Health Care and Nose Bleeds

Have you ever had a nose bleed? Some people get them more often than others. And, there is a variety of reasons why your nose would all of a sudden start to bleed for no apparent reason. Naturally, if you got punched in the nose on purpose or by accident, it may start to bleed. If you broke your nose for any reason, no doubt you would have a nose bleed. But what causes your nose to start bleeding just because?

The nose is an area of the body that contains many tiny blood vessels (or arterioles) that can break easily, according to the American Academy of Otolaryngology. In the United States, one of every seven people will develop a nosebleed some time in their lifetime. Nosebleeds can occur at any age but are most common in children aged 2-10 years and adults aged 50-80 years. Nosebleeds are divided into two types, depending on whether the bleeding is coming from the front or back of the nose. More info can be found at this site: http://www.entnet.org/content/nosebleeds .

According to eMedicineHealth.com, nosebleeds (epistaxis, nose bleed) can be dramatic and frightening. Fortunately, most nosebleeds are not serious and usually can be managed at home, although sometimes medical intervention may be necessary. Nosebleeds are categorized based on where they originate, and are described as either anterior (originating from the front of the nose) or posterior (originating from the back of the nose).

Anterior nosebleeds make up most nosebleeds. The bleeding usually originates from a blood vessel on the nasal septum, where a network of vessels converge (Kiesselbach plexus). Anterior nosebleeds are usually easy to control, either by measures that can be performed at home or by a health care practitioner.

Posterior nosebleeds are much less common than anterior nosebleeds. They tend to occur more often in elderly people. The bleeding usually originates from an artery in the back part of the nose. These nosebleeds are more complicated and usually require admission to the hospital and management by an otolaryngologist (an ear, nose, and throat specialist).

Nosebleeds tend to occur more often during winter months and in dry, cold climates. They can occur at any age, but are most common in children aged 2 to 10 years and adults aged 50 to 80 years. For unknown reasons, nosebleeds most commonly occur in the morning hours. More details can be found at this website: http://www.emedicinehealth.com/nosebleeds/article_em.htm

Nosebleeds are common. Most often they are a nuisance and not a true medical problem. But they can be both, according to the Mayo Clinic. Here are a few tips how to stop them:

·         Sit upright and lean forward. By remaining upright, you reduce blood pressure in the veins of your nose. This discourages further bleeding. Sitting forward will help you avoid swallowing blood, which can irritate your stomach.

·         Pinch your nose. Use your thumb and index finger to pinch your nostrils shut. Breathe through your mouth. Continue to pinch for five to 10 minutes. Pinching sends pressure to the bleeding point on the nasal septum and often stops the flow of blood.

·         To prevent re-bleeding, don't pick or blow your nose and don't bend down for several hours after the bleeding episode. During this time remember to keep your head higher than the level of your heart.

·         If re-bleeding occurs, blow out forcefully to clear your nose of blood clots and spray both sides of your nose with a decongestant nasal spray containing oxymetazoline (Afrin, Mucinex Moisture Smart, others). Pinch your nose again as described above and call your doctor.

You should seek emergency care if the bleeding lasts for more than 20 minutes, or if the nosebleed follows an accident, a fall or an injury to your head, including a punch in the face that may have broken your nose. Much more detailed information about nose bleeds can be located at this site: http://www.mayoclinic.org/first-aid/first-aid-nosebleeds/basics/art-20056683 .

Children are especially susceptible to nose bleeds. If your child gets a lot of nose bleeds, ask your pediatrician about using saltwater (saline) nose drops every day. Doing so may be particularly helpful if you live in a very dry climate, or when the furnace is on in your home. In addition, a humidifier or vaporizer will help maintain your home’s humidity at a level high enough to prevent nasal drying. Also tell your child not to pick his nose, according to the American Academy of Pediatrics. Also, you should contact your child’s doctor in the following situations:

·         You think your child may have lost too much blood. (But keep in mind that the blood coming from the nose always looks like a lot.)

·         The bleeding is coming only from your child’s mouth, or he’s coughing or vomiting blood or brown material that looks like coffee grounds.

·         Your child is unusually pale or sweaty, or is not responsive. Call your pediatrician immediately in this case, and arrange to take your child to the emergency room.

·         He has a lot of nosebleeds, along with a chronically stuffy nose. This may mean he has a small, easily broken blood vessel in the nose or on the surface of the lining of the nose, or a growth in the nasal passages.

Your child is almost certain to have at least one nosebleed—and probably many—during these early years. Some preschoolers have several a week. This is neither abnormal nor dangerous, but it can be very frightening. If blood flows down from the back of the nose into the mouth and throat, your child may swallow a great deal of it, which in turn may cause vomiting. For more details, visit this website: https://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/Chronic-Nosebleeds-What-To-Do.aspx .

Frequent nosebleeds may mean you have a more serious problem. For example, nosebleeds and bruising can be early signs of leukemia. Nosebleeds can also be a sign of a blood clotting or blood vessel disorder, or a nasal tumor (both cancerous and non-cancerous), according to this website: http://familydoctor.org/familydoctor/en/diseases-conditions/nosebleeds.html .

Your doctor will try to find out where the bleeding is coming from in your nose. He or she will probably ask you some questions and examine your nose. If the bleeding doesn't stop on its own or when pressure is applied, your doctor may cauterize the bleeding vessel or pack your nose to stop the bleeding. That should help your situation, although it’s uncomfortable for a little while. An occasional nosebleed may make you worry, but there's no need to panic. If it becomes problematic or chronic, see your doctor for other options.

Until next time.