What is Nose Bleeding (Epistaxis)?

Nosebleeds, medically known as epistaxis, occur when blood vessels inside the nose rupture, causing bleeding. While nosebleeds are usually not serious and can be treated at home, frequent or severe nosebleeds may indicate an underlying issue that requires medical attention.

We provide comprehensive evaluation and treatment for both acute and chronic nosebleeds to ensure lasting relief and peace of mind.

Types of Nosebleeds:

Anterior Nosebleeds: These are the most common type of nosebleeds and occur when the small blood vessels in the front part of the nose (near the nostrils) break. They are usually mild and easy to manage.
Posterior Nosebleeds: Less common but more serious, posterior nosebleeds originate from deeper parts of the nasal cavity and can cause more significant bleeding. These often require medical intervention.

Common Causes of Nosebleeds:

Dry air: Dry climates or indoor heating can dry out nasal membranes, making them more prone to cracking and bleeding.
Nasal trauma: Picking the nose, blowing the nose forcefully, or an injury to the face can damage blood vessels in the nose.
Allergies or infections: Conditions like allergic rhinitis or sinus infections can irritate the nasal passages and lead to bleeding.
Medications: Blood thinners, antihistamines, or decongestants can contribute to nosebleeds.
Underlying health conditions: High blood pressure, clotting disorders, or abnormal blood vessels can cause frequent or severe nosebleeds.
Foreign objects: Small objects lodged in the nose, especially in children, can cause trauma and bleeding.
Nasal polyps or tumors: Abnormal growths in the nasal passages can irritate blood vessels, leading to bleeding.

Symptoms of Nosebleeds:

Sudden bleeding from one or both nostrils
Blood running down the back of the throat (especially in posterior nosebleeds)
Nasal congestion or stuffiness during bleeding
Lightheadedness or dizziness in the case of significant blood loss

If you experience frequent nosebleeds, or if they are accompanied by symptoms like shortness of breath, chest pain, or pale skin, it is important to seek medical evaluation.

When to Seek Medical Attention for a Nosebleed:

Although most nosebleeds are not serious, you should consult a doctor if:

The nosebleed lasts longer than 20 minutes.
The bleeding is heavy or difficult to control.
You experience frequent nosebleeds (more than once a week).
You have a history of high blood pressure, clotting disorders, or are on blood thinners.
The bleeding is due to a facial injury or trauma.
You have other symptoms, such as palpitations, dizziness, or difficulty breathing.

Diagnosis and Treatment of Nosebleeds:

ENT specialists will conduct a thorough evaluation to identify the underlying cause of your nosebleeds and recommend an appropriate treatment plan.

Evaluation:

We begin with a physical examination of your nose and nasal passages using a nasal speculum or an endoscope to locate the source of the bleeding.
In some cases, additional tests such as blood work or imaging studies may be needed to rule out underlying conditions like blood clotting disorders or nasal tumors.

Treatment Options:

First Aid for Nosebleeds:

Sit upright and lean slightly forward to prevent blood from going down your throat.
Pinch the soft part of your nostrils together for about 10-15 minutes.
Apply an ice pack to the bridge of your nose to constrict blood vessels and reduce bleeding.

Medical Interventions:

Nasal Cautery: In cases of frequent or recurrent nosebleeds, we may recommend cauterizing the bleeding vessel. This procedure uses heat or a chemical agent (like silver nitrate) to seal off the affected blood vessel and prevent further bleeding.
Nasal Packing: For more severe nosebleeds, especially posterior nosebleeds, nasal packing may be used to apply pressure and stop the bleeding. A special gauze or balloon catheter is inserted into the nasal cavity.
Topical Medications: Moisturizing ointments or nasal sprays may be prescribed to prevent dry nasal membranes and reduce the risk of bleeding.
Addressing Underlying Causes: If your nosebleeds are due to underlying conditions, such as high blood pressure or a blood clotting disorder, managing these conditions is essential to reducing nosebleeds.

Surgical Options:

For patients with structural issues like deviated septum or nasal polyps that contribute to chronic nosebleeds, surgical intervention may be recommended. Procedures such as septoplasty or polypectomy can correct the issue and reduce the frequency of nosebleeds.
In rare cases, ligation of the blood vessels may be necessary if other treatments are unsuccessful in controlling posterior nosebleeds.

Preventing Future Nosebleeds:

While some nosebleeds are unavoidable, there are steps you can take to reduce your risk:

Keep your nasal passages moist: Use a saline nasal spray or a humidifier to prevent dryness, especially in dry climates or heated indoor environments.
Avoid nasal trauma: Refrain from picking your nose, and blow your nose gently to avoid irritating the delicate nasal blood vessels.
Manage allergies: Use antihistamines or prescribed medications to control nasal allergies and avoid irritation.
Stay hydrated: Drinking plenty of water helps maintain moisture in your nasal membranes.
Quit smoking: Smoking can irritate and dry out the nasal passages, increasing the risk of nosebleeds.