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Nosebleeds

Nosebleeds are common but are scary. They do not usually indicate any serious problem. However, if nosebleeds occur very often, it can be a sign of a serious problem. During a nosebleed, the blood can flow from either of the nostrils. This can be light or heavy and may last for a few seconds to several minutes.

Symptoms

The symptoms that co-occur with a nosebleed and need a doctor’s consultation include:

  • Breathlessness
  • abnormal heartbeat
  • Dizziness or weakness

Consult the physician if the nosebleed is severe or if it lasts for more than 20 minutes. Nosebleeds that happen following an injury and may indicate bleeding from the posterior part of the nose which is a sign of serious problem.

Causes

Nose is more prone to blows and injuries. Also, it is richly supplied with blood vessels that are fragile and can bleed easily. Nosebleeds occur when any damage occurs to the delicate parts of the nose. This can happen due to multiple reasons which may include the following:

  • Drying of the inside of the nose due to changes in the air temperature
  • Injury or broken nose
  • Picking or blowing of the nose
  • Presence of any foreign objects in the nose
  • High blood pressure or other conditions which affect the blood vessels
  • Repeated sneezing
  • Medical conditions, which alter the clotting process
  • Use of certain medicines, such as warfarin can increase the risk of bleeding
  • Use of decongestants and antihistamines, which can cause the drying of the nasal membranes

Occasionally, the exact cause of nosebleeds cannot be identified.

Risk factors

Certain people are at high risk of developing nosebleeds, including:

  • Children (especially aged between 3 to 11 years)
  • Elderly people
  • Pregnant women

Other factors that increase the risk of nosebleeds include:

  • Dry climate or cold air
  • Exposure to central heating system or chemical irritants

Diagnosis

The doctor conducts a physical examination of the nose and checks for the presence of any foreign objects in the nose. One or more of the following tests may be ordered to determine the exact cause:

  • Complete blood count (CBC) to check for any blood disorders
  • Partial thromboplastin time to determine the clotting time
  • Nasal endoscopy is performed to examine the inside of the nose using a special instrument
  • X-rays of the face and nose to check for internal damages to the nasal bones
  • CT scans are performed to obtain two-dimensional images of the nose

Treatment

The treatment of nosebleeds is based on the cause and includes the following options:

  • Upon identifying the exact spot of bleeding, a sticker containing a chemical is pressed to seal the bleeding spot.
  • If a foreign object is present, it is carefully removed using special tools.
  • Cauterization may be performed to treat frequent and persistent nosebleeds. In this technique, the blood vessels inside the nose are burnt using a heating device or with silver nitrate.
  • Sometimes, special sponges may be used to pack the nose to stop the bleeding by creating pressure on the blood vessels.

Self-care

The following self-care measures can help to stop a nosebleed before medical help is available:

  • Sit or stand straight, and do not lie down.
  • Lean forward and breathe through the mouth.
  • Pinch the nose just above the nostrils for about 10-15 minutes. Release and check if the bleeding stops. Otherwise, repeat the above steps.
  • Place an ice pack or frozen peas wrapped in cloth at the top of the nose.

It is important to follow the precautions for 24 hours after the nosebleed stops to prevent any further damage. The precautions include:

  • Do not blow or pick the nose.
  • Do not pick any scabs formed inside the nose.
  • Avoid alcohol or hot drinks.
  • Do not lift any heavy objects or perform strenuous exercises.

Prevention

It is possible to prevent nosebleeds to some extent by the following ways:

  • Use a humidifier to improve the moisture content of the room air.
  • Reduce the use of blood thinning agents, such as aspirin.
  • Avoid picking of the nose.
  • Wear a head guard while involving in activities, which have a risk of a nose injury.
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