Why do I get nosebleeds?
A nosebleed or nose bleed, medically known as epistaxis, is the relatively common occurrence of hemorrhage (bleeding) from the nose, usually noticed when it drains out through the nostrils. There are two types: anterior (the most common), and posterior (less common, and more severe). Sometimes in more severe cases, the blood can come up the sinus and out from the eye. Fresh blood and clotted blood can also flow down into the stomach and cause upset stomachs and vomiting.
Causes
There are several causes for the nosebleed including trauma (such as hitting the
nose), fracture (broken nose), pressure (such as may be caused by altitude),
anticoagulant (anti-clotting) medication, excessively dry air, excessive
nose-picking, allergic rhinitis and high blood pressure among the elderly. Some
rare diseases that may cause nosebleeds are Wegener's granulomatosis and
hereditary hemorrhagic telangiectasia (HHT, Rendu-Osler-Weber disease);
sarcoidosis, when it involves the nose, has been reported to cause nosebleeds.
von Willebrand disease may cause nosebleeds.
Both the frequency of spontaneous epistaxis and the length and severity of
bleeding can be increased by anticoagulants. These may include prescription
medications such as warfarin or aspirin as well as herbal supplements such as
ginkgo. Cultures with a diet rich in fish sources that include high levels of
omega-3 fatty acids (especially the Inuit) have also been observed to experience
a higher incidence of nosebleeds. Athletes and bodybuilers who supplement their
diets with fish oil also report increased frequency of nosebleeds.
Pathophysiology
All nosebleeds are due to tears in the mucosal lining and the many small blood
vessels it contains. Fragility or injury may cause the tears, while
inflammation, coagulation problems and other disorders may make the injury
harder to repair.
Treatment
The flow of blood normally stops when the blood clots, which may be encouraged
by direct pressure. Medical opinion is divided on whether the best position to
apply pressure is the bridge of the nose or the fleshy part. It is also
undecided as to whether it is better to tilt the head forward during this
procedure (to drain the blood and prevent it from flowing down the throat and
into the stomach) or backward (to minimize the volume of blood in the nose).
Petroleum jelly is often used to stop the blood from seeping out.
Chronic epistaxis resulting from a dry nasal mucosa is often treated by spraying
saline in the nose up to three times per day.
If techniques such as pressure, ice on the bridge of the nose, application of a
vasoconstrictor, etc. don't work, a nasal tampon is usually the next step. The
nasal tampon stops the bleeding by applying pressure from inside of the nose and
is usually kept in for 1-3 days.
Persistent epistaxis is an indication for urgent medical consultation. Nasal packing, cryosurgery, electrocautery or application of trichloracetic acid are options that may be used in severe epistaxis.
It is uncommon to exsanguinate (die from bleeding) through nosebleeds. However, damage to the maxillary artery can lead to rapid blood loss via the nose and present difficulty in treatment, pressure, vasoconstrictor and rhinocort occasionally proving ineffective. Ligation of the artery, risking damage to the facial nerves, may be the only solution.
Nevertheless, severe protracted nosebleeds may cause anemia due to iron deficiency.
Look up Nosebleed in Wiktionary, the free dictionary[edit]
Famous nosebleeds
Attila the Hun, a legendary commander and the founder of an empire, is reputed by the contemporary historian Priscus to have died of a nosebleed after his wedding.
The source of these articles is Wikipedia, the free encyclopedia. The text of this article is licensed under the GFDL
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