Epistaxis or nosebleed is due to the rupture of tiny, swollen vessels in the mucous membrane of the frontal septum which may result from injury or disease and is not uncommon in normal young persons. Small nosebleeds are usually caused by picking of the nose, although there are other local causes such as deviated septum, perforated septum, cancer and trauma. Epistaxis may also occur as a symptom of acute rheumatic fever, acute sinusitis, arterial hypertension and hemorrhagic diseases.
Rhinitis is an inflammatory lesion involving the mucous membrane of the nose, sometimes a manifestation of allergy, in which case it is referred to as vascular rhinitis, and is usually due to an infection. The most common type of infection which causes rhinitis is Coryza known as the common cold.
In acute rhinitis, the nasal mucous membrane becomes congested, swollen and edematous. This quickly subsides, and the membrane returns to normal. After repeated attacks, particularly in cases which originate as a result of chronic sinusitis, this swelling becomes obstinate, and causes a chronic catarrh. Excluding the recurring attacks of allergic vasomotor rhinitis, these attacks are acute exacerbations of the same common cold. If continued, chronic rhinitis leads to the deposition of abnormally large amounts of connective tissue in the nasal mucous membrane, which thickens it greatly, and causes the formation of spurs, polyps and hypertrophies on the nasal septum. Wasting away or atrophy of the mucous membrane, the cartilage and the bones lining the nasal passages may eventually occur. These result in a condition called Ozena, where these passages become large empty caverns, and an abundance of secretion sticking to the walls emanates a disagreeable odor.
Obstruction to the passage of air through the nostrils results frequently from a deflection of the nasal septum, hypertrophy of the turbinate bones or from the pressure of polyps, these are grapelike swellings that arise from the mucous membrane of the sinuses, especially the ethmoids. This obstruction may also lead to condition of chronic infection of the nose and result in frequent attacks of Nasopharyngitis. Very often the infection extends to the sinuses of the nose, mucous lined cavities filled with air that normally drains into the nose. When sinusitis develops and the drainage from theJe cavities is obstructed by deformity or swelling within the nose, pain is experienced in the region of the affected sinus. Fractures of the nose usually result from direct violence. Although fractures do not produce any serious consequences, the deformity that may follow often gives rise to obstruction of the nasal passages and facial disfigurement. Immediately after the injury there is usually a considerable amount of bleeding from the nose, both from the nostrils and into the pharynx. There is noticeable swelling of the soft tissues adjacent to the nose and frequently, a definite deformity.
Nosebleeds actually have a number of causes with some more common than others, but all can be controlled or even prevented” Most nosebleeds are caused by simple improper treatment of the nose such as either blowing it too hard when it’s stuffed up or picking at it constantly, which many people do.
CAUSES OF NOSEBLEED
- Nosebleed can be caused by tumors in the nose, which is something one should have checked immediately if one suffers from chronic nosebleeds.
- High blood pressure
- Blood diseases
- Rheumatic fever
- Nosebleeds are commonly caused by a blow to the nose. This is a very easy area to damage as there is not a lot of protection there.
- Nosebleeds are common in places where the air is very dry and one is breathing in this dry air constantly.
PREVENTION OF NOSEBLEEDS
In most cases, unless the causes are serious, preventing nosebleeds is quite easy.
- Blow the nose gently for starters, blowing just one side at a time while pressing the finger against the other side.
- Avoid picking at the nose. If this is a habit, find a way to break it.
- Using a humidifier if one lives in a dry air environment. This will put some moisture into the air.
STEPS TO STOP NOSEBLEED
If one does get a nosebleed, there are some simple ways to stop them.
- For starters, tilt your head back and place some cotton with peroxide into the nostrils.
- Keep the head back for about 10 to 1″5 minutes or until the bleeding stops.
- If this doesn’t work, which it should in most cases, place a cold compress against the bridge of the nose. Usually, this works but if nothing seems to be working, then call doctor.
- On a nutritional level, getting extra vitamin C, vitamin E, vitamin K and zinc into the diet will also help prevent nosebleeds.
2. FREQUENT NOSEBLEEDS
Nosebleeds that recur often are commonly caused by bleeding from the front of the nose (anterior epistaxis). Common causes of this type of nosebleed are:
- Blowing or picking the nose.
- Structural problems in the nose, either present from birth (congenital) or caused by an injury.
- Low humidity.
- Minor health problems, such as colds or allergies.
- Minor injuries to the nose.
- Medicines: Be safe with medicines. Read and follow all instructions on the label: Aspirin; warfarin such as Coumadin; enoxaparin (Lovenox); clopidogrel (Plavix) or non-steroidal anti-inflammatory drugs (NSAIDs); Antihistamines, decongestants, and medicated nasal sprays that dry the tissue of the nose and sinuses.
