Nosebleeds (epistaxis)

Description

The bursting of blood vessels of the nasal mucosa causes nosebleeds. Most often it affects the nasal septum, the most anterior part of the nasal septum. At this point, a dense network of vessels (Locus Kiesselbachi) is found under a sensitive mucous membrane. Frequent blowing or picking the nose is extremely stressful and injures both the mucosa and underlying vessels.

Normally, nosebleeds are harmless; almost every adult has been affected by them at some point in his or her life. However, medical treatment is rarely necessary, e.g. in case of severe blood loss due to a coagulation disorder.

Common Causes:

• Repetitive and violent blowing of nose
• Picking the nose
• Violent impact (e.g. a blow)
• Allergy
• Acute infections (e.g. flu, cold)
• Dry room climate
• Hypertension (high blood pressure)
• Anticoagulant drugs (e.g. phenprocoumon; acetylsalicylic acid)
• Chemicals (e.g., chlorine irritates mucous membranes)

Rarely:

• Foreign body (injury to mucosa)
• Skull base fracture (without direct injury to the nose)
• Blood diseases (e.g. haemophilia, leukaemia)
• Tumours (in nasal cavities and sinuses)
• Osler's disease (hereditary bleeding from vascular nodules)

In the case of nosebleeds, a few drops up to severe blood loss with subsequent circulatory shock are possible. The intensity of the bleeding depends on the injury causing it.

Nausea is a common side effect of nosebleeds, as blood is easily swallowed and then clots in the stomach.

• Bend head forward with upper body upright.
• Drain or spit out blood (prevents nausea).
• Squeeze the nostrils for 5-10 minutes.
• Ice tie - To do this, cool the neck with ice packs or cold compresses (vessels constrict when cold, stopping bleeding).
• After a nosebleed, do not blow your nose for at least 12 hours.

If nosebleeds occur frequently, a doctor should be consulted. This will broaden the treatment options:

• Nasal tamponade (pressure on the damaged vessel)
• Sclerotherapy, cauterization
• vessel ligation under anaesthesia (very rare)
• Treat underlying disease (if high blood pressure or coagulation disorders cause nosebleeds)

Mostly nosebleeds occur without complications. Medical treatment is rarely necessary, e.g. in case of severe blood loss due to a coagulation disorder.

• Do not injure the nasal mucosa (e.g. by picking the nose).
• Use humidifiers to prevent a dry room climate
• Avoid frequent and excessive nose blowing
• Take care of dry nasal mucosa (e.g. nasal ointment)
• Treat underlying disease (e.g. coagulation disorder, high blood pressure)