood loss from the tissues that line the nose. It can affect both nostrils, but usually, it occurs in one nostril.

Nosebleeds are often caused by mild trauma, sinus infections, prolonged exposure to dry air, etc. Children are also susceptible to nosebleeds ^[2] .

What Causes Nosebleeds

The nose has numerous tiny blood vessels that help to warm and humidify the air you breathe in. These tiny vessels lie close to the nose surface which make them susceptible to injury. Most nosebleeds happen within the lower end of the nose in the lower septum (the wall that separates the two airways of the nose that ends in the nostrils).

Nosebleeds are categorized into two categories:

1. Anterior nosebleeds ^[3]

The bleeding occurs in the lower septum which has delicate blood vessels. Anterior nosebleeds are common in children and can easily be treated.

The causes of anterior nosebleeds are as follows:

• Picking the inside of your nose often
• A knock or blow on the nose can damage the soft blood vessels
• Sinusitis
• Deviated septum
• Hot climates with low humidity
• A cold, flu or a nasal allergy
• Dry climates can cause drying and cracks inside the nose.
• High altitude
• Medications like blood thinners or non-steroidal anti-inflammatory drugs
• Excessive intake of drugs like cocaine
• Liver disease

2. Posterior nosebleeds ^[3]

Posterior nosebleeds are heavier because they occur high up in the nose where artery branches supply blood to the nose. It is often more serious and requires medical attention. It is more common in adults.

The causes of posterior nosebleeds are as follows:

• Nasal surgery
• High blood pressure
• Tumour
• Calcium deficiency
• Blood diseases like leukaemia or haemophilia
• Chemical exposure

Other causes of nosebleed include low platelet count, foreign particles in the nose, broken nose, rheumatic fever, liver cirrhosis, celiac disease, Osler-Weber-Rendu disease ^[4] , ebola, aortic coarctation, factor X deficiency, deficiency of factor II, V, or VII, glomerulonephritis, Von Willebrand disease, leishmaniasis, and idiopathic thrombocytopenic purpura.

Symptoms Of Nosebleeds

The most obvious symptom of a nosebleed is light or heavy blood oozing out from the nose. And if nosebleed occurs while lying down, you will feel liquid trickling in the back of the throat before the blood comes out from the nose.

Other symptoms are heart palpitations, heavy bleeding, turning pale, and shortness of breath.

When To See A Doctor

Most nosebleeds are not serious and will stop on their own. However, if you are having a heavy blood flow that interferes with breathing and lasts longer than 30 minutes, you should seek medical intervention.

Treatment Of Nosebleeds

The treatment varies depending on the type of nosebleeds.

Ways to treat anterior nosebleeds: ^[5]

• Remain calm and sit up straight. Lean forward a little to prevent blood from going into the throat.
• Carefully blow your nose, don't put much pressure.
• Pinch the soft parts of the nose for 5 minutes. If bleeding continues, repeat for 10 more minutes.
• Sit upright to reduce blood pressure and slow down further bleeding.
• Apply a cold compress or ice pack on the nose.
• If the cause of nosebleed is dryness, apply vaseline inside the nose.

If the cause of a nosebleed is of an underlying condition like high blood pressure, anaemia or nasal fracture, the doctor will conduct an X-ray test before doing the following treatment options.

• Cautery - A minor procedure which involves burning the area where the bleeding is coming from to seal it.

• Nasal packing - Stuffing ribbon gauze or nasal sponges inside the nose to put pressure on the blood vessels to stop bleeding.

• Septal surgery - It is done to straighten a crooked septum to reduce bleeding of the nose.

• Ligation - A type of surgery that involves tying the ends of the identified blood vessels that causes bleeding.

Tips To Prevent Nosebleeds

• Keep your nose moist during the drier months or when at high altitudes.

• Avoid picking the nose.

• Avoid blowing your nose too hard.

Disclaimer: The information provided in this article is for general informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or a qualified healthcare provider with any questions you may have regarding a medical condition.