Recurring nosebleeds can also be caused by:
- Rupture of the blood vessels that are very close to the surface of the lining of the nose.
- An abnormal growth (polyp or tumor) in the nose or sinuses.
- Health conditions that affect normal blood clotting.
- Abnormal blood vessels in the nose, such as with Osler-Weber-Rendu syndrome. This syndrome is passed in families (inherited). The abnormal blood vessels make it hard to control a nosebleed.
- A nosebleed that recurs 4 times or more in a week needs medical evaluation to determine the seriousness of the problem. A nosebleed that recurs 2 to 3 times in a month may mean that a chronic condition ,r.f, ,, allergies is causing the nosebleeds.
- When nosebleeds cannot be controlled by home treatment, you need to see your doctor.
3. NOSEBLEEDS IN KIDS
Around 30 percent of children have at least one nosebleed by the time they are 5 years old. Between the ages of 6 and l-0, the frequency rises to 56 percent. They’re rare in infancy and infrequent during and after adolescence. So as frightening as the sight of blood flowing from a child’s nose may be, it’s extremely common and almost never something truly serious. Nosebleeds increase in the winter months when environmental humidity is relatively low and heating systems make home. The most usual cause of childhood nosebleeds is inflammation of the nasal mucosa from an upper respiratory infection. Even so, if a child’s nosebleeds are relentless in their frequency or difficult to control, request a referral to an otorynolaryngologist (an ear, nose and throat doctor) to rule out possible serious causes.
Causes of Nosebleeds in Children
- Thrombocytopenia, a condition in which the blood platelet count is low.
- Leukemia or HlV.
- Bleeding disorders, including von Willebrand’s disease, hemophilia and Glanzmann’s thrombastenia.
- Liver disease, severe vitamin K deficiency or malabsorption.
- Blood vessel disorders.
- Vitamin C deficiency.
- Tumors (very rare in children)
How to Stop a Nosebleed
Although nosebleeds generally stop on their own, one can take these steps to stop them more quickly.
- Help the child lean forward, instead of tipping his or her head backward.
- Squeeze the soft tip of the nose closed with your fingers or a washcloth and keep it closed for 5-10 minutes.
- Do not place wedge cotton, tissues or gauze up into your child’s nose to stop a nosebleed.
Prevention Tips if frequent
- Take a look at the child’s fingernails if he or she is prone to nosebleeds.
- Ragged or sharp fingernails can cause nosebleeds when the child pokes them around inside the nose.
- Obtain a humidifier for the child’s bedroom and perhaps the whole house.
- Vaseline gel inside the nostrils can also help keep the nose from being overly dry.
4. NOSEBLEED DURING PREGNANCY
Nosebleeds do tend to occur more often during pregnancy. Pregnancy can cause the blood vessels in one’s nose to expand, and increased blood supply puts more pressure on those delicate vessels, causing them to rupture more easily. Although it’s unpleasant and inconvenient, an occasional minor nosebleed is generally harmless. Nosebleed is likely to occur when one has a cold, sinus infection, or allergies, or when the membranes inside one’s nose dry out, as in cold weather, air-conditioned rooms, airline cabins, and other dry environments. Trauma and certain medical conditions, such as high blood pressure or a clotting disorder, may cause nosebleeds as well.
- When nose starts to bleed, sit down, keep your head higher than the heart, and put pressure on the bleeding nostril for five to ten minutes.
- Using the thumb and the side of the bent index finger, firmly pinch the whole soft lower part of the nose and exert pressure toward the face.
- Don’t let up for a second, even if getting very curious to see if the bleeding has stopped because that could interfere with the coagulation process.
- Applying ice can help, too, because it constricts blood vessels.
- Hold a cold pack or a bag of frozen peas over your nose and cheeks with the hand that’s not pinching the nostrils closed.
- Don’t lie down or tilt head back to avoid swallowing blood, which could cause nausea or even vomiting.
- If the bleeding hasn’t stopped after ten minutes of pressure and ice, continue for another ten minutes as long as the bleeding is not heavy.
- Consult healthcare practitioner if the bleeding doesn’t stop after 20 minutes of pressure.
GENERAL PREVENTION OF NOSEBLEED TIPS
- Drink extra fluids to help keep all of the mucous membranes well hydrated.
- Blow nose gently. Aggressive blowing can lead to nosebleeds.
- Try to keep the mouth open when one sneezes.
- Avoid dry air, especially in wintertime or in dry climates, by running a humidifier inside the house and not overheating the bedroom.
- Also stay away from irritants like smoke, which you should be avoiding anyway.
- Use a lubricant to prevent nasal dryness like petroleum jelly, a special water-based nasal lubricant, saline nasal sprays or drops.
- Don’t overuse medicated nasal sprays or decongestants as they can dry out and further irritate one’s nose.