Dorothy FarrarNosebleeds
A nosebleed is not a disease per se, but may be a symptom of one of many possible diseases. In most cases, however, the nosebleed can be classified as a harmless small injury to the nasal mucosa and should normally stop after a few minutes. If it occurs more often or if it persists for a long time, it should definitely be clarified by an ear, nose and throat doctor.
What is nosebleeds?
The reason for nosebleeds is usually in the nose itself. Small burst blood vessels in the nose (e.g. caused by blowing your nose too hard) often lead to a bleeding nose. Other underlying diseases are rarely responsible for nosebleeds. Regular use of nasal sprays can also irritate and damage the nasal mucosa. Nosebleeds are a common symptom of a cold, runny nose or flu.
If the nosebleed lasts for an unusually long time (20 minutes or more), if the blood has a watery consistency or smells extremely badly, then you should definitely consult a doctor (ENT specialist).
causes
The main source of nosebleeds are the blood vessels in the mucous membrane of the nasal septum (Locus Kiesselbachi). Bleeding from this occurs mainly in high blood pressure crises, chronic inflammation of the nasal mucosa, acute colds in children or vascular malformations in the nasal area.
Likewise, nosebleeds can be a symptom of flu, measles, or typhoid. Rarely, nosebleeds are a harbinger of atherosclerosis, pregnancy , or vitamin C deficiency .
Mechanical causes of nosebleeds are also common, for example, minor bleeding can occur after picking your nose, blowing your nose hard when you have a cold or injuries (hit, fall). The reason here is that the nose, as the organ of air heating and humidification, is simply exceptionally well supplied with blood.
If nosebleeds occur frequently, a blood clotting disorder could also be the cause. Such diseases are often hereditary, so family history could provide clues. For example, if a parent has or has had frequent bleeding complications, a hemostasis disorder is quite likely.
Last but not least, medical therapy measures should also be considered as a cause of nosebleeds, especially in older people. For example, anticoagulation (blood thinning) with Marcumar or other medications used in thousands of heart patients leads to an increased tendency to bleed, which often first manifests itself in the area of the nose.
Diseases
When to the doctor?
Occasional, slight nosebleeds, especially after a long stay in heavily heated or air-conditioned rooms, are harmless for both children and adults. However, if the nose bleeds profusely and the blood flow lasts longer than a quarter of an hour, a doctor, preferably an ear, nose and throat specialist, should be consulted. This is especially true if trauma , such as a fall or a ball thrown at the head, could be responsible for the nosebleed. Here a vascular injury is obvious, which has to be sclerosed.
Patients who regularly suffer from nosebleeds several times a week should have the causes clarified by a doctor. If arterial hypertension (high blood pressure) is responsible for the nosebleed, there is a risk of a stroke if left untreated. The doctor must also examine the patient’s blood values to rule out coagulation disorders.
In rare cases, chronic nosebleeds can also indicate pathological changes in the ear, nose and throat area or even a brain tumor . A medical examination is therefore essential. In pregnant women, the increased estrogen level causes a loosening of the connective tissue in the body, which can also affect the inside of the nose. Slight nosebleeds during pregnancy are therefore harmless. However, heavy bleeding should be discussed with a doctor.
diagnosis and course
In most cases, nosebleeds are completely harmless. Very rarely, various underlying diseases (blood clotting disorders, vascular diseases) can lead to frequent and severe blood loss. If the nosebleeds are regular, very strong or long-lasting, you should definitely see a doctor.
In addition to questioning the patient (medical history), the specialist (ENT doctor) will try to localize the source of the bleeding using a special endoscope or nasal mirror (rhinoscope). If the cause is unclear, other disciplines and diagnostic techniques must be consulted. A blood test, various imaging examination methods ( X- ray , ultrasound , computed tomography ( CT ) or magnetic resonance imaging ( MRI ) can help to further identify the cause.
complications
Only in a few cases does a doctor have to be consulted for nosebleeds. In most cases, nosebleeds are only a very short-term symptom that does not necessarily need to be treated and will stop on their own. However, if the nosebleed occurs with low blood pressure and a high heart rate, it can be a sign of blood loss. In such cases, you should definitely go to a hospital. Nosebleeds should be stopped in all cases to prevent blood loss. This is also the case if the nosebleed occurs after an accident or a blow to the nose.
A severe nosebleed after an accident is often a sign that the nose is broken. However, a broken nose is nothing serious and can be treated by a doctor. After the break, it is usually not obvious that the nose was broken. Nosebleeds can also be caused by benign tumors that are pressing on certain areas inside the nose. These can be surgically removed. In most cases, nosebleeds are a less serious symptom that can be treated and stopped very easily. A doctor should only be consulted in the event of heavy bleeding that does not stop on its own.
treatment and therapy
Some initial measures for harmless nosebleeds can be carried out by everyone affected: It is recommended to keep the upper body upright.
In the minds of many people, the measure of throwing your head back just to keep the blood in your head is still stuck. However, this should not be done – it only ensures that blood runs down the nose into the throat and is swallowed there – vomiting can be the result.
So it is better to let the blood run out at the front and at the same time to cool the neck (e.g. with a cold, wet towel). This will make the bleeding stop on its own more quickly.
If this does not succeed, an ENT doctor has many other options for stopping a nosebleed: Various nasal tamponades or balloon catheters, which can be inserted into the nasal cavity from the front or through the mouth from behind, usually do the trick.
Severe nosebleeds can be treated by sclerotherapy or etching with silver nitrate. There are also medicinal options, for example with mucous membrane decongestants such as highly diluted adrenaline .
Furthermore, there is the surgical possibility of stopping bleeding vessels in various parts of the facial skull (vascular ligation). However, this is an absolute emergency measure if other attempts have failed.
In the event of major blood loss, it may be necessary to stabilize the circulation. Anyone who loses so much blood through their nose should definitely seek medical attention. Furthermore, the possibility of an underlying blood coagulation disorder should at least be ruled out. A search for the cause should therefore be carried out after the acute therapy.
outlook and prognosis
Most nosebleeds have a harmless cause. The many small blood vessels in the nose can burst even with the slightest impact and are usually well closed by the body’s own blood clotting.
If the nosebleed occurs as a result of an external influence, it can be expected that the bleeding can be stopped easily with appropriate measures.
However, if such minor bleeding occurs frequently and for no apparent reason, the cause should be clarified. Otherwise it is to be expected that the epistaxis will recur.
The prognosis is all the better, the more gently the affected person deals with his nose after bleeding. An unjustified recurrence of nosebleeds can usually be prevented if the person concerned refrains from blowing or fingering their nose for a while.
If the bleeding is such that it cannot be stopped, a doctor must be consulted, whose prognosis depends on the source of the bleeding. If a larger vessel (e.g. in the sinuses or an artery) is the cause, subsequent bleeding must be expected if the damage is not repaired. Even people who take blood thinners have to reckon with the fact that epistaxis can become long-lasting. In such cases, the bleeding often has to be stopped by tamponades or sclerotherapy.
prevention
↳ More information: Home remedies for nosebleeds
Nosebleeds are often harmless and end after a short time, so there is no prophylaxis in the narrower sense. It can only be recommended to refrain from manipulations in or on the nose and not to overdose any blood thinners that may be taken.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